Spiral artery remodeling and maternal cardiovascular risk

Abstract

Systematic study of vascular pathology in uterine spiral artery biopsy samples in relation to CVD risk factors provides valuable insight into the link between cardiovascular health and placental bed disorders.

Recurrence of pre‐eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta‐analysis

“…6,44 Pre-eclampsia and CVD also share other pathological features indicating similar pathways such as the presence of acute atherosis and endothelial cell dysfunction. 45,46 All of the above strengthens the idea that pregnancy can be seen as a 'stress test' for cardiovascular health, identifying women at risk early in life.…”

“…Other mechanisms that potentially plays a role in pre‐eclampsia and CVD are of an inflammatory nature with chronic inflammatory risk markers being significantly higher in former pre‐eclampsia patients . Pre‐eclampsia and CVD also share other pathological features indicating similar pathways such as the presence of acute atherosis and endothelial cell dysfunction . All of the above strengthens the idea that pregnancy can be seen as a ‘stress test’ for cardiovascular health, identifying women at risk early in life.…”

Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

“…In addition, vascular insufficiency is commonly detected in the placentas of women with preeclampsia, and some of these lesions are characterized by inflammation and lipid‐laden macrophages that are remarkably similar to features of early stage atherosclerotic plaques 25. These placental lesions may be an early expression of susceptibility to vascular impairments later in life 26. Another possible pathophysiologic mechanism is that future CVD is a direct result of endothelial dysfunction generated by HDP that persists after delivery.…”

Human regulatory T cells at the maternal-fetal interface show functional site-specific adaptation with tumor-infiltrating-like features

“…Detailed description of the study set-up and protocol was previously published. 71 For this analysis, we included 20 women who delivered by elective Caesarean section, i.e. without any contractions or other signs of labour such as rupture of membranes, after an uneventful pregnancy and without any major underlying pathology, N=5 of which were included for transcriptomics of T cell populations, N=4 for suppression assays, and N=11 for flow cytometry.…”

“…After delivery of the neonate and placenta, the placental bed was manually located and two biopsies of the central placental bed from the inner uterine myometrial wall were obtained as previously described. 71 Additionally, biopsies were taken from the incision site when the placenta was not situated on this part of the uterine wall.…”