Emilie Hitzerd*, Michelle Broekhuizen, Rugina I. Neuman, Katrina M. Mirabito Colafella, Daphne Merkus, Sam Schoenmakers, Sinno H.P. Simons, Irwin K.M. Reiss and A.H. Jan Danser Pages 505 - 527 ( 23 )
Adequate development of the placenta is essential for optimal pregnancy outcome. Pre-eclampsia (PE) is increasingly recognized to be a consequence of placental dysfunction and can cause serious maternal and fetal complications during pregnancy. Furthermore, PE increases the risk of neonatal problems and has been shown to be a risk factor for cardiovascular disease of the mother later in life. Currently, there is no adequate treatment for PE, mainly because its multifactorial pathophysiology remains incompletely understood. It originates in early pregnancy with abnormal placentation and involves a cascade of dysregulated systems in the placental vasculature. To investigate therapeutic strategies it is essential to understand the regulation of vascular reactivity and remodeling of blood vessels in the placenta. Techniques using human tissue such as the ex vivo placental perfusion model provide insight in the vasoactive profile of the placenta, and are essential to study the effects of drugs on the fetal vasculature. This approach highlights the different pathways that are involved in the vascular regulation of the human placenta, changes that occur during PE and the importance of focusing on restoring these dysfunctional systems when studying treatment strategies for PE.
Placenta, pre-eclampsia, vascular reactivity, perfusion, vasculature, vasoconstriction, vasodilation.
Department of Pediatrics, Division of Neonatology, Erasmus MC University Medical Center, Rotterdam, Department of Pediatrics, Division of Neonatology, Erasmus MC University Medical Center, Rotterdam, Department of Internal Medicine; Division of Pharmacology and Vascular Medicine, Erasmus MC University Medical Center, Rotterdam, Department of Internal Medicine; Division of Pharmacology and Vascular Medicine, Erasmus MC University Medical Center, Rotterdam, Department of Cardiology; Division of Experimental Cardiology, Erasmus MC University Medical Center, Rotterdam, Department of Gynecology and Obstetrics, Erasmus MC University Medical Center, Rotterdam, Department of Pediatrics, Division of Neonatology, Erasmus MC University Medical Center, Rotterdam, Department of Pediatrics, Division of Neonatology, Erasmus MC University Medical Center, Rotterdam, Department of Internal Medicine; Division of Pharmacology and Vascular Medicine, Erasmus MC University Medical Center, Rotterdam