Related Experiment Video
Updated: Feb 18, 2026
Author Spotlight: Modeling an Aspect of Preeclampsia in Female Mice Using Hypoxic Human Placenta-Derived Small Extracellular Vesicles
Published on: January 26, 2024
The placental bed vascular pathology revisited: a risk indicator for cardiovascular disease
Ivo Brosens1, Marisa Benagiano2, Patrick Puttemans1
1a Leuven Institute for Fertility and Embryology , Leuven , Belgium.
Insights
Vascular pathology in the placental bed, specifically atherosclerosis of utero-placental spiral arteries, is linked to increased cardiovascular disease risk. Atherosis in these arteries, not basal arteries, indicates future risk.
Area of Science:
- Obstetrics and Gynecology
- Cardiovascular Pathology
- Vascular Biology
Background:
- The placental bed's vascular system, including utero-placental spiral arteries and basal arteries, plays a crucial role in pregnancy.
- Understanding the distinct pathologies of these vessels is essential for assessing long-term maternal health risks.
- Vascular changes in the placental bed have been implicated in pregnancy complications and subsequent cardiovascular disease.
Purpose of the Study:
- To clarify terminology surrounding placental bed vascular pathology.
- To differentiate the roles of utero-placental spiral arteries and basal arteries in relation to cardiovascular disease risk.
- To establish a link between specific vascular lesions and long-term cardiovascular outcomes.
Main Methods:
- Systematic review of existing literature on placental bed vascular pathology.
- Analysis of the structural and functional characteristics of utero-placental spiral arteries and basal arteries.
- Correlation of vascular lesions with obstetric conditions and cardiovascular disease risk.
Main Results:
- Utero-placental spiral arteries (200-600 microns) undergo physiological changes and are prone to atherosclerosis, especially in preeclampsia.
- Basal arteries (<120 microns) retain their musculoelastic structure and are not significantly affected by physiological changes.
- Acute atherosis is an nonspecific lesion found in both artery types under various obstetric conditions.
Conclusions:
- Atherosis and atherosclerosis of utero-placental spiral arteries are associated with an increased risk of future cardiovascular disease.
- Pathology of decidual basal arteries is not linked to long-term cardiovascular disease risk.
- Precise terminology and differentiation of vascular pathologies are critical for risk assessment.
Aim:
The present paper intends in the first place to clarify the confusing terminology for describing the vascular pathology of the placental bed in relation to long-term risk of cardiovascular disease.
Methods:
Systematic review of relevant topics.
Results:
The maternal blood supply to the placenta is achieved by some 100 utero-placental spiral arteries with an outside diameter varying between 200 and 600 microns. Defective physiological changes of the myometrial segment of utero-placental spiral arteries and, particularly in preeclampsia associated to hypertensive disease, the presence of atherosclerosis in their proximal segment are a cause of obstructive vascular pathology. On the other hand, basal arteries which supply the inner myometrium and basal decidua are not affected by physiological change and maintain their musculoelastic structure. They can be identified by their external diameter of less than 120 microns. Acute atherosis is an aspecific vascular lesion that occurs in basal as well as spiral arteries inside, as well as outside, the placental bed in association with a variety of obstetrical conditions.
Conclusions:
An increased risk of future cardiovascular disease, should be linked to atherosis or, at a later stage, atherosclerosis of utero-placental spiral arteries, rather than to that of decidual basal arteries.
Related Concept Videos
01:07Development of Blood Vessels
The initial formation of this system is facilitated by the small amount of yolk present in the ovum and yolk sac. Blood vessels originate from...
01:30Peripheral Artery Disease I: Introduction
01:14Fetal Circulation
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:30Coronary Artery Disease I: Introduction
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation