Shunting the intervillous space: new concepts in human uteroplacental vascularization
Open accessAbstract
Objective It is supposed that the intervillous space is not perfused by maternal blood during the first trimester, suggesting vascular shunts in the myometrium. We therefore attempted to provide arguments for a functional vascular anastomotic network located in the placental bed during human pregnancy.Study design Three-dimensional (3D) sonography, laboratory analyses, and anatomic studies (hysterectomy specimens, uteroplacental vascular cast) were performed.Results Color Doppler showed a vascular network with anastomotic aspect located in the placental bed. A vascular cast of a uterus, obtained after postpartum hemorrhage, demonstrated a vascular anastomotic network in the myometrium. Higher PO2 levels in the uterine vein compared with the intervillous space confirmed the functional nature of this shunt. Low resistances in the uterine arteries during the first week after delivery suggested that this vascular network remains functional after placental expulsion.Conclusion Our studies have yielded functional and anatomic evidence of an arteriovenous shunt located in the subplacental myometrium.
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FGR/SGA and PET are associated with disordered remodelling of the spiral arteries.
“There is also histological evidence that FGR/SGA and PET are associated with disordered remodelling of the spiral arteries [45–47].”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [46]
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References 18 · Cited by 142
- Authors
- Schaaps, J.-P., Tsatsaris, V., Goffin, F., Brichant, J.-F., Delbecque, K., Tebache, M., Collignon, L., Retz, M. C., & Foidart, J.-M.
- Affiliations
- University of Liège (BE)
- Hôpital Cochin (FR)
- Centre hospitalier régional de la Citadelle (BE)
- Centre Hospitalier Universitaire de Liège (BE)
- Corresponding author
- Schaaps, Jean-Pierre
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2005-01
- Volume
- 192
- Issue
- 1
- Pages
- 323-332
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2026945435
- Cited by
- 142
- References
- 18
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 5 · 2023: 8 · 2022: 8 · 2021: 11 · 2020: 9 · 2019: 5 · 2018: 9 · 2017: 6 · 2016: 6 · 2015: 6 · 2014: 3 · 2013: 4 · 2012: 12
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- green
- orbi.uliege.be
- Licence
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Open Repository and Bibliography (University of Liège) (submittedVersion, other-oa)
- Funders
- Collège National des Gynécologues et Obstétriciens Français
- Fonds De La Recherche Scientifique - FNRS
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Keywords
- intervillous space, arteriovenous shunt, placental bed, myometrium, vascular anastomosis, uterine artery resistance, first trimester, postpartum hemorrhage, three-dimensional sonography, vascular casts
- MeSH terms
- Cross-Sectional Studies, Female, Humans, Models, Biological, Placenta, Pregnancy, Pregnancy Trimesters, Prospective Studies, Ultrasonography, Prenatal, Placental Circulation, Postpartum Period
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