Normal and abnormal transformation of the spiral arteries during pregnancy

Jimmy Espinoza, Roberto Romero, Mee Kim Yeon, Juan Pedro Kusanovic, Sonia Hassan, Offer Erez, Francesca Gotsch, Nandor Gabor Than, Zoltan Papp, Jai Kim Chong

Research output: Contribution to journalReview articlepeer-review

135 Scopus citations


This article reviews the anatomy and physiology of the uterine circulation, with emphasis on the remodeling of spiral arteries during normal pregnancy, and the timing and anatomical pathways of trophoblast invasion of the spiral arteries. We review the definitions of the placental bed and basal plate of the placenta, their relevance to the study of the physiologic transformation of the spiral arteries, as well as the methods to obtain and examine placental bed biopsy specimens. We also examine the role of the extravillous trophoblast in normal and abnormal pregnancies, and the criteria used to diagnose failure of physiologic transformation of the spiral arteries. Finally, we comment on the use of uterine artery Doppler velocimetry as a surrogate marker of chronic uteroplacental ischemia.

Original languageEnglish
Pages (from-to)447-458
Number of pages12
JournalJournal of Perinatal Medicine
Issue number6
StatePublished - 1 Dec 2006
Externally publishedYes


  • Atherosis
  • Immunohistochemistry
  • Impedance to blood flow
  • Integrin
  • Physiologic transformation of the spiral arteries
  • Placental bed

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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