Original contributionThe contribution of placental oxidative stress to early pregnancy failure☆
Section snippets
Materials and methods
Placental samples were collected with informed written consent from women attending the Early Pregnancy Unit at University College Hospital, London. The University College London Hospitals Committee on the Ethics of Human Research approved the study design. Samples were obtained under low-vacuum aspiration from 65 patients presenting for evacuation of missed miscarriage. The quality and quantity of maternal blood flow to the intervillous space was determined by color-power Doppler ultrasound
Villous morphology
Villi presented a variety of morphological changes within the trophoblast layers and the stromal core. In some samples the fetal capillaries were intact and contained normal biconcave erythrocytes, whereas in others the stromal core was avascular. Intermediate states in which the capillaries displayed discontinuities in their walls and contained fragmented erythrocytes were also observed. A significant negative correlation was found between the volume fraction of the capillaries and the
Discussion
The results demonstrate significant increases in both morphological and immunohistochemical evidence of oxidative syncytial stress and damage in placental tissues from missed miscarriages. The syncytiotrophoblast of early placental villi is highly susceptible to oxidative damage in vitro, as indicated by morphological changes identical to those illustrated here.29 This peculiar susceptibility may reflect the low concentrations of antioxidant enzymes present in this tissue during the first
Acknowledgements
The authors are grateful to Dr. G. Semenza for the gift of a Hif-1α antibody.
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This study was funded by Tommy’s, The Baby Charity (grant 41). The imaging was performed in the Multi-Imaging Centre of the School of Biological Sciences, Cambridge, UK, which was established with grants from the Wellcome Trust.