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Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies

During pregnancy, the maternal cardiovascular system undergoes significant changes, including increased heart rate, cardiac output, plasma volume, and uteroplacental blood flow (UPBF) that are required for a successful pregnancy outcome. The increased UPBF is secondary to profound circumferential gr...

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Autor principal: Mandalà, Maurizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177259/
https://www.ncbi.nlm.nih.gov/pubmed/32276444
http://dx.doi.org/10.3390/ijms21072592
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author Mandalà, Maurizio
author_facet Mandalà, Maurizio
author_sort Mandalà, Maurizio
collection PubMed
description During pregnancy, the maternal cardiovascular system undergoes significant changes, including increased heart rate, cardiac output, plasma volume, and uteroplacental blood flow (UPBF) that are required for a successful pregnancy outcome. The increased UPBF is secondary to profound circumferential growth that extends from the downstream small spiral arteries to the upstream conduit main uterine artery. Although some of the mechanisms underlying uterine vascular remodeling are, in part, known, the factors that drive the remodeling are less clear. That higher circulating levels of estrogens are positively correlated with gestational uterine vascular remodeling suggests their involvement in this process. Estrogens binding to the estrogen receptors expressed in cytotrophoblast cells and in the uterine artery wall stimulate an outward hypertrophic remodeling of uterine vasculature. In preeclampsia, generally lower concentrations of estrogens limit the proper uterine remodeling, thereby reducing UPBF increases and restricting the growth of the fetus. This review aims to report estrogenic regulation of the maternal uterine circulatory adaptation in physiological and pathological pregnancy that favors vasodilation, and to consider the underlying molecular mechanisms by which estrogens regulate uteroplacental hemodynamics.
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spelling pubmed-71772592020-04-28 Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies Mandalà, Maurizio Int J Mol Sci Review During pregnancy, the maternal cardiovascular system undergoes significant changes, including increased heart rate, cardiac output, plasma volume, and uteroplacental blood flow (UPBF) that are required for a successful pregnancy outcome. The increased UPBF is secondary to profound circumferential growth that extends from the downstream small spiral arteries to the upstream conduit main uterine artery. Although some of the mechanisms underlying uterine vascular remodeling are, in part, known, the factors that drive the remodeling are less clear. That higher circulating levels of estrogens are positively correlated with gestational uterine vascular remodeling suggests their involvement in this process. Estrogens binding to the estrogen receptors expressed in cytotrophoblast cells and in the uterine artery wall stimulate an outward hypertrophic remodeling of uterine vasculature. In preeclampsia, generally lower concentrations of estrogens limit the proper uterine remodeling, thereby reducing UPBF increases and restricting the growth of the fetus. This review aims to report estrogenic regulation of the maternal uterine circulatory adaptation in physiological and pathological pregnancy that favors vasodilation, and to consider the underlying molecular mechanisms by which estrogens regulate uteroplacental hemodynamics. MDPI 2020-04-08 /pmc/articles/PMC7177259/ /pubmed/32276444 http://dx.doi.org/10.3390/ijms21072592 Text en © 2020 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Mandalà, Maurizio
Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies
title Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies
title_full Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies
title_fullStr Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies
title_full_unstemmed Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies
title_short Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies
title_sort influence of estrogens on uterine vascular adaptation in normal and preeclamptic pregnancies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177259/
https://www.ncbi.nlm.nih.gov/pubmed/32276444
http://dx.doi.org/10.3390/ijms21072592
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