胎盘是妊娠期保证胎儿正常生长发育的临时性器官,是胎儿与母体进行营养和气体交换的唯一渠道。胎盘发育异常不仅会造成胎儿发育障碍和多种妊娠疾病,还可影响母体乃至后代的远期健康。深入了解胎盘发育的生理特征及其调控机理,阐释胎盘发育障碍在妊娠相关疾病发生过程中的作用机制,进而探讨靶向胎盘的妊娠疾病的防治策略,对全面提高人类生殖健康水平、出生人口素质乃至终生的健康水平都具有深远的意义。首先简介胎盘发育过程中滋养层细胞分化及对母体子宫螺旋动脉的改建过程;分析胎盘发育不良与子痫前期等妊娠疾病的关系;进而阐述胎盘发育过程中,母体肝脏、肾脏、循环系统、免疫系统以及凝血系统的妊娠适应性调节;最后简单阐述胎盘发育不良对母婴远期健康的影响。对上述问题的整体认识会大力推进妊娠维持及母胎健康研究领域产生新的突破。
Placenta is a temporary organ to nurse the growing embryo in the uterus. It is the only place where the fetus exchanges nutrients and gases with the mother during pregnancy. Disorders in placentation will not only hamper the fetal development, cause various pregnancy diseases, but also lead to long-term problems in the healthof the mother and the offspring. Systematic research in the physiological properties and the regulatory mechanisms of human placenta development is vitally important to explore strategies for predicting and intervening the placentaorigin pregnancy diseases, and therefore to improve the reproductive health as well as the long-term health of human beings. In this article, we briefly introduce the processes of placental trophoblast cell differentiation and the reconstruction of maternal uterine spiral arteries, and summarize the knowledge on the pregnancy adaptation of maternal liver, kidney, circulation system, immune system, and coagulation system. The contribution of placental dysfunctions to pregnancy diseases such as preeclampsia, as well as the long-term effect of these disorders to maternal and fetal health are also discussed. The integral understanding on these aspects will substantially advance the investigations on pregnancy maintenance and maternal-fetal health.