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The human placenta: new perspectives on its formation and function during early pregnancy

Burton, Graham J; Jauniaux, Eric; (2023) The human placenta: new perspectives on its formation and function during early pregnancy. Proceedings of the Royal Society B: Biological Sciences , 290 (1997) , Article 20230191. 10.1098/rspb.2023.0191. Green open access

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Abstract

The placenta has evolved to support the development of the embryo and fetus during the different intrauterine periods of life. By necessity, its development must precede that of the embryo. There is now evidence that during embryogenesis and organogenesis, the development of the human placenta is supported by histotrophic nutrition secreted from endometrial glands rather than maternal blood. These secretions provide a plentiful supply of glucose, lipids, glycoproteins and growth factors that stimulate rapid proliferation and differentiation of the villous trophoblast. Furthermore, evidence from endometrial gland organoids indicates that expression and secretion of these products are upregulated following sequential exposure to oestrogen, progesterone and trophoblastic and decidual hormones, in particular prolactin. Hence, a feed-forward signalling dialogue is proposed among the trophoblast, decidua and glands that enables the placenta to stimulate its own development, independent of that of the embryo. Many common complications of pregnancy represent a spectrum of disorders associated with deficient trophoblast proliferation. Increasing evidence suggests that this spectrum is mirrored by one of impaired decidualization, potentially compromising histotroph secretion through diminished prolactin secretion and reduced gland function. Optimizing endometrial wellbeing prior to conception may therefore help to prevent common pregnancy complications, such as miscarriage, growth restriction and pre-eclampsia.

Type: Article
Title: The human placenta: new perspectives on its formation and function during early pregnancy
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1098/rspb.2023.0191
Publisher version: https://doi.org/10.1098/rspb.2023.0191
Language: English
Additional information: © 2023 The Authors. Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited.
Keywords: development, endometrium, nutrition, placenta, trophoblast, Pregnancy, Female, Humans, Decidua, Prolactin, Placenta, Endometrium, Trophoblasts
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health
URI: https://discovery.ucl.ac.uk/id/eprint/10169733
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