Impaired Trophoblast Invasion in the Pathogenesis of Preeclampsia

The following article describes the relationship between the endometrium, mother’s vascu­lar system and the invasive trophoblast. This relationship is crucial for the adaptation of the uterus and the placenta during gestation. The article also focuses on the differentiation of the trophoblast, which is composed of cytotrophoblast, syncytiotrophoblast and three deve­lopmental forms of cytotrophoblast; the latter is also called the intermediate trophoblast, because based on differentiation it is situated between the cytotrophoblast and the syncytio- trophoblast. One of the forms of the invasive cytotrophoblast, the intermediate invasive trop­hoblast, plays an important role in the enhancement of uteroplacental blood flow during gestation. It actually remodels mothers’ spiral arteries, providing in so doing a higher influx of bloodstream into them. To ensure a healthy pregnancy, the invasion of the intermediate trophoblast into the endometrial stroma has to be well regulated. Imbalances during the inva­sion of the trophoblast and the process of decidualization result in the complications of preg­nancy. The author particularly focuses on problems related to the ethipato genesis of preeclampsia and gestational trophoblastic disease.