Pregnancy-Induced Uterine Vascular Remodelling and the Pathophysiology of Decidual Vasculopathy

Maternal vasculopathy encompasses several related lesions, including incomplete physiologic remodelling, fibrinoid necrosis, and atherosis, that occur within the maternal blood vessels feeding the placenta. These lesions are thought to develop early in gestation, but their effects do not generally arise until the latter half of pregnancy. The alterations in the maternal vasculature change both the volume and flow characteristics of the blood entering the placenta, resulting in hypoxic/oxidative damage. Maternal vasculopathy is associated most closely with the hypertensive disorders of pregnancy but can also be found in several other adverse pregnancy outcomes.