Human placental oxygenation in late gestation: experimental and theoretical approaches

Nye, Gareth A.; Ingram, Emma; Johnstone, Edward D.; Jensen, Oliver E.; Schneider, Henning; Lewis, Rohan M.; Chernyavsky, Igor L.; Brownbill, Paul

Abstract

The placenta is crucial for life. It is an ephemeral but complex organ acting as the barrier interface between maternal and fetal circulations, providing exchange of gases, nutrients, hormones, waste products and immunoglobulins. Many gaps exist in our understanding of the detailed placental structure and function, particularly in relation to oxygen handling and transfer in healthy and pathological states in utero. Measurements to understand oxygen transfer in vivo in the human are limited, with no general agreement on the most appropriate methods. An invasive method for measuring partial pressure of oxygen in the intervillous space through needle electrode insertion at the time of Caesarean sections has been reported. This allows for direct measurements in vivo whilst maintaining near normal placental conditions; however, there are practical and ethical implications in using this method for determination of placental oxygenation. Furthermore, oxygen levels are likely to be highly heterogeneous within the placenta. Emerging non-invasive techniques, such as MRI, and ex vivo research are capable of enhancing and improving current imaging methodology for placental villous structure and increase the precision of oxygen measurement within placental compartments. These techniques, in combination with mathematical modelling, have stimulated novel cross-disciplinary approaches that could advance our understanding of placental oxygenation and its metabolism in normal and pathological pregnancies, improving clinical treatment options and ultimately outcomes for the patient.

• Journal Article Type: Article
• Acceptance Date: Jan 18, 2018
• Online Publication Date: Feb 25, 2018
• Publication Date: 2018-12
• Deposit Date: Jan 24, 2025
• Publicly Available Date: Jan 24, 2025
• Journal: The Journal of Physiology
• Print ISSN: 0022-3751
• Electronic ISSN: 1469-7793
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 596
• Issue: 23
• Pages: 5523-5534
• DOI: https://doi.org/10.1113/jp275633
• PMID: 29377190