IMR Press / CEOG / Volume 44 / Issue 4 / DOI: 10.12891/ceog3598.2017

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with S.O.G.

Original Research
The role of angiogenic factors in first trimester pregnancy losses
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1 Merkezefendi State Hospital, Department of Obstetrics and Gynecology, Manisa, Turkey
2 Celal Bayar University, Department of Histology and Embryology, School of Medicine, Manisa, Turkey
3 Merkezefendi State Hospital, Department of Pathology, Manisa, Turkey
Clin. Exp. Obstet. Gynecol. 2017, 44(4), 566–571;
Published: 10 August 2017
Objective: A good blood supply towards the peri-implantation endometrium is an essential requirement for pregnancy. Intermedin (IMD), vascular endothelial growth factor (VEGF), and endothelial nitric oxide synthase (eNOS), are angiogenic and vasoactive agents that play contributory roles in endometrial vascularity. The goal of this study was to immunohistochemically investigate the roles of various vasoactive factors in first trimester pregnancy losses. Materials and Methods: This was a prospective case-controlled study carried out on decidual and placental tissue samples obtained from women with unwanted pregnancies who served as the control group (n=10), and those with missed abortions who were the “missed abortion group”(n = 10). Immunohistochemistry techniques were used to compare IMD, receptor activity modifying protein (RAMP)1, RAMP2, RAMP3, VEGF, and eNOS expression of decidual and placental cells. Immunostaining for these factors was evaluated semiquantitatively by H-score analysis. Results: IMD and RAMPs in decidual cells exhibited higher expression in the control group. However, IMD and RAMP2 had a stronger expression in placental cells in the missed abortion group. In the control group, VEGF and eNOS had a higher expression in decidual cells and on the placental side, especially in syncytiotrophoblasts and cytotrophoblasts. Conclusion: Expressions of vasoactive agents, such as IMD, VEGF, and eNOS, decrease in first trimester pregnancy losses. Additionally, a compensatory mechanism against decreased endometrial and subendometrial vascularity results in the death of the embryo/fetus enhances in missed abortion cases. This mechanism characterized by increased expressions of IMD and RAMP2 initially begins in the syncytiotrophoblasts and cytotrophoblasts.
Vascular endothelial growth factor
Nitric oxide synthase type III
Spontaneous abortion
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