Anatomical-functional and pathological aspects of the mechanisms of interaction of the mother - placenta - fetus system
DOI:
https://doi.org/10.15574/SP.2025.2(146).111118Keywords:
perinatal development, placenta, fetal membranes, fetus, humanAbstract
In recent decades, there has been a significant breakthrough in studying the embryonic and fetal periods of human development. This achievement was made possible by introducing the latest technologies, such as ultrasound scanners, computed tomography scanners, and genetic analysis methods. The expanded capabilities allow for a more detailed study of fetal development, detecting abnormalities in the formation of organs and timely response to possible pathologies, which opens up new horizons for fetal surgery and perinatal medicine.
The aim of the study was to examine modern sources of literature and systematize disparate and insufficiently organized theoretical information on the mechanisms of integration of the functional system "mother - placenta - fetus", the boundaries of the external environment surrounding the fetus, and also to assess the prospects for treating the fetus as a full-fledged patient.
According to modern ideas, the first anatomical and functional complex in the "mother - fetus" system is formed between the vessels of the endometrium and the blastocyst, in the creation of which progesterone plays a key role. In the processes of implantation and placentation, synchronization between the preparation of the blastocyst and the endometrium is critically important. Complete integration of the maternal and fetal organisms becomes possible only after the formation of the placenta.
The Amsterdam Working Group divides pathological conditions of the placenta into four main categories: maternal vasculopathy of pregnancy, fetal vasculopathy, infections, and inflammations, including chorioamnionitis and placentitis, and other pathological conditions, such as placental abnormalities, chronic inflammatory processes or implantation disorders.
The authors declare no conflict of interest.
References
Andreescu M. (2024, Jun 16). Correlation between maternal-fetus interface and placenta-mediated complications. Cureus. 16(6): e62457. PMID: 38882223; PMCID: PMC11180486. https://doi.org/10.7759/cureus.62457
Atallah F, Hamm RF, Davidson CM, Combs CA. (2022). Society for Maternal-Fetal Medicine Special Statement: Cognitive bias and medical error in obstetrics - challenges and opportunities. Am J Obstet Gynecol. 227(2): B2-10. https://doi.org/10.1016/j.ajog.2022.04.033; PMid:35487325
Boss AL, Chamley LW, James JL. (2018). Placental formation in early pregnancy: how is the centre of the placenta made? Hum Reprod Update. 24(6): 750-760. https://doi.org/10.1093/humupd/dmy030; PMid:30257012
Bulletti C, Bulletti FM, Sciorio R, Guido M. (2022). Progesterone: The key factor of the beginning of life. Int J Mol Sci. 23(22): 14138. https://doi.org/10.3390/ijms232214138; PMid:36430614 PMCid:PMC9692968
Burton GJ, Jauniaux E. (2015). What is the placenta? Am J Obstet Gynecol. 213(4): S6.e1-S6.e4. https://doi.org/10.1016/j.ajog.2015.07.050; PMid:26428504
Chaaban H, Burge K, McElroy SJ. (2024). Evolutionary bridges: how factors present in amniotic fluid and human milk help mature the gut. J Perinatol. 44(11): 1552-1559. https://doi.org/10.1038/s41372-024-02026-x; PMid:38844520 PMCid:PMC11521761
Cherayil BJ, Jain N. (2024). From womb to world: Exploring the immunological connections between mother and child. ImmunoHorizons. 8(8): 552-562. https://doi.org/10.4049/immunohorizons.2400032; PMid:39172025 PMCid:PMC11374749
Chervenak FA, McCullough LB. (2017). Ethical dimensions of the fetus as a patient. Best Pract Res Clin Obstet Gynaecol. 43: 2-9. https://doi.org/10.1016/j.bpobgyn.2016.12.007; PMid:28190695
Chervenak FA, McCullough LB. (2022). Professional ethics and decision making in perinatology. Semin Perinatol. 46(3): 151520. https://doi.org/10.1016/j.semperi.2021.151520; PMid:34839938
Cindrova-Davies T, Sferruzzi-Perri AN. (2022). Human placental development and function. Semin Cell Dev Biol. 131: 66-77. https://doi.org/10.1016/j.semcdb.2022.03.039; PMid:35393235
Coles C. (1994). Critical periods for prenatal alcohol exposure: Evidence from animal and human studies. Alcohol Health Res World. 18(1): 22-29.
Costa MA. (2016). The endocrine function of human placenta: an overview. Reprod Biomed Online. 32(1): 14-43. https://doi.org/10.1016/j.rbmo.2015.10.005; PMid:26615903
Finnemore A, Groves A. (2015). Physiology of the fetal and transitional circulation. Semin Fetal Neonatal Med. 20(4): 210-216. https://doi.org/10.1016/j.siny.2015.04.003; PMid:25921445
Gauster M, Moser G, Wernitznig S, Kupper N, Huppertz B. (2022, Jun 5). Early human trophoblast development: from morphology to function. Cell Mol Life Sci. 79(6): 345. https://doi.org/10.1007/s00018-022-04377-0; PMid:35661923 PMCid:PMC9167809
Gyamfi-Bannerman C, Miller R. (2020). Updates in maternal fetal medicine. Clin Perinatol. 47(4): XIX-XX. https://doi.org/10.1016/j.clp.2020.09.002; PMid:33153666 PMCid:PMC7566817
Herkert D, Meljen V, Muasher L, Price TM, Kuller JA, Dotters-Katz S. (2022). Human chorionic gonadotropin - A review of the literature. Obstet Gynecol Surv. 77(9): 539-546. https://doi.org/10.1097/OGX.0000000000001053; PMid:36136076
Hod M, Lieberman N. (2015). Maternal - fetal medicine - How can we practically connect the "M" to the "F"? Best Pract Res Clin Obstet Gynaecol. 29(2): 270-283. https://doi.org/10.1016/j.bpobgyn.2014.06.008; PMid:25225060
Hu MS, Borrelli MR, Hong WX, Malhotra S, Cheung ATM, Ransom RC et al. (2018). Embryonic skin development and repair. Organogenesis. 14(1): 46-63. https://doi.org/10.1080/15476278.2017.1421882; PMid:29420124 PMCid:PMC6150059
Inanc A, Bektas NI, Kecoglu I, Parlatan U, Durkut B, Ucak M et al. (2024). Label-free differentiation of functional zones in mature mouse placenta using micro-Raman imaging. Biomed Opt Express. 15(5): 3441. https://doi.org/10.1364/BOE.521500; PMid:38855670 PMCid:PMC11161348
Khorami-Sarvestani S, Vanaki N, Shojaeian S, Zarnani K, Stensballe A, Jeddi-Tehrani M et al. (2024, Apr 19). Placenta: an old organ with new functions. Front Immunol. 15: 1385762. https://doi.org/10.3389/fimmu.2024.1385762; PMid:38707901 PMCid:PMC11066266
Kliegman RM, Cohen SS. (2022). Current controversies in perinatology. Clin Perinatol. 49(1): XXI-XXII. https://doi.org/10.1016/j.clp.2021.12.001; PMid:35210013
Knöfler M, Haider S, Saleh L, Pollheimer J, Gamage TKJB, James J. (2019). Human placenta and trophoblast development: key molecular mechanisms and model systems. Cell Mol Life Sci. 76(18): 3479-3496. https://doi.org/10.1007/s00018-019-03104-6; PMid:31049600 PMCid:PMC6697717
Kratimenos P, Penn AA. (2019). Placental programming of neuropsychiatric disease. Pediatr Res. 86(2): 157-164. https://doi.org/10.1038/s41390-019-0405-9; PMid:31003234 PMCid:PMC11906117
Maltepe E, Fisher SJ. (2015). Placenta: The forgotten organ. Annu Rev Cell Dev Biol. 31(1): 523-552. https://doi.org/10.1146/annurev-cellbio-100814-125620; PMid:26443191
Maraldi T, Russo V. (2022). Amniotic fluid and placental membranes as sources of stem cells: Progress and challenges. Int J Mol Sci. 23(10): 5362. https://doi.org/10.3390/ijms23105362; PMid:35628186 PMCid:PMC9141978
Masserdotti A, Gasik M, Grillari-Voglauer R, Grillari J, Cargnoni A, Chiodelli P et al. (2024). Unveiling the human fetal-maternal interface during the first trimester: biophysical knowledge and gaps. Front Cell Dev Biol. 12: 1411582. https://doi.org/10.3389/fcell.2024.1411582; PMid:39144254 PMCid:PMC11322133
Matsumoto M, Tsuchiya KJ, Yaguchi C, Horikoshi Y, Furuta-Isomura N, Oda T et al. (2020). The fetal/placental weight ratio is associated with the incidence of atopic dermatitis in female infants during the first 14 months: The Hamamatsu Birth Cohort for Mothers and Children (HBC Study). Int J Womens Dermatol. 6(3): 176-181. https://doi.org/10.1016/j.ijwd.2020.02.009; PMid:32637540 PMCid:PMC7330435
Menon R, Moore JJ. (2020). Fetal membranes, not a mere appendage of the placenta, but a critical part of the fetal-maternal interface controlling parturition. Obstet Gynecol Clin North Am. 47(1): 147-162. https://doi.org/10.1016/j.ogc.2019.10.004; PMid:32008665
Petroff MG, Nguyen SL, Ahn SH. (2022). Fetal‐placental antigens and the maternal immune system: Reproductive immunology comes of age. Immunol Rev. 308(1): 25-39. https://doi.org/10.1111/imr.13090; PMid:35643905 PMCid:PMC9328203
Sánchez-Villagra MR. (2022, Jul 12). Claude Lévi-Strauss as a humanist forerunner of cultural macroevolution studies. Evol Hum Sci. 4: e31. https://doi.org/10.1017/ehs.2022.30; PMid:37588929 PMCid:PMC10426008
Segovia SA, Vickers MH, Gray C, Reynolds CM. (2014). Maternal obesity, inflammation, and developmental programming. Biomed Res Int. 2014: 1-14. https://doi.org/10.1155/2014/418975; PMid:24967364 PMCid:PMC4055365
Seshagiri PB, Vani V, Madhulika P. (2016). Cytokines and blastocyst hatching. Am J Reprod Immunol. 75(3): 208-217. https://doi.org/10.1111/aji.12464; PMid:26706391
Slack JC, Parra-Herran C. (2022). Life after Amsterdam: Placental pathology consensus recommendations and beyond. Surg Pathol Clin. 15(2): 175-196. https://doi.org/10.1016/j.path.2022.02.001; PMid:35715157
Staud F, Karahoda R. (2018). Trophoblast: The central unit of fetal growth, protection and programming. Int J Biochem Cell Biol. 105: 35-40. https://doi.org/10.1016/j.biocel.2018.09.016; PMid:30266525
Sun C, Groom KM, Oyston C, Chamley LW, Clark AR, James JL. (2020). The placenta in fetal growth restriction: What is going wrong? Placenta. 96: 10-18. https://doi.org/10.1016/j.placenta.2020.05.003; PMid:32421528
Truong N, Menon R, Richardson L. (2023, Jan 31). The Role of Fetal Membranes during Gestation, at Term, and Preterm Labor. Placenta Reprod Med. 2: 4. Epub 2023 Mar 20. https://doi.org/10.54844/prm.2022.0296; PMid:38304894 PMCid:PMC10831903
Turco MY, Moffett A. (2019). Development of the human placenta. Development. 146(22). https://doi.org/10.1242/dev.163428; PMid:31776138
Tutar R, Çelebi-Saltik B. (2022). Modeling of Artificial 3D Human Placenta. Cells Tissues Organs. 211(4): 527-536. Epub 2021 Mar 10. https://doi.org/10.1159/000511571; PMid:33691312
Vacher C-M, Bonnin A, Mir IN, Penn AA. (2023). Editorial: Advances and perspectives in neuroplacentology. Front Endocrinol (Lausanne). 14: 1206072. https://doi.org/10.3389/fendo.2023.1206072; PMid:37274324 PMCid:PMC10236794
Verbruggen SW, Oyen ML, Phillips ATM, Nowlan NC. (2017). Function and failure of the fetal membrane: Modelling the mechanics of the chorion and amnion. PLoS One. 12(3): e0171588. https://doi.org/10.1371/journal.pone.0171588; PMid:28350838 PMCid:PMC5370055
Wu D, Cao J, Xu M, Zhang C, Wei Z, Li W et al. (2024, Jun 27). Fetal membrane imaging: current and future perspectives - a review. Front Physiol. 15: 1330702. https://doi.org/10.3389/fphys.2024.1330702; PMid:38994451 PMCid:PMC11238276
Xiao Z, Yan L, Liang X, Wang H. (2020). Progress in deciphering trophoblast cell differentiation during human placentation. Curr Opin Cell Biol. 67: 86-91. https://doi.org/10.1016/j.ceb.2020.08.010; PMid:32957014
Yaguchi C, Ueda M, Mizuno Y, Fukuchi C, Matsumoto M, Furuta-Isomura N et al. (2024). Association of placental pathology with physical and neuronal development of infants: A narrative review and reclassification of the literature by the Consensus Statement of the Amsterdam Placental Workshop Group. Nutrients. 16(11): 1786. https://doi.org/10.3390/nu16111786; PMid:38892717 PMCid:PMC11174896
Zamorsky II, Khmara TV, Biryuk IG, Pankiv TV, Koval OA. (2024). Deyaki pytannya istoriï stanovlennya ta perspektyvy rozvytku teoretychnoï ta klinichnoï medytsyny. Morphologia. 3.
Zamorsky II, Khmara TV, Yuzko TA, Khodan AG. (2023). Aktualʹni zavdannya ta moralʹno-etychni problemy perynatalʹnoyi medytsyny. Klynychna anatomiya ta operatyvna khirurhiya. 22: 70-75. https://doi.org/10.24061/1727-0847.22.1.2023.10
Zhang Y, Liu Z, Sun H. (2023, Jul 18). Fetal-maternal interactions during pregnancy: a 'three-in-one' perspective. Front Immunol. 14: 1249476. https://doi.org/10.3389/fimmu.2023.1249476; PMid:37533871 PMCid:PMC10393116
Zhou Q, Acharya G. (2022, Apr 28). Editorial: Placental hormones and pregnancy-related endocrine disorders. Front Endocrinol (Lausanne). 13: 905829. https://doi.org/10.3389/fendo.2022.905829; PMid:35573985 PMCid:PMC9097261
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Modern pediatrics. Ukraine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
