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Normal Anatomy of the Female Pelvis and Sonographic Demonstration of Pelvic Abnormalities
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Much better results can be obtained if ultrasonic findings are interpreted together with sensitive radioimmunoassay of the β-subunit of human chorionic gonadotropin, which has been introduced recently into clinical practice. The combination of a positive serum pregnancy test and the absence of an intrauterine gestational sac on pelvic sonography accurately predicts ecotopic pregnancy in 93% of cases.62 This approach presumes that sonography can reliably recognize the presence or absence of the intrauterine gestation. After 6 weeks of amenorrhea, the fetus can be regularly identified within the gestational sac, and such distinction is not difficult. However, particular care should be taken to differentiate intrauterine pregnancy prior to depiction of the embryonic pole from the intrauterine decidual changes. Decidual casts of an ectopic pregnancy, resembling the ultrasonic appearance of an early gestation (“pseudogestational sac”), can be seen in 20% of patients.63 According to the recent reports, two concentric rims of decidua (the double decidual sac) can be seen in 98.3% of patients with early intrauterine pregnancy.64 This finding is believed to represent the decidua capsularis around the chorionic cavity and the decidual parietalis that surrounds the decidua capsularis and developing gestational sac. The decidual cast of ectopic pregnancy, in contrast, has a single echogenic rim similar to decidua parietalis.
Controlled Therapeutic Delivery in Wound Healing
Published in Emmanuel Opara, Controlled Drug Delivery Systems, 2020
Adam Jorgensen, Zishuai Chou, Sean Murphy
MSCs have been isolated from placental tissues as well as from the amnion and chorion [123,124]. The process of isolating stem cells from the placenta involves mechanically separating the fetal placental specimens from the maternal decidua by blunt dissection, followed by tissue homogenization and digestion with collagenase and dispase mixtures. Afterwards, the product is filtered and cells are placed into tissue culture [125]. The resulting placental MSCs resemble adult bone marrow-derived MSCs in terms of a spindle-shaped fibroblast appearance, the ability to adhere to plastic, and the ability to expand ex vivo. However, it has been reported that placental MSCs expand faster in vitro than adult MSCs, and appear to be less immunogenic and more immunosuppressive than their adult counterparts [126,127]. These properties make placental MSCs attractive as a potential clinical therapy for the treatment of burns and chronic nonhealing wounds. Kong et al. described a placental MSC treatment for wound healing in diabetic Goto-Kakizaki rats. They performed a full-thickness circular excisional wound, around which they delivered 1 million MSCs by intradermal injection. They found that MSC treatment increased the wound healing rate and reduced subsequent scarring. Additionally, a higher microvessel density was observed in the wound bed biopsy sites, and the transplanted MSCs were localized to the wound tissue and incorporated into the recipients’ vasculature [127].
Mechanobiology in the Reproductive Tract
Published in Jiro Nagatomi, Eno Essien Ebong, Mechanobiology Handbook, 2018
Julie Anne MacDonald, Dori C. Woods
Human uterine structure, in comparison to other organs (and even uterine structure of other mammalian species) is relatively simple. The simplex uterus, found in higher primates, is a small pear-shaped fibromuscular organ, which can be divided into three main anatomical regions: the fundus, corpus uteri, and cervix. The fundus is located at the top of the uterus and is the site of the utero-tubal junction with the Fallopian tubes (as discussed in Section 22.2; see Figure 22.1). The main uterine cavity, or corpus uteri, is surrounded by the uterine walls and is typically triangular in shape, with its upper boundary composed of the fundus between each utero-tubal junction, with the internal orifice of the uterus leading to the cervical canal acting as lower boundary. Uterine walls are composed of the endometrium, myometrium, and perimetrium layers. The endometrium layer of the uterine wall is the innermost epithelial layer, itself composed of both a basal and functional layer. The functional endometrium layer is hormone-responsive and thickens in response to estrogen-induced proliferation of epithelial cells during the follicular phase of the human menstrual cycle. Following ovulation, the corpus luteum in the ovary produces progesterone, which shifts endometrial cells from a proliferative state to the development of a secretory lining to support blastocyst implantation and decidua formation. However, without hormonal feedback from an implanted blastocyst, the endometrial lining is shed via menstruation in humans. The myometrium, or smooth muscle layer, will be the main focus of this section, as this muscular layer powers uterine contraction. The outermost layer of the uterus is the perimetrium, which covers the outer surface of the organ. The lowest region of the uterus is the cervix, joining the uterus to the vagina, which plays an essential role in childbirth.
Retinoic acid as a teratogen: IX-Induction of fetal skeletal anomalies and alteration in the utero-placental expression pattern of EGFR during mice development
Published in Egyptian Journal of Basic and Applied Sciences, 2022
Ahmed Said, Abdel-Rahman S. Sultan, Reda A. Ali, Mohsen A. Moustafa
Histologically, on gestation day 9.5 the placenta became mature and consisted of two parts: maternal and fetal parts, the maternal part consisted of maternal triangle and decidual basalis, the decidual basalis was composed of regression of mesometrial decidua, containing decidual cells, fibers, and vascular channels. The fetal part consisted of three layers: the trophoblastic giant cell layer, the spongiotrophoblast layer, and the labyrinth layer. Trophoblastic giant cells, identified by their large nuclei, were present as a layer separating the spongiotrophoblasts from decidual basalis, and the spongiotrophoblast layer consisted of large trophoblast cells with small blood sinuses. Both the trophoblast giant cells and spongiotrophoblast cells form the junctional zone. The labyrinth layer is formed by contact between the chorionic trophoblast and allantoic mesoderm, and contains blood sinuses (Figure 4(a,e,j)).