Decidualization: Preparing the Uterus for Pregnancy
Decidualization is a natural process that transforms the uterus lining, called endometrium, to support pregnancy. During each menstrual cycle, hormones like progesterone prepare the endometrium, to embrace an embryo. This transformation helps to create a healthy environment for implantation and the early stages of pregnancy.
When this process does not happen correctly—a condition called decidualization resistance (DR)—it can lead to pregnancy complications such as preeclampsia, affecting both mother and baby.
What Is Preeclampsia?
Preeclampsia is a pregnancy complication that affects about 8% of first-time pregnancies. It usually appears after the 20th week and is characterized by high blood pressure and proteinuria among others. Severe cases can cause complications like seizures, organ damage, and premature birth. For the baby, preeclampsia can result in low birth weight and other health problems.
Our research focuses on decidualization, a stage prior to placentation. An aberrant decidualization may be involved in the subsequent aberrant placentation and, later in pregnancy, cause all the symptoms associated with preeclampsia.
How Does Decidualization Resistance Contribute?
Our team used advanced techniques to study the endometrial tissue of women who had experienced severe preeclampsia (sPE). We found some key differences:
- Unbalanced Endometrial Cells: In women with sPE, the uterine lining contains a mix of cells fully differentiated from others that aren’t fully developed.
- Communication Issues: The cells in a healthy endometrium work together, sending signals to support pregnancy. In women with sPE, these signals were disrupted, affecting important processes like blood vessel formation.
- Hormonal Problems: Hormones like progesterone are crucial for decidualization. In sPE cases, we found that the cells were less responsive to these hormonal signals.
Why Does This Matter?
Understanding these differences can help us:
- Identify Risks Early: By finding markers of decidualization problems, doctors could screen for preeclampsia risk before pregnancy.
- Develop New Treatments: Therapies that improve the uterus’s ability to respond to hormones could reduce complications.
Moving Forward in Maternal-Fetal Health
Our research highlights how essential the endometrium, the uterus cover, is to achieve a healthy pregnancy. Decidualization is not just a background process but a key player in ensuring that both mother and baby thrive.
For more details on this research, read our study in Nature Medicine here.