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Molecular and cellular morphology of placenta unveils new mechanisms of reproductive immunology.

J Adv Res

January 2025

Jinxin Research Institute for Reproductive Medicine and Genetics, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, China; Provincial Key Laboratory of Molecular Pathology and Personalized Medicine, Center of Collaborative and Creative Center, Department of Pathology and Pathophysiology, Shantou University Medical College, Shantou, China. Electronic address:

Introduction: Despite of numerous studies of the placenta, some molecular and cellular characteristics, particularly the relationship among different cell types, have not been well understood. We aim to investigate the basic and intricate details of cellular and molecular elements in early and late phase placentas to gain better understanding of the immune regulation of human reproductive process.

Methods: A novel combination of techniques of spatial transcriptomics(ST), multiple immunohistochemistry, and a dual labeling combining immunohistochemistry and (fluorescence in situ hybridization) FISH on normal and ectopic pregnancy and animal models was employed to investigate the placenta at tissue, cell, protein and molecular levels and to trace the fetal and maternal origin of every cell in early and late placentas.

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Objective: To determine the diagnostic performance and clinical utility of the M4 prediction model and the NICE algorithm managing women with pregnancy of unknown location (PUL).

Design: The study has a superiority design regarding specificity for non-ectopic pregnancy for M4, given that the primary outcome of sensitivity for ectopic pregnancy (EP) is non-inferior in comparison with the NICE algorithm.

Setting: Emergency gynaecology units in Sweden.

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This case highlights the critical role of early radiological screening by ultrasound in identifying uterine anomalies. In this report, we discuss a 39-year-old pregnant woman, gravida 4 para 3, and her fetus at gestational age 18 weeks. The patient was referred to the Obstetrics and Gynecology Emergency Department at Qatif Central Hospital, Saudi Arabia, from a private hospital due to an ultrasound study indicating a possible ectopic pregnancy with an abdominal fetal location.

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Heterotopic pregnancy is defined as the simultaneous presence of an intrauterine and an extrauterine pregnancy and is considered a rare condition. As a part of this entity, heterotopic triplet pregnancy, defined as the presence of three embryos, with at least one being ectopic, is exceedingly rare. In recent years, the broad use of assisted reproductive techniques to help infertile couples has contributed to the constant rise of non-spontaneous heterotopic triplets.

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A young female patient suffered cardiogenic shock after undergoing surgery for an ectopic pregnancy. Coronary artery computed tomography angiography (CTA) revealed a left main artery (LM) originating from the right coronary sinus and traveling between the aorta and pulmonary artery. We successfully resuscitated the patient with mechanical circulatory support using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and an intra-aortic balloon pump (IABP).

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