Classics revisited. Raissa Nitabuch, on the uteroplacental circulation and the fibrinous membrane

• In 1887, Raissa Nitabuch was the first to give an accurate description of the uteroplacental circulation.
• At the time, this was published as a doctoral thesis.
• It did not receive much attention, since it was not published in a scientific journal.
• The dogma at the time was, that there was no maternal blood inside the placental intervillous space.
• In view of ongoing studies on function and regulation of uteroplacental vasculature, this early finding deserves to be revisited as a “Classic”.

The adaptive conversion of spiral arteries is essential for pregnancy physiology and incomplete conversion is associated with preeclampsia and intrauterine growth restriction. The anatomy of the uteroplacental circulation as well as the basic concept of nutrition of the foetus had been a matter of dispute among scientists for a long time. Based on the study of an autopsy of a pregnant uterus, Raissa Nitabuch was the first to give an accurate description of the uteroplacental circulation in her doctoral thesis in 1887. In this thesis, the fibrinous layer in the decidua was identified as site of detachment of the placenta from the uterine wall after delivery of the baby. Although this was only an accidental finding, as “Nitabuch membrane” this fibrinous layer up to this day is associated with her name. It is unclear, why the much more important findings on the uteroplacental circulation never were published in a scientific journal.Today the basic anatomy of the uteroplacental circulation is unquestioned. However, it remains largely unknown, that the first accurate description appeared as a doctoral thesis. In view of the ongoing investigations on function and regulation of uteroplacental circulation, there can be no doubt, that an original publication of the findings of Raissa Nitabuch in a scientific journal today would be a “Classic” deserving to be revisited.