Lymphatic Vessel Dynamics in the Uterine Wall

During pregnancy, maternal uterine blood vessels undergo dramatic vascular remodeling. However, until now, little was known about whether the lymphatic circulation experiences similar changes and whether these vessels interact with placental cells that invade maternal tissue. Recent studies demonstrate that lymphatic vessels in the uterine wall are highly compartmentalized where their presence is mostly restricted to the deeper layers. In humans, this arrangement changes during pregnancy when extensive lymphangiogenesis occurs at the maternal–fetal interface. Placental cytotrophoblasts stimulate lymphatic growth in vivo and in vitro suggesting that they play a role in triggering pregnancy-induced decidual lymphangiogenesis. These data indicate that lymphatic vessels may have important functions at the implantation site during pregnancy.