Suppression of Extravillous Trophoblast Invasion of Uterine Spiral Arteries by Estrogen During Early Baboon Pregnancy

The present study determined whether estrogen plays a role in regulating invasion and remodeling of the uterine spiral arteries by extravillous trophoblasts during early baboon pregnancy. The level of trophoblast invasion of spiral arteries was assessed on day 60 of gestation (term is 184 days) in baboons untreated or treated on days 25–59 with estradiol or aromatizable androstenedione. The administration of estradiol or androstenedione increased (P < 0.01) maternal serum estradiol levels approximately 3-fold above normal. The mean ± SE percentage of spiral arteries/arterioles invaded by extravillous cytotrophoblasts in estradiol-treated baboons for vessels with diameters of 26–50 μm (0.0 ± 0.0), 51–100 μm (1.2 ± 0.7) and >100 μm (13.2 ± 5.5) was 100%, 90%, and 75% lower (P < 0.001), respectively, than in untreated baboons (2.4 ± 1.2%; 11.0 ± 5.5%, and 54.5 ± 8.5%, respectively). Similar results were obtained with androstenedione treatment. However, the distribution of uterine spiral arteries grouped by diameter or number of arteries per basal plate area, i.e. microvessel density, were similar in untreated and estrogen-treated baboons. We suggest, therefore, that the low levels of estrogen exhibited during early primate pregnancy are required to permit normal progression of trophoblast vascular invasion and that the surge in estrogen which occurs during the second-third of normal pregnancy has a physiological role in suppressing further arterial trophoblast invasion. Consequently, we propose that the estrogen-dependent restraint of spiral artery invasion/remodeling ensures optimal blood flow dynamics across the uteroplacental vascular bed to promote normal fetal growth and development.