The role of uterine arterial remodeling in fetal development and adverse pregnancy outcomes
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The uterine artery undergoes significant remodeling during pregnancy including alterations in length, diameter, and contractility. In line with these changes to the uterine vascular system, is a reduction in vascular resistance, permitting increased blood flow to the fetoplacental unit. Such hemodynamic adaptation is imperative to accommodate the expanded blood volume and is common among gestating mammals. Impaired uterine vascular adaptation has been identified as a key component in the pathogenesis of adverse pregnancy outcomes including preeclampsia and fetal growth restriction. Altered uterine arterial flow has been associated with exposure to numerous environmental pollutants in both epidemiological and laboratory studies, representing an important adverse outcome pathway for further investigation. This presentation will focus on the forces that drive uterine arterial remodeling during pregnancy and how disruptions in these processes impact fetal and maternal health. Overall, the attendee will gain an understanding of the role of uterine vascular remodeling in mediating fetal development and common laboratory methods to investigate these processes. Lastly, how such endpoints may be incorporated in adverse outcome pathways for regulatory decision making will also be addressed.