关键词: 流产, 习惯性, 先兆子痫, 胎儿生长迟缓, 子宫螺旋动脉, 重铸

Abstract: Uterine spiral artery remodeling is the key procedure in normal pregnancy. The proliferation and invasion of trophoblast cells is necessary for vascular remodeling process. When the trophoblast invasion is not fully enough, the spiral artery embolism is uncomplete, maternal-fetal circulation occurs earlier, the villi are damaged mechanically and directly. Oxidative stress cause cellular dysfunction and injury indirectly, followed by placental degeneration; cyclin-dependent kinase inhibitor 1A（CDKN1A） and Bax gene expressing abnormally caused by the pathway mediated TP53 protein, the apoptosis of trophoblast over regulated by miR-520 may lead to the emergence of the recurrent spontaneous abortion. The abnormal expression of MMP-9 produced by trophoblast cells and the release of a large number of inflammatory factors cause placental ischemia and hypoxia. The decrease of the vascular density, the volume of villus space, the degree of differentiation of trophoblast cells，hypoxia in microenvironment and the low level expression of synapse defective 1 (SDYE1) in placental villi may be an important cause of fetal growth restriction. So the study of spiral artery remodeling process has important significance for early diagnosis and treatment of pathological pregnancy.
【Keywords】 

Key words: Abortion, habitual, Pre-eclampsia, Fetal growth retardation, Uterine spiral artery, Remodel