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PERFUSION OF HUMAN PLACENTA AS A MODEL OF VASCULAR RESEARCH
Pregnancy is the unique, short reproductive event with far reaching
consequences for the individual, family and society. The placenta is the
primary fetal organ of respiration, metabolism, nutrition and
excretion. The early detection of placental dysfunction is critical for
the fetal and maternal survival. Additionally the placenta is a highly
vascular organ and has been used as a model for brain research and
vascular responses.
The structure and function of the placenta differs between male and
female fetuses, which makes it a perfect model to study gender-
dependent vascular responses. There are indeed obvious gender
differences in vascular responsiveness and vascular metabolism, which
has been identified in other vascular beds. The technique of placental
perfusion in vitro provides a unique opportunity to evaluate the
physiological responses to the vascular active substances and estimate
the feto-maternal drug transfer.
Abstract
Maira Carrillo1, James Maher1, Gary Ventolini1, Ailena Mulkey2, Moss Hampton1
and Natalia Schlabritz-Loutsevitch1*
1Dept. of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Odessa
2Clinical Research Institute, Odessa, TX
The objective is to establish the model of perfusion of human placenta
in-vitro and to record indirectly placental vessel contractility.
Objectives
After obtaining the informed consent, placenta was received after non-
complicated cesarean section delivery, the fetal artery was
immediately cannulated, followed by the cannulation of fetal vein
(Figure1 A). The cannulation and flushing re-established the circulation
in one of the intact cotyledons (Figure 1 B) at which time it is placed
into the perfusion chamber (Figure 1 B). The re-established circulation
is open circle fetal circulation (Figure 2). A basal fetal arterial
hydrostatic pressure (FAHP) was recorded (Figure 3). After baseline is
established, 3M KCl is added to induce vasoconstriction pressure is
recorded using Lab Chart software (ADInstruments,U.S, Colorado
Springs, Colorado). In addition to recording FAHP we also measure and
record: temperature, pH, oxygen tension using Lab Chart. We also used
the FLIR1 infrared technology to examine temperature of the sample
which also provides indication that the placenta is still metabolically
active.
Materials and Methods
The mean FAHP was 35.3±5 mmHg, mean weight of the cotyledons was
44.0±4 g. The temperature in the perfused cotyledon was constant
throughout the experiment.
Results
Conclusions
• We were able to establish placental perfusion in vitro in our
laboratory, the only placental perfusion lab in West Texas.
• Our data is in line with those published by Dr. Brownbill.
• We were able to establish a baseline FAHP and subsequently induce
vasoconstriction using 3M KCl. Induction of vasoconstriction shows
that the placenta is viable and metabolically active.
• Placenta perfusion is an excellent tool for the study fetal gender
specific responses.
Acknowledgements
• This study was supported by the funds of the Department of
Obstetrics and Gynecology TTUHSC at the PB and regional Dean
start-up funds to NSL.
• We acknowledge help of the Clinical Research institute in IRB
preparation, patients’ management and consents.
• The critical advise and help of Dr. Paul Brownbill (University of
Manchester, UK) is highly appreciated.
• We are deeply thankful medical staff and patients of MCH for their
incredible support and understanding of this study.
Patient Gestational Age (weeks) Race
Maternal age (yrs ) BMI feta l sex
Feta l wt. (g)
Cotyledon Wt. (g)
Feta l Pressure (mmHg)
1 39 Hispanic 25 28.21 female 3900 68.73 6.64
2 39 Hispanic 24 30.01 female 2830 30.4 19.46
3 29 Hispanic 34 25.31 male 3580 45.61 36.28
4 39 Hispanic 25 31.88 female 3330 63.2 38.67
39 Black 23 24.20 female 2960 27.96 51.35
1 39 Hispanic 32 36.29 male 3480 43.2 33.23
2 39 Hispanic 24 25.76 male 3680 36.94 42.62
3 39 Hispanic 27 28.54 male 3330 35.6 53.78
4 39 White 23 36.15 male 3740 45.34 -
Figure 2. Perfusion system. Orange arrows show fetal and maternal reservoirs. Blue arrows show
fetal and maternal peristaltic pumps. Green arrow heated water bath. Turquoise arrow perfusion
chamber. Pink arrow syringe pump. Yellow arrow: tank for gassing maternal and fetal perfusate.
Figure 3. Pressure recording of FAHP at baseline measurement and induction of
vasoconstriction using 3M KCl.
0
10
20
30
40
50
60
20 30 40 50 60 70 80
Basa
l fe
tal art
eri
al
hydro
stati
c
pre
ssure
(m
mH
g)
Perfused cotyledon wet weight (g)
Figure 4. Graphs showing Cotyledon weight vs FAHP ( Fetal arterial hydrostatic pressure)
A) Data collected from our laboratory.B) Data collected from Laboratory of Dr. Brownbill (University of
Manchester, UK)
Table 1. Patient, fetal and placental information.
Patient
Gestational
age
(weeks)
Maternal
age (yrs) BMI fetal sex
Newborn’s weight
(g)
Cotyledon
Wt. (g)
Fetal
Pressure
(mmHg)
1 39 25 28.21 female 3900 68.73 6.64
2 39 24 30.01 female 2830 30.4 19.46
3 29 34 25.31 male 3580 45.61 36.28
4 39 25 31.88 female 3330 63.2 38.67
5 39 23 24.20 female 2960 27.96 51.35
6 39 32 36.29 male 3480 43.2 33.23
7 39 24 25.76 male 3680 36.94 42.62
8 39 27 28.54 male 3330 35.6 53.78
9 39 23 36.15 male 3740 45.34 -
Mean±SEM 38 26 29.60±1 3386.25±112 43.96±13 35.25±5
KCl
Figure 1. Cannulation of vessels and corresponding cotyledon. A and C) Chorionic plate (A) where
vessels are cannulated (C) (blue and orange arrow) B and D) Decidual surface (B) (maternal side) after
isolation of placental lobule and cotyledon perfusion (D). Orange arrows point to temperature sensor.
Turquiose arrow shows oxygen sensor E and F) temperature map of the maternal side of placenta in the
perfusion chamber just prior to (E) and after (F) perfusion. G) Doppler image of perfused placental
cotyledon in vitro, yellow arrow shows perfusate flowing through a vessel.
Time (seconds)
Baseline
A C
B D
E
F
G
B A