| Autor: |
Tindal K; The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC 3168, Australia.; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia.; NHMRC Centre for Research Excellence (CRE) in Stillbirth, Brisbane, QLD 4101, Australia., Cousins FL; The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC 3168, Australia.; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia., Ellery SJ; The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC 3168, Australia.; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia., Palmer KR; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia.; Women's and Newborn Program, Monash Health, Clayton, VIC 3168, Australia., Gordon A; NHMRC Centre for Research Excellence (CRE) in Stillbirth, Brisbane, QLD 4101, Australia.; Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia., Filby CE; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia., Gargett CE; The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC 3168, Australia.; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia., Vollenhoven B; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia.; Women's and Newborn Program, Monash Health, Clayton, VIC 3168, Australia., Davies-Tuck ML; The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC 3168, Australia.; Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia.; NHMRC Centre for Research Excellence (CRE) in Stillbirth, Brisbane, QLD 4101, Australia. |
| Abstrakt: |
Not discounting the important foetal or placental contribution, the endometrium is a key determinant of pregnancy outcomes. Given the inherently linked processes of menstruation, pregnancy and parturition with the endometrium, further understanding of menstruation will help to elucidate the maternal contribution to pregnancy. Endometrial health can be assessed via menstrual history and menstrual fluid, a cyclically shed, easily and non-invasively accessible biological sample that represents the distinct, heterogeneous composition of the endometrial environment. Menstrual fluid has been applied to the study of endometriosis, unexplained infertility and early pregnancy loss; however, it is yet to be examined regarding adverse pregnancy outcomes. These adverse outcomes, including preeclampsia, foetal growth restriction (FGR), spontaneous preterm birth and perinatal death (stillbirth and neonatal death), lay on a spectrum of severity and are often attributed to placental dysfunction. The source of this placental dysfunction is largely unknown and may be due to underlying endometrial abnormalities or endometrial interactions during placentation. We present existing evidence for the endometrial contribution to adverse pregnancy outcomes and propose that a more comprehensive understanding of menstruation can provide insight into the endometrial environment, offering great potential value as a diagnostic tool to assess pregnancy risk. As yet, this concept has hardly been explored. |
