Factors regulating placental angio/vasculogenesis in complications of pregnancy and childbirth

Khomyakova E.V., Ziganshina М.М., Baev O.R.

1) Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia
The normal development and functioning of the placenta can be due to the proper regulation of the vasculogenesis and angiogenesis processes. Factors that regulate vasculogenesis and angiogenesis are the VEGF family and their receptors (VEGFR-1, VEGFR-2 and VEGFR-3). The disbalance of these factors leads to aberrant development of placental vessels which results in pathological disorders of placentation and can be associated with pregnancy complications such as preeclampsia, gestational hypertension, preterm birth, fetal growth retardation, acute fetal hypoxia. Mild placental angiogenesis disorders may not have obvious clinical manifestations, such as those that develop in preeclampsia and fetal growth retardation. However, due to the influence of trigger factors in childbirth, inadequate angiogenesis can lead to decompensation of placental circulation which is clinically manifested as acute fetal hypoxia. This review presents a brief characteristic and description of the main functions of the factors regulating angiogenesis, namely the VEGF family (VEGF-B, VEGF-C, VEGF-D, VEGF-E, VEGF-F, PlGF) and their receptors (VEGFR-1, VEGFR-2 and VEGFR-3), their role in physiological or pathological vasculo-genesis and angiogenesis of the placenta. The changes in angiogenic factors in the maternal blood in normal pregnancy/childbirth and in pathology, as well as in different methods of delivery, are presented. The effect of labor and induction of labor on changes in angiogenic factors is shown and the pathophysiological mechanisms underlying these changes are described. This review presents a modern perspective on the possibilities of predicting complications of pregnancy and childbirth based on monitoring of these factors.
Conclusion: The level of angiogenic factors in the maternal peripheral blood correlates with the morphofunctional state of the placenta. The profile of angiogenic factors is likely to reflect a particular clinical picture of placental insufficiency including a latent form that does not manifest itself during pregnancy but leads to fetal hypoxia during childbirth.

Authors’ contribution. Khomyakova E.V. – developing the design of the study, obtaining the data for analysis, reviewing the publications, processing and analyzing the material on the issue, writing the text of the manuscript; Baev O.R., Ziganshina M.M. – reviewing, editing the text.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Khomyakova E.V., Ziganshina М.М., Baev O.R. Factors regulating placental angio/vasculogenesis in complications of pregnancy and childbirth.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (9): 12-21 (in Russian)


angiogenic factors
fetal growth retardation
fetal hypoxia


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Received 13.06.2023

Accepted 28.06.2023

About the Authors

Ekaterina V. Khomyakova, postgraduate student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia, +7(495)438-30-47, e_khomyakova@oparina4.ru, 117997, Russia, Moscow, Ac. Oparina str., 4.
Marina M. Ziganshina, PhD, Leading Researcher at the Laboratory of Clinical Immunology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-11-83, mmz@mail.ru, 117997, Russia, Moscow, Ac. Oparina str., 4.
Oleg R. Baev, Dr. Med. Sci., Professor at the Maternity Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Professor at the Department of Obstetrics, Gynecology, Perinatology, and Reproductology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, +7(495)438-11-88, o_baev@oparina4.ru, 117997, Russia, Moscow, Ac. Oparina str., 4.

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