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Decidualization is a process that results in significant changes to cells of the endometrium in preparation for, and during, pregnancy. This includes morphological and functional changes (the decidual reaction) to endometrial stromal cells (ESCs), the presence of decidual white blood cells (leukocytes), and vascular changes to maternal arteries.
The decidua is the modified mucosal lining of the uterus (that is, modified endometrium) that forms every month, in preparation for pregnancy. It is shed off each month when there is no fertilized egg to support. [1] The decidua is under the influence of progesterone. Endometrial cells become highly characteristic.
The corresponding specific proteins are expressed in the glandular and stromal cells of the endometrial mucosa. The expression of many of these proteins vary depending on the menstrual cycle, for example the progesterone receptor and thyrotropin-releasing hormone both expressed in the proliferative phase, and PAEP expressed in the secretory phase.
Uterine glands or endometrial glands are tubular glands, lined by a simple columnar epithelium, found in the functional layer of the endometrium that lines the uterus. Their appearance varies during the menstrual cycle. During the proliferative phase, uterine glands appear long due to estrogen secretion by the ovaries.
The secretory phase is the final phase of the uterine cycle and it corresponds to the luteal phase of the ovarian cycle. During the secretory phase, the corpus luteum produces progesterone, which plays a vital role in making the endometrium receptive to the implantation of a blastocyst (a fertilized egg, which has begun to grow). [56]
Arias-Stella reaction, also Arias-Stella phenomenon, is a benign change in the endometrium associated with the presence of chorionic tissue. [1] Arias-Stella reaction is due to progesterone primarily. Cytologically, it resembles a malignancy and, historically, it was misdiagnosed as endometrial cancer. [1]
Towards the end of the secretory phase, around days 23-35, the regression period occurs. In this stage, the structure shrivels and appears wrinkly. [8] Not every pinopode on the endometrial surface develops at the same time, affecting the consistency of distribution along the membrane. [2] F-actin is found within pinopodes. The cytoskeleton is ...
Whereas in cases where placental fragments are firmly attached to the wall of the uterus, dilation and curettage is the definitive and therapeutic method of choice. [8] Once the remaining placenta is removed, the mother will be able to restore the expected decline in progesterone level and initiate the onset of lactation. [6] [18]