Sectional plan of the gravid uterus in the third and fourth month.
Anatomical terminology
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Micrograph showing decidualization of the endometrium due to exogenous progesterone (oral contraceptive pill). H&E stain.
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 sum of these changes results in the endometrium changing into a structure called the decidua. In humans, the decidua is shed during childbirth.[1]
Decidualization plays an important role in promoting placenta formation between a mother and her fetus by mediating the invasiveness of trophoblast cells. It also triggers the production of cellular and molecular factors that result in structural changes, or remodeling, of maternal spiral arteries. Decidualization is required in some mammalian species where embryo implantation and trophoblast cell invasion of the endometrium occurs, also known as hemochorial placentation. This allows maternal blood to come into direct contact with the fetal chorion, a membrane between the fetal and maternal tissues, and allows for nutrient and gas exchange. However, decidualization-like reactions have also been observed in some species that don't display hemochorial placentation.[2]
In humans, decidualization occurs after ovulation during the menstrual cycle. After implantation of the embryo, the decidua further develops to mediate the process of placentation. In the event no embryo is implanted, the decidualized endometrial lining is shed or, as is the case with species that follow the estrous cycle, absorbed.[1] In menstruating species, decidualization is spontaneous and occurs as a result of maternal hormones. In non-menstruating species, decidualization is non-spontaneous, meaning it only happens after there are external signals from an implanted embryo.[3]
^ abPansky, Ben (1982-08-01). Review of Medical Embryology. McGraw-Hill. ISBN 9780071053037.
^Kurjak, Asim; Chervenak, Frank A. (2006-09-25). Textbook of Perinatal Medicine, Second Edition. CRC Press. ISBN 9781439814697.
^Emera, Deena; Romero, Roberto; Wagner, Günter (2011-11-07). "The evolution of menstruation: A new model for genetic assimilation". BioEssays. 34 (1): 26–35. doi:10.1002/bies.201100099. ISSN 0265-9247. PMC 3528014. PMID 22057551.
However, decidualization-like reactions have also been observed in some species that don't display hemochorial placentation. In humans, decidualization occurs...
which resemble epithelium (and are referred to as "epithelioid"). Decidualization includes the process of differentiation of the spindle-shape stromal...
uterine lining but do not menstruate. A theory based on spontaneous decidualization (a process that results in significant changes to cells of the endometrium...
endometrium into decidua, which is termed endometrial transformation or decidualization. This is mediated by the progestogenic and functional antiestrogenic...
secretes progesterone, which is a steroid hormone responsible for the decidualization of the endometrium (its development) and maintenance, respectively...
play an important role in embryo implantation and interaction with the decidualized maternal uterus. The core of placental villi contain mesenchymal cells...
effective treatment for adenomyosis. They reduce symptoms by causing decidualization of the endometrium, reducing or eliminating menstrual flow. Additionally...
exhibit a decidualized phenotype and display upregulation of common decidualization markers such as prolactin and IGFBP1. Kearns, M; Lala, PK (March 1983)...
preparation for implantation of the blastocyst, the endometrium undergoes decidualization. Spiral arteries in the decidua are remodeled so that they become less...
Endocannabinoid System in the Postimplantation Period: A Role during Decidualization and Placentation". International Journal of Endocrinology (Review)...
is the first and only known rodent species that exhibit spontaneous decidualization and menstruation. The Cairo spiny mouse grows to a head and body length...
example, some endometriomas (a type of benign ovarian cyst) will undergo decidualization, which can make them look more like a cancerous tumor in medical imaging...
the endometriosis. Ovarian endometriosis may complicate pregnancy by decidualization, abscess and/or rupture. Thoracic endometriosis can be associated with...
undergoes atrophy, with small, straight glands and a stroma that is decidualized. Cervical mucus remains viscous. Because of its steady blood levels over...
fatty acid synthase is closely linked to proliferation and stromal decidualization in cycling endometrium". International Journal of Gynecological Pathology...
the progestin to the foreign body reaction. The endometrium becomes decidualized with atrophy of the glands.65 The progestin IUD probably has two mechanisms...
Endocannabinoid System in the Postimplantation Period: A Role during Decidualization and Placentation". International Journal of Endocrinology. 2013: 510540...
tubes into the uterus. Ormeloxifene also suppresses proliferation and decidualization of the endometrium (the transformation of the endometrium in preparation...
of circadian sleep/wake cycle, non-REM sleep cartilage development decidualization regulation of cell population proliferation growth hormone secretion...
secretory phase of the menstrual cycle, in a process called decidualization. Decidualized pleural endometrial implants can disrupt the pleura and lead...
the progestin to the foreign body reaction. The endometrium becomes decidualized with atrophy of the glands.65 The progestin IUD probably has two mechanisms...
accreta, due to the presence of a uterine scar leading to abnormal decidualization of the placenta. Due to abnormal adherence of the placenta to the uterine...
Pavlicev M, Tilburgs T, Simón C, Norwitz ER (June 2020). "Endometrial Decidualization: The Primary Driver of Pregnancy Health". International Journal of...
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