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Studies shine light on placenta mystery

Research and Development Engineer Avinash Eranki examines a donated placenta as scientists are working to create a version for study at the Children's National Medical Center in Washington. They are looking into how problems with the placenta can lead to various health threats.
Organ serves many purposes

WASHINGTON — Scientists carefully probe a placenta donated after birth, bluish umbilical cord still attached. This is the body’s most mysterious organ, and inside lie clues to how this giver of life forms — and how it can go awry, leading to stillbirth, preterm birth, even infections like the Zika virus that somehow sneak past its protective barrier.

In labs around the country, major research is under way to finally understand and monitor this floppy, bloody tissue that’s often dismissed as the “afterbirth,” the organ that lives about nine months and then gets thrown away.

The stakes are high. The placenta is the ultimate multitasker: It nourishes a fetus, acts as its lungs, kidneys and liver, provides immune defense, and even produces key hormones.

“We take it for granted,” said Dr. Catherine Spong of the National Institutes of Health, which has spurred a research boom with its $50 million Human Placenta Project. “Yet there are lifelong implications for both the mother and the baby.”

Zika’s shocking birth defects have brought into focus the desperate need to learn how a healthy placenta does its many jobs, and find treatments for when it is undermined.

“Tomorrow there may be a new virus,” warned Dr. Yoel Sadovsky of the University of Pittsburgh Medical Center, a leading placenta researcher. “If I was a virus and wanted to attack humans, probably the best time to do it was during pregnancy, where you’re attacking the next generation.”

Doctors have few tools today to examine a placenta during pregnancy. And precious as that donated placenta is for research, studying one that already ushered in a birth reveals only so much, like counting the rings in a downed tree to visualize the sapling.

What scientists, and obstetricians, really need is a way to peek at how the placenta forms and changes in the different stages of pregnancy. That could help spot problems early — such as preeclampsia, a blood pressure complication that can be life-threatening to mother and baby. It affects up to 8 percent of pregnancies but typically isn’t detected until the second trimester even though it’s thought to stem from abnormal placenta formation.

How? In a Washington lab, engineer Avinash Eranki turns over the donated placenta, examining the side that attached to the mom. That outer layer is made up of cells called trophoblasts that had to invade the uterine wall and then burrow into maternal arteries, enlarging them to provide blood flow for the fetus.

The theory: If those cells get off course and the blood vessels don’t widen enough, the downstream effects of a placenta struggling to support the fetus eventually stress the mother’s own organs.

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