Endothelial cell-driven migratory remodeling transforms the human endometrial vasculature to establish maternal-fetal circulation in pregnancy

Endothelial cell-driven migratory remodeling transforms the human endometrial vasculature to establish maternal-fetal circulation in pregnancy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Endothelial cell-driven migratory remodeling transforms the human endometrial vasculature to establish maternal-fetal circulation in pregnancy Meghan Riddell, Bethan Wilson, Efia Wiredu, Juan Garcia Rivas, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8971723/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted You are reading this latest preprint version Abstract The transformation of the endometrium into the decidua is essential for pregnancy establishment. Maternal endometrial vasculature must undergo remodelling in preparation for maternal-fetal circulation initiation at ~10 weeks gestation. Improper remodeling is associated with increased risk of spontaneous miscarriage and preeclampsia; however, characterization of these adaptations is limited. Using 3D imaging we characterize the vascular morphology from the proliferative phase of the menstrual cycle to the end of the first trimester. We show that the endometrial vasculature is a highly proliferative vascular plexus that expands and transforms into a hierarchical vascular network by ~10 weeks gestation, though this transformation occurs without significant endothelial cell (EC) proliferation post-implantation. Single cell RNA-sequencing analyses reveal a pro-migratory decidual EC signature and identify novel pathways that may contribute to the development of maternal-fetal circulation. Thus, disruption of EC-driven migratory remodeling could limit network efficiency and contribute to the development of pregnancy pathologies. Biological sciences/Developmental biology/Angiogenesis Health sciences/Anatomy Full Text Additional Declarations There is NO Competing Interest. Tables 1 to 4 are available in the supplementary files section Supplementary Files Table1.docx Table 1 Table2.docx Table 2 Table3.docx Table 3 Table4.docx Table 4 nrreportingsummaryFeb2026.pdf Reporting summary CollatedSupFigs.pdf Supplementary Figures CopyofMovie15.5wkJan19Movie3D2.avi.zip Movie 1 CopyofMovie27.5weekfusingvesselvideo.avi Movie 2 Cite Share Download PDF Status: Under Review Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8971723","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":598086814,"identity":"3d081911-b3b6-4bb7-92b0-91a1857f19ec","order_by":0,"name":"Meghan 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