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Hepar uterinum: a history of ideas on fetal nutrition

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Published/Copyright: May 24, 2017
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 45 Issue 7

Abstract

The means of fetal nutrition has been debated for over two millennia, with the controversy of oral versus parenteral nutrition already in the Corpus Hippocraticum. In 1587 Aranzio rejected connections between maternal and fetal blood vessels, and coined the term “hepar uterinum” for the placenta. From the 16th to the 18th century, a fervent debate focused on the type and extent of connection between maternal and fetal vessels, which was finally settled by Hunter’s injection experiment in 1774. But up to the middle of the 19th century, an important nutritive function was attributed to amniotic fluid. When with the discovery of oxygen the placenta’s respiratory function became understood, its nutritional function fell from grace. Most scientists realized reluctantly that the organ had numerous functions. As late as in the 19th century, the advent of microscopy allowed cell theory to develop, and analytical chemistry furthered the understanding of the transport of nutrients across the placenta. The identification of the syncytiotrophoblast made passive diffusion unlikely. Radioisotopes, molecular biology and the fluid mosaic model of the cell membrane revealed active transport mechanisms for nearly all macronutrients.

Keywords: Active transport; fetal nutrition; history; placenta function; syncytiotrophoblast

Acknowledgments

This paper required the extensive study of classical Latin texts. The author would like to thank Dr. Angela Karasch, University Library Freiburg, for access to the ancient sources, Sieghard Irrgang, Kassel, for substantial and patient help with the translations from Latin; Markus Obladen, Berlin, for graphic work in Figure 4, and Carole Cürten, University of Freiburg, for editing the English.

  1. Author’s statement

  2. Conflict of interest: Authors state no conflict of interest.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

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Received: 2016-12-9
Accepted: 2017-1-10
Published Online: 2017-5-24
Published in Print: 2017-10-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Preeclampsia and intrauterine growth restriction: placental disorders still not fully understood
  4. Review article
  5. Hepar uterinum: a history of ideas on fetal nutrition
  6. Original articles
  7. Twin pregnancy in women above the age of 45 years: maternal and neonatal outcomes
  8. Maternal endothelial damage as a disorder shared by early preeclampsia, late preeclampsia and intrauterine growth restriction
  9. Maternal venous SHARP1 levels in preeclampsia
  10. Second-trimester maternal serum markers in the prediction of preeclampsia
  11. Pregnancy outcomes regarding maternal serum AFP value in second trimester screening
  12. Quantification of mechanical dyssynchrony in growth restricted fetuses and normal controls using speckle tracking echocardiography (STE)
  13. Serum cholesterol acceptor capacity in intrauterine growth restricted fetuses
  14. Antithrombin improves the maternal and neonatal outcomes but not the angiogenic factors in extremely growth-restricted fetuses at <28 weeks of gestation
  15. Simple approach based on maternal characteristics and mean arterial pressure for the prediction of preeclampsia in the first trimester of pregnancy
  16. Fetal death: an extreme manifestation of maternal anti-fetal rejection
  17. Intrauterine growth restriction and placental gene expression in severe preeclampsia, comparing early-onset and late-onset forms
  18. The relationship between maternal and umbilical cord adropin levels with the presence and severity of preeclampsia
  19. Expression of placental regulatory genes is associated with fetal growth
  20. Circulating soluble fms-like tyrosine kinase-1 and placental growth factor from 10 to 40 weeks’ pregnancy in normotensive women
  21. A one year review of eclampsia in an Ethiopian Tertiary Care Center (Saint Paul’s Hospital Millennium Medical College, SPHMMC)
  22. Congress Calendar
  23. Congress Calendar
https://doi.org/10.1515/jpm-2016-0402
Keywords for this article
Active transport; fetal nutrition; history; placenta function; syncytiotrophoblast

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Preeclampsia and intrauterine growth restriction: placental disorders still not fully understood
  4. Review article
  5. Hepar uterinum: a history of ideas on fetal nutrition
  6. Original articles
  7. Twin pregnancy in women above the age of 45 years: maternal and neonatal outcomes
  8. Maternal endothelial damage as a disorder shared by early preeclampsia, late preeclampsia and intrauterine growth restriction
  9. Maternal venous SHARP1 levels in preeclampsia
  10. Second-trimester maternal serum markers in the prediction of preeclampsia
  11. Pregnancy outcomes regarding maternal serum AFP value in second trimester screening
  12. Quantification of mechanical dyssynchrony in growth restricted fetuses and normal controls using speckle tracking echocardiography (STE)
  13. Serum cholesterol acceptor capacity in intrauterine growth restricted fetuses
  14. Antithrombin improves the maternal and neonatal outcomes but not the angiogenic factors in extremely growth-restricted fetuses at <28 weeks of gestation
  15. Simple approach based on maternal characteristics and mean arterial pressure for the prediction of preeclampsia in the first trimester of pregnancy
  16. Fetal death: an extreme manifestation of maternal anti-fetal rejection
  17. Intrauterine growth restriction and placental gene expression in severe preeclampsia, comparing early-onset and late-onset forms
  18. The relationship between maternal and umbilical cord adropin levels with the presence and severity of preeclampsia
  19. Expression of placental regulatory genes is associated with fetal growth
  20. Circulating soluble fms-like tyrosine kinase-1 and placental growth factor from 10 to 40 weeks’ pregnancy in normotensive women
  21. A one year review of eclampsia in an Ethiopian Tertiary Care Center (Saint Paul’s Hospital Millennium Medical College, SPHMMC)
  22. Congress Calendar
  23. Congress Calendar
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