Extracellular vesicles (EVs) play a crucial role in pregnancy, revealed by the presence of placental-derived EVs in maternal blood, their in vitro functionality, and their altered cargo in pregnancy pathologies. These EVs are thought to be involved in the development of pregnancy pathologies, such as pre-eclampsia, pre-term birth, and fetal growth restriction, and have been suggested as a source of biomarkers for gestational diseases. However, to accurately interpret their function and biomarker potential, it is necessary to critically evaluate the EV isolation and characterization methodologies used in pregnant cohorts. In this systematic scoping review, we collated the results from 152 studies that have investigated EVs in the blood of pregnant women, and provide a detailed analysis of the EV isolation and characterization methodologies used. Our findings indicate an overall increase in EV concentrations in pregnant compared to non-pregnant individuals, an increased EV count as gestation progresses, and an increased EV count in some pregnancy pathologies. We highlight the need for improved standardization of methodology, greater focus on gestational changes in EV concentrations, and further investigations into the functionality of EVs. Our review suggests that EVs hold great promise as diagnostic and translational tools for gestational diseases. However, to fully realize their potential, it is crucial to improve the standardization and reliability of EV isolation and characterization methodologies, and to gain a better understanding of their functional roles in pregnancy pathologies.

中文翻译：

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健康和病理妊娠中的循环细胞外囊泡：方法、严格性和结果的范围审查

母体血液中胎盘来源的 EV 的存在、其体外功能及其在妊娠病理中的改变表明，细胞外囊泡 (EV) 在妊娠中发挥着至关重要的作用。这些 EV 被认为与妊娠病理的发展有关，例如先兆子痫、早产和胎儿生长受限，并被建议作为妊娠疾病生物标志物的来源。然而，为了准确解释其功能和生物标志物潜力，有必要严格评估妊娠群体中使用的 EV 分离和表征方法。在这次系统范围审查中，我们整理了 152 项研究孕妇血液中 EV 的研究结果，并对所使用的 EV 分离和表征方法进行了详细分析。我们的研究结果表明，与非怀孕个体相比，孕妇的 EV 浓度总体增加，随着妊娠的进展，EV 计数增加，并且某些妊娠病理中 EV 计数增加。我们强调需要改进方法标准化，更加关注 EV 浓度的妊娠变化，以及进一步研究 EV 的功能。我们的综述表明，电动汽车作为妊娠疾病的诊断和转化工具具有巨大的前景。然而，为了充分发挥其潜力，提高 EV 分离和表征方法的标准化和可靠性，并更好地了解其在妊娠病理中的功能作用至关重要。