Stem cells in gynecology and obstetrics.

Over the past 10 years, we have become involved in a new research effort and an increasing scientific interest in the field of stem cell-based therapy. We are therefore able to describe different areas in which stem cell research can be applied and developed in gynecology and obstetrics. I) Hematopoietic stem cells have been used to set up therapeutic strategies for the treatment of gynecological solid tumors such as ovarian cancer. In this context different autologous or allogeneic transplantation approaches have been proposed and clinically investigated. II) Umbilical cord blood, which was often considered a waste material of the delivery, actually represents a precious source of stem cells that can be used for cell-based treatments of malignancies and inherited diseases. III) A feto-maternal cell traffic has recently been demonstrated through the placental barrier during pregnancy. This cellular exchange also includes stem cells from the fetus, which can generate microchimerisms in the mother and contribute to tissue repair mechanisms in different maternal organs. IV) Stem cells can be used for prenatal transplantation to treat different severe congenital diseases of the fetus. Nevertheless, several problems need to be solved to achieve an efficient in utero stem cell transplantation. Recent reports have pointed out the importance of timing in prenatal stem cell transplantation procedures and have shown the advantage of an early stem cell injection. An ultrasound-guided intracelomic approach could allow this possibility.