This study assessed the effect of 20 and 6% ambient oxygen (O(2)) or 5-50 micromol/l hydrogen peroxide (H(2)O(2)) on apoptosis, necrosis, proliferation and fusion of BeWo cells. The expression of p53, Mdm2 and Bax was assessed by western blotting. Apoptosis was increased in cells cultured in 6% O(2) tension and 50 micromol/l H(2)O(2) (P < 0.05, P < 0.01 by ADP:ATP ratio). In the same conditions, cell viability as estimated by the MTT assay was decreased (6% O(2) P < 0.01, 50 micromol/l H(2)O(2) P < 0.05). Human chorionic gonadotrophin secretion was decreased by culture in 6%O(2) and 50 micromol/l H(2)O(2) (P < 0.05). Cell fusion was also decreased by treatment with 50 micromol/l H(2)O(2) (P < 0.05). Treatment with 50 micromol/l H(2)O(2) was associated with increased expression of p53 and decreased expression of Mdm2 (P < 0.05). This study provides evidence that BeWo cell turnover is altered following exposure to hypoxia or ROS. It is concluded that BeWo cell culture is an appropriate model for investigating the regulation of trophoblast cell turnover. In addition, these data support a role for p53 in mediating altered trophoblast cell turnover in response to oxidative stress.