Влияние непрерывного профилактического приема ацетилсалициловой кислоты на гистологическую картину плаценты у беременных группы высокого риска развития задержки роста плода

Abstract

Background: fetal growth restriction (FGR) is the main cause of perinatal mortality. We have relatively effective methods of predicting and preventing this condition, however, it has not yet been possible to achieve a significant reduction of the FGR incidence. Acetylsalicylic acid (ASA) is the only effective pharmacological method for the prevention of FGR, but the mechanism of its action is still in doubt. Aim: to study the placental morphology in pregnant women at high risk of FGR according to the first trimester screening (FTS), depending on whether female patients took ASA for the FGR prevention or not. Patients and Methods: the study was conducted in 2019–2021. By that time, the clinical recommendations concerning «Insufficient fetal growth requiring the provision of medical care to the mother (fetal growth restriction)», developed by the Ministry of Health of the Russian Federation, had not yet come into effect. In a prospective analysis, the placental morphology of 125 pregnant women at high risk of FGR and 554 placentas of pregnant women at low risk was studied according to the FTS results. Pregnant women at high risk of FGR were divided into 2 groups: 51 female patients received ASA from 14 to 36 weeks pregnant, 74 did not receive ASA; the control group consisted of 554 pregnant women at low risk of FGR according to the FTS. The placenta was examined in 3 stages according to the conventional management scheme, including macroscopic analysis, material incisure and histology. Results: placental pathological changes (dystrophic changes, syncytial knots formation, fibrinoid deposition, disorders of placental villous maturation) in patients who did not receive ASA were significantly more common than in the control group and in the subgroup receiving ASA. Conclusion: FGR incidence decrease in patients receiving ASA was due to an improvement in the histological structure of the placenta. KEYWORDS: fetal growth restriction, small for gestational age, placenta, acetylsalicylic acid. FOR CITATION: Shamugiya V.V., Kuznetsov P.A., Dobrokhotova Yu.E. Effect of the continuous prophylaxis with acetylsalicylic acid on the placental histological image in pregnant women at high risk of fetal growth restriction. Russian Journal of Woman and Child Health. 2024;7(1):12–17 (in Russ.). DOI: 10.32364/2618-8430-2024-7-1-2.