СКРИНИНГОВОЕ ПАТОЛОГО-АНАТОМИЧЕСКОЕ ИССЛЕДОВАНИЕ ПОСЛЕДА КАК РЕЗЕРВ ДЛЯ СНИЖЕНИЯ ПЕРИНАТАЛЬНОЙ ЛЕТАЛЬНОСТИ

Abstract

Introduction. The continuity of the morphofunctional system "mother-placenta-fetus" allows for the histological examination of the placenta to reveal risk groups for the newborn, pregnant women, puerperas, and to take out preventive measures. Aim of the research. To study the structure and localization of pathological changes in the placenta and the significance of mass pathomorphological studies as a reserve for reducing infant and perinatal mortality. Materials and methods. The afterbirths were examined according to the algorithm proposed by A.P. Milovanov (1999). Histological examination assessed the maturity of the placenta, the severity of compensatory-adaptive reactions and involutive-dystrophic changes, noted the presence and severity of inflammatory changes both in the placenta (placentitis, intervillusitis, villusitis) and extraplacental membranes (choriodeciduiitis, chorioamnionitis). Results. In a large-scale pathoanatomical examination of placentas, the proportion of normal mature placentas without pathological findings was up to 20%. The main pathological process in the placenta is an acute and chronic inflammation, often combined with chronic placental insufficiency (up to 77%). Among the forms of chronic placental insufficiency, the variant of pathological immaturity predominates – immature intermediate villi. For severe inflammation, the most common localization was noted in the fetal membranes, which reflects the ascending route of intrauterine infection. For chronic inflammation, the most common localization was basal deciduitis and parietal choriodeciduitis, which is associated with a high incidence of latent infectious foci in women. Conclusion. A large-scale pathoanatomical examination of placentas , with the identification of risk groups for newborns, along with other factors, can serve as a reserve for reducing perinatal and early neonatal mortality.