Abstract
Introduction. The prevalence of acute and chronic liver diseases in pregnant women increases every year, which is associated with a high risk of adverse outcome for the mother and fetus. At the same time, the mechanisms that ensure an increase in uterine mass, structural changes in the myometrium before childbirth and the process of postpartum involution of the uterus to the initial mass, the participation of molecular cellular mechanisms in pregnant women with liver pathology, and ways to correct it remain poorly understood. Aim. The aim of the study was to investigate morphological changes in the myometrium, during pregnancy and the late postpartum period in the myometrium of mice with acute CCl4-induced hepatosis and under conditions of its correction with immobilized hyaluronidase. Materials and methods. The experiment was performed on 200 female pregnant mice of the C57B1/6 line at two months of age. Acute toxic hepatosis was modeled by a single injection of tetrachlormethane. Correction of acute hepatosis was performed on the next day after administration of tetrachloromethane and subsequent days of pregnancy with a single injection of immobilized hyaluronidase. The animals were divided into 4 groups: a group with physiological pregnancy, animals with the immobilized hyaluronidase drug injection; animals with acute hepatosis; animals with acute hepatosis treated with immobilized hyaluronidase. Uterine samples were collected on the 18th, 21st days of pregnancy and on the 1st, 5th, 10th, 15th days after delivery. Results. The volume density (Vv) of myocytes in the state of apoptosis, interstitial cytoplasmic conglomerates, which are products of clasmacytosis, and necrotized myocytes were calculated, as well as the numerical density (Nai) of myocytes with positive expression of the p53 protein. Under conditions of acute hepatosis, structural transformations of the myometrium in the form of an increase in clasmacytosis, necrotized myocytes occur already during pregnancy. The main structural mechanism of the process of postpartum involution of the myometrium of mice in conditions of acute hepatosis in the long-term period of postpartum involution was clasmacyto sis and, to a lesser extent, necrosis of myocytes. The processes of myometrial involution in mice under conditions of acute hepatosis slow down and do not complete by the 15th day of the postpartum period. When correcting acute hepatosis with immobilized hyaluronidase, the volume density of cytoplasmic conglomerates, apoptotically altered myocytes and necrotized myocytes decreases from the 1st to the 15th day of the postpartum period, which indicates the completeness of postpartum uterine involution. Conclusion. Liver damage is accompanied by a change in the metabolism of sex hormones, which leads to an abnormality of the mechanisms of postpartum involution of the uterus, as well as its structural changes before childbirth.
Published Version
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