CLINICO-MORPHOLOGICAL PARALLELS OF PLACENTAL DYSFUNCTION AGAINST THE BACKGROUND OF LOW PLACENTATION

Abstract

Introduction. Complications of pregnancy, which cause high perinatal morbidity and mortality, are accompanied by pathological changes in the placenta, namely, placental dysfunction (PD). 50.7% of PD are diagnosed in pregnant women with a low‐lying placenta (LLP). Aim. Тo study the pathomorphological parameters of placental dysfunction against the background of low placentation. Morphological and histometric features of the placenta from pregnant women with placental dysfunction (PD) against a background of low placental location were studied. The conducted studies show that the formation of placental dysfunction in pregnant women with a low location of the placenta is due to the violation of the physiological mechanisms of the formation of the feto-placental system in the first and second trimesters of gestation, as evidenced by: the predominance of the placenta of oval and anomalous forms (pleated, waist, with additional lobules ); the domination of the eccentric type of attachment of the umbilical cord and the main and intermediate types of branching of vessels. The manifestation of a positive type of compensatory-adaptive reactions at the organ level was a reduction in the thickness of the placenta in combination with an increase in the area of its maternal surface. A negative type of reaction in women with PD on a background of low placentation is a decrease in the volume of the placenta. At the tissue level in placentas from women with PD on a background of low placentation, compensatory-adaptive reactions were diagnosed in 70% of cases: a high percentage of terminal villi (69.4%), terminal villi with SCM (62.3%) and syncytial knots formation (29.5%), increased vascularization of villi (29.5%). In 25% of cases the degree of compensatory-adaptive reactions was significantly lower than in the control. Conclusions. In pregnant women with abnormal placentation, it is advisable to prevent the development of placental dysfunction from early gestation.