Etiopathogenetic aspects of placental dysfunction in women with miscarriage (literature review)

Abstract

Advances in perinatology have revealed new problems related to the gestational process and antenatal protection of the fetus. Among them, the leading place belongs to chronic placental insufficiency (CPI). One of the main causes of CPI is miscarriage. The aim of the work is to consider the main aspects of the etiology and pathogenesis of the development of placental insufficiency in women with miscarriage. The article covers the issues of etiology, as well as the main pathogenetic ways in the development of placental dysfunction in women with miscarriage. Risk factors, mechanisms of development of placental insufficiency (PI), and also its forms depending on etiological factors are allocated. The peculiarities of the morphological structure of the placenta in women with this pathology in early and late gestation terms, their impact on the subsequent course of pregnancy, development and condition of the fetus are considered in detail. The relationship between structural changes in the placenta and clinical manifestations of PI is shown. The influence of rheology and hemodynamic disorders on the condition of the fetus is highlighted.Conclusions. There are a large number of etiological factors that lead to the development of placental insufficiency. However, for a variety of reasons, this pathology has key pathogenetic ways, which are common for different forms. Knowledge of the causes of placental dysfunction during miscarriage, features of pathogenesis and morphological changes that develop even in early terms of gestation has a great clinical importance, because it will contribute to the development of methods of early prevention and pathogenetically conditioned correction of this pathology.