MORPHOLOGICAL AND IMMUNOGISTOCHEMICAL CHARACTERISTICS OF PLACENTAL DISORDERS IN WOMEN WITH PREECLAMPSIA IN PREGNANCY AFTER ART

Abstract

Pregnancy resulting from the use of ART is classified as a high risk of preeclampsia. The etiology of preeclampsia is not well understood.The aim of the research was to study the morphological and immunohistochemical signs of placental abnormalities in women with preeclampsia during pregnancy after ART.Materials and research methods. A pathomorphological and immunohistochemical study was carried out on 20 placentas of women in the main group who became pregnant after using ART: 10 placentas of women with preeclampsia and 10 placentas without preeclampsia, 10 placentas of healthy women with spontaneous physiological pregnancy (control group). Monoclonal antibodies to the CD31 + factor, VEGF and von Willebrand factor were used.The results of the research. For women with preeclampsia, pronounced phenomena of degenerative changes in the tissue of the membranes of the placenta and placental tissue are characteristic. Cases with moderate inflammatory infiltration in the placental membranes were observed. Characteristic were manifestations of severe subtotal fibrinoid villi necrosis with severe degenerative-sclerotic changes in the presence of lipid metabolism disorders, the phenomenon of syncytiotrophoblast hyperplasia with the formation of nodules and manifestations of blood rheology disorders. On the fruit surface of the membranes, layering of fibrin with an admixture of lymphohistiocytic inflammatory infiltration is noted, in the lumens of the vessels - parietal formation of fibrin thrombi with the phenomena of erythrolimphostasis. In the majority (70%) of the placenta, hemorrhages were noted, located mainly around the vessels. An immunohistochemical study with monoclonal antibodies to CD31 + showed a marked decrease in the expression of endothelial cells after ART with preeclampsia of a relatively high level of expression in physiological pregnancy. The high and increased level of expression of von Willebrand factor after ART corresponds to the severity of sclerotic and thrombotic changes in the tissue of the placenta. A high level of VEGF expression during preeclampsia was revealed compared with a slight expression during physiological pregnancy.Findings. In the placenta of women with preeclampsia, immunohistochemical studies revealed pronounced changes indicating the presence of endothelial dysfunction, sclerotic and thrombotic changes, and instability of the vascular wall. Both pathomorphological and immunohistochemical changes in the placenta were more pronounced with the early development of preeclampsia, which corresponds tomodern views on the placental origin of early preeclampsia and non-placental - late.