MORPHOLOGICAL AND IMMUNOLOGICAL CHANGES IN STRUCTURES FETUS-PLACENTAL BARRIER IN WOMEN WITH TORCH - INFECTIONS IN ANAMNESIS

Abstract

Formation of chronic placental insufficiency in the stage of decompensation in pregnant women promotes intrauterine infection of the child.Today, histologic, morphological and immunohistochemical changes of the placenta in women with TORCH infections in the anamnesis. At TORCH-infection there are considerable infringements of mechanisms of functioning of a feto-placental barrier. Identifying these features should be an additional criterion for early diagnosis of perinatal infections in newborn risk groups.The aims. To evaluate macroscopic, histological, morphological and immunohistochemical changes in the placenta and to prove violation of the feto-placental barrier of women with TORCH-infections in the anamnesis.Materials and methods of research. 40 placens of women were investigated. The I group - 20 placenta of women with transmitted TORCH - infections in the anamnesis (confirmed immunologically during pregnancy transmitted of CMV, herpesvirus and toxoplasmic infections); The II group of control - 20 placets of healthy women with the physiological couse of pregnancy. In the placenta study, organometric, macroscopic, and general histological methods were used. Immunohistochemical - indirect streptavidin-peroxidase method of detecting the level of expression of the marker of proliferation and regeneration of Ki-67. Histochemical method - DNA according to Felgen with the following definition of apoptosis index.Results of the research. In the micro and macroscopic study placenta from mothers with transmitted TORCH infections revealed significant changes: an increase in the mass of the placenta (50%), thickening of the umbilical cord (75%), moderate swelling of precious candles (75%), vasculitis (30%), amniotic edema (30%), inflammatory infiltration in the decidua (25%), chorionic plate (35%), intervertebral space (30%), stroma villi (25%), vessels (30%); impaired blood circulation and degenerative changes in the decidua (50%). Distribution of calcifications (30%) in the regional and paracentral zones of the placenta. The uneven intensity of the DNA reaction in the placental barrier structures and a significant increase in the apoptotic index indicate an injury and a violation of their development. Immunohistochemically increased increase in expression levels of the proliferative marker KI-67 and the index of the proliferative index.Conclusions. Identified macroscopic and histological changes in the state structures feto-placental barrier in women with TORCH-infections indicate that they placental insufficiency due to productive vascular-cell response in the stroma of villi and decidua membrane and possibly the result the effects of viruses and toxoplasma. The findings should be taken into account by neonatologists for more careful monitoring of newborns at risk for perinatal infection from mothers with TORCH-infected history.