Peculiarities of the morphology of the placenta of women with premature birth

Abstract

The objective: аnalysis of the features of the morphological structure of the placenta of a woman who had complications from the group of main obstetric syndromes, which clinically constantly occur with previous defects. Materials and methods. The research was conducted according to the principles of the Declaration of Helsinki. The protocol of research was proved by the local ethical committee, mentioned in the institution’s work. An informed sonnet was collected to carry out the research. The study of the features of the morphological structure of the placenta of women was carried out - the main group (OG) of n=28 pregnant women with spontaneous preterm birth (PB) at a gestation period of 24-36 weeks and 6 days. The control group (CG) consisted of 20 placentas of practically healthy pregnant women with a healthy reproductive history and an uncomplicated course of this pregnancy. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs. Results. The presence of inflammatory diseases of the lower parts of the reproductive system and urinary tract in pregnant women contributes to the development of membranitis (rs=0.42 and rs=0.31 respectively; p<0.05) and omphalovasculitis (rs=0.45 and rs=0,35 respectively; р<0.05). Fetal development delay syndrome is associated with the presence of involutive-dystrophic changes in the litter and dissociation of villi (rs=0.37 and rs=0.51 respectively; р<0.05). At the same time, there are no compensatory-adaptive reactions and pronounced involutional-dystrophic changes and signs of villous maturation disorder in the placentas. An increase in the duration of the waterless interval is associated with the development of membranitis, omphalovasculitis, and pneumonia in the newborn (rs=0.36, rs=0.41, rs=0.57 respectively; p<0.05). During the morphological examination of the placentas, inflammatory changes of varying severity were observed in all placentas. Omphalovasculitis was statistically significantly more frequent(p=0.04) in women with PB and in all cases was combined with the presence of membranes. The presence in the placenta of membraneous, omphalovasculitis and the presence of involutional dystrophic changes is associated with the development of clinical manifestations of chorioamnionitis and pneumonia in a newborn (rs=0.53, rs=0.52, and rs=0.40, respectively; p<0.05). In the placentas of women with PB, compensatory and adaptive reactions are statistically significantly less frequent (p=0.00001) and involutive-dystrophic changes (p=0.00001), blood circulation disorders (p=0.0009) and villi dissociation are statistically significantly more frequent; р=0.02). Conclusions. Feature of the morphological structure of the placenta in women with premature birth is the frequent detection of inflammatory changes, signs of villous maturation disorders and involutional-dystrophic changes, and the absence of compensatory and adaptive reactions.