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

Abstract

DOI: 10.52705/2788-6190-2023-04-1
УДК 618.396:618.36-094-039

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 principles of Declaration of
Helsinki . Protocol of research was proved by local ethical committee, mentioned in institution’s
work. A informed sonsennt was collected in order 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 severitywere 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 membranitis.
The presence in the placenta of membranitis, omphalovasculitis and the presence of involutionaldystrophic
changes is associated with the development of clinical manifestations of choriamnionitis
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.