Ultrasound and morphological features of the placenta in women giving birth for the first time, of different reproductive ages

Abstract

DOI: 10.52705/2788-6190-2026-01-4
УДК 683.3:618.36-07:618.36-094:613.1:618.2

The objective: to conduct an analysis of the ultrasound and morphological features of the placenta in women giving birth for the first time, of different reproductive ages, to predict and optimize obstetric tactics in this category of pregnant women.
Materials and methods. The study of echographic and morphological features of the placenta was conducted in women giving birth for the first time of different reproductive ages: 286 histories of pregnancy and childbirth of women who were divided into groups: Group I of the study – 174 pregnant women giving birth for the first time: subgroup IA – 85 women aged 20–29 years, subgroup IB - 89 pregnant women aged 30–40 years; Group II – 112 pregnant women giving birth again: IIA – 54 pregnant women aged 20–29 years, IIB – 58 pregnant women aged 30–40 years. Placentagraphy was performed to determine the localization of the placenta, its thickness, degree of maturity, structure and pathological changes. For the morphological analysis of structural changes in the placenta, the following methods of research were used: organometric, macroscopic, general histological and histochemical,
Statistical processing of research results was carried out using standard programs «Microsoft Excel 7.0» and «Statistica 8.0»
Results. In group I, the placenta was located on the anterior uterine wall (38.8 % and 39.3 %; p = 0.001), mainly due to the IB subgroup, compared with the PB group (29.6 % and 31.0 %; p = 0.032); on the posterior uterine wall (45.9% and 49.4 %; p = 0.001), significantly less due to the IB subgroup, compared with the IIB subgroup (70.4 % and 62.15 %; p = 0.001); on the lateral uterine wall, significantly more (16.5 % and 10.1 %; p = 0.038) due to the IA subgroup, compared with the PA subgroup (3.7 % and 3.4 %; p = 0.010). The percentage of pregnant women with low placentation (11.8 % and 12.4 %, p = 0.001) in subgroups IA and IB was higher due to the IB subgroup versus 5.6 % and 3.4 % in subgroups IIA and IIB, p = 0.010 and p = 0.033). The number of pregnant women in subgroups IA and IB with normal placenta structure was significantly lower (5.9 % and 4.5 % versus 100.0 % and 32.7 %; p = 0.001), with the presence of dystrophic changes (calcifications of calcium salts) was significantly higher (87.1 % and 89.9 %; p = 0.001) versus subgroups IIB – 67.3 %; p < 0.05, and degenerative changes (cystic formations) in the structure of the placenta diagnosed only in group I (7.1 % and 5.6 %).
Conclusions. The structural and functional features of the fetoplacental complex of women giving birth for the first time, regardless of reproductive age, are characterized by significantly worse ultrasound placentometry indicators, a significant decrease in compensatory and adaptive reactions of the placenta, and involutional, pathological changes and their combinations are more often diagnosed in them.