- Placental Pathomorphological Peculiarities in Parturient Women with the History of Endocrine Infertility
Placental Pathomorphological Peculiarities in Parturient Women with the History of Endocrine Infertility
PERINATOLOGIYA I PEDIATRIYA. 2017.2(70):84-90; doi 10.15574/PP.2017.70.84
Zadorozhna T. D., Tumanova L. E., Kolomiets О. V., Kylyhevych S. М., Stratiychuk H. H.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv
Objective — to conduct a morphological and morphometric analysis of the placental villous and chorionic structures in parturient women with the history of endocrine infertility, which is important for clarifying the pathogenetic mechanisms of placental dysfunction development.
Materials and methods. The study comprised the parturient women (n=34) with the history of endocrine infertility, which was provided with medical assistance during the period of 2015-2016 on the basis of the Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine. The research of placental structural and functional features included organometric, macroscopic, general histological methods. In total 34 placentas were investigated, 28 of which with hyperandrogenism were included in the 1st group; 6 placentas with hyperprolactinemia formed the 2nd group, and the 3rd (control) group was comprised of 10 placentas of parturient women who became pregnant naturally. The obtained morphological data compared with the control group indicated the placental dysfunction in parturient women of the 1st and 2nd groups.
Results. The critical impaired circulation was detected in the villi of all calibres of syncytiotrophoblast in both groups under investigation (the 1st and 2nd ones). In the 1st group, the changes were diffusive in all structures of both the maternal and the fetal surfaces. The most pronounced changes were observed in the placenta with a reduced mass: an increased number of infarctions, fibrosis of the villous chorion, and circulatory disturbances. In the 2nd group, the pathological changes prevailed in the decidual membrane: destructive changes, apoptosis and necrosis in structural cells and stroma of the decidual membrane. In the chorionic villi of the 2nd group, especially in the terminal ones, there was an increase in stromal fibrosis up to 90%.
Conclusions. Based on the performed morphological and morphometric placental analysis in the parturient women with hyperandrogenism and hyperprolactinemia before pregnancy, the important features of the development of placental dysfunction were revealed. The latter is known to be the main cause of antenatal developmental disturbances and fetal distress. It is interesting to know that in women with the history of endocrine infertility, the pathological changes in the placental villous and chorionic structures play a leading role in disturbing the endocrine function of placenta, in particular, in chorionic gonadotrophin, placental lactogen, etc. synthesis.
Key words: morphology and morphometry of placenta, pregnancy, a past medical history of endocrine infertility.
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