
Histological aspects of remodeling of the placental complex in pregnancy complicated by late preeclampsia with different options for its correction
Author(s) -
U. Ya. Franchuk,
S. V. Khmil,
Yu. M. Orel
Publication year - 2021
Publication title -
vìsnik vìnnicʹkogo nacìonalʹnogo medičnogo unìversitetu
Language(s) - English
Resource type - Journals
eISSN - 2522-9354
pISSN - 1817-7883
DOI - 10.31393/reports-vnmedical-2021-25(3)-07
Subject(s) - pregnancy , preeclampsia , placenta , medicine , placental insufficiency , pathological , fetus , obstetrics , physiology , biology , genetics
Annotation. The study of the problem of preeclampsia is still relevant because it is one of the most common complications of pregnancy and is one of the causes of maternal mortality, ranking second after obstetric bleeding. Perinatal mortality rates vary widely and depend on the severity and duration of late preeclampsia. The aim of the study was to investigate the histological aspects of placental complex remodeling in patients whose pregnancy was complicated by late preeclampsia on the background of metabolic syndrome. Women, pregnancy complicated by late gestosis on the background of metabolic syndrome, were divided into two groups: patients of group I received standard protocol therapy group (31 women), women of group II received preventive, modified, pathogenetically justified therapy – protocol treatment + vitamin D in dose of 2000 IU per day, L-arginine, calcium, magnesium sulfate and salicylates 1 sachet for 10 days (38 patients), group III consisted of 40 women whose physiological pregnancy was without complications and extragenital pathology. The obtained histological specimens were examined using a Nikon Eclipse Ci-E light microscope. The algorithm of histological examination was regulated by the generally accepted protocol of pathological examination of manure. In the first study group there were histological changes, which should be regarded as morphological markers of functional disorders in the system “mother-placenta-foetus”, accompanying late preeclampsia. Metaplasia of the cylindrical epithelium of the foetal surface into a multi-layered flat one was observed in the placental amnion, and in some places increased proliferative activity of epitheliocytes was observed, which formed plaque-like structures and growths. In the second study group, which received a modified treatment, the tissue structure of the manure was also characterized by deviations from the histological picture of the control group. However, the intensity and prevalence of pathological changes were significantly lower than in the first study group. In most of the studied histological sections, the cell structure of the amniotic epithelium was preserved, desquamation was not observed. Circulatory disorders in the villous chorion were present, but the structure of most vessels remained unchanged. Based on the results of histological examination, it can be concluded that a comprehensive, modified therapy of late preeclampsia on the background of metabolic syndrome, allows you to normalize the structure of the placenta.