PATHOMORPHOLOGY OF PLACENTA IN WOMEN WITH PRETERM BIRTHS AT DIFFERENT AGE OF GESTATION

Abstract

The aim: to identify pathological characteristics of placenta in women with preterm labor according to the gestational age.

Materials and methods. The study involved 55 women who gave birth prematurely: 21 women with gestational age from |22 to 32 weeks (group 1) and 34 women with gestational age from 32 to 37 weeks (group 2). All the women had spontaneous singleton pregnancies followed by preterm spontaneous births. We conducted a comparative analysis of the social, clinical and amnestic information, as well as a histopathological study of the placentas; the latter included macroscopic description, organometry and microscopic morphology. The analysis aimed to identify the placental factors associated with the premature delivery occurred before and after 32 weeks of gestation.

Results. The study revealed a number of anamnestic and clinical factors associated with preterm births. At a gestational age up to 32 weeks, the placentas showed hypoplasia with a mass deficit of more than 30% in combination with proliferative vylusitis, post-inflammatory hypovascularization, abnormal differentiation of the vascular-stromal component of the villi, and insufficient compensatory and adaptive reactions. After 32 weeks of pregnancy the placenta characteristics included chronic disorders of the maternal and fetal blood circulation, compensatory hyperplasia of the terminal villi, capillaries and their syncytia capillary membranes.

Conclusion. There is a need for individual rehabilitation programs for women with the history of preterm births that would include their clinical and anamnestic background together with the pathomorphological characteristics of their placentas. Such a program is expected to help these women to be better prepared prior to their subsequent pregnancy.