The purpose of the study was to establish the organometric features of the placenta without disturbing the chorionic tree maturation processes against the background of iron deficiency anemia during pregnancy in two periods of gestation – 29-32 and 33-36 weeks. Materials and methods. A total of 103 placentas were examined. The object of the study was placental chorionic tree at two gestational periods – 29-32 and 33-36 weeks in combination with iron deficiency anemia in gravidas. The study of the placenta at the organ level involved the determination of the basic organometric parameters, umbilical cord and free amniotic membranes, the evaluation of the attachment of the umbilical cord to the organ, the type of branching of the chorionic plate, descriptive characteristics of the maternal surface of the placenta with assessment of cotyledons. Placenta’s weight, thickness, maternal surface area and volume of each placenta were determined. The determination of gestational period is based on a combination of two principles: morphological stages of development of the chorionic tree of the placenta and clinical affiliation of the material (premature birth). The planning of the required number of observations in each study group was determined on the basis of calculations of a sufficient number for the specific statistical method used at a sensitivity level of 0.80 and a significance level of p = 0.05. Results and discussion. In both study groups with normal maturation of the chorionic tree of the placenta in combination with iron deficiency anaemia during pregnancy, the degree of maturity of the chorionic tree does not reach the level of physiological pregnancy, p<0.001. At the gestation period of 29-32 weeks, intermediate mature and terminal chorionic villi predominate histologically. At 33-36 weeks, terminal chorionic villi are significantly predominant. For both terms, fibrinoid is found in the form of a continuous or sometimes intermittent layer that covers the villus on its surface from the outside. A high percentage of trophoblastic and villous growths is characteristic, which is associated with the strengthening of the phenomena of regeneration of damaged villi. Conclusion. Iron deficiency anaemia during pregnancy affects the development of the chorionic tree of the placenta – the degree of maturity of the chorionic tree does not reach the level of physiological pregnancy; the phenomena of regeneration of damaged villi are enhanced. Regardless of the gestation period, the volume of the placenta does not reach the level of a physiological pregnancy. Iron deficiency anaemia during pregnancy can potentiate premature birth in women at 29-32 and 33-36 weeks of gestation

The purpose of the study is to establish quantitative parameters of cell proliferation and apoptosis in the trophoblast of the chorionic villi in chorioamnionitis and basal deciduitis combined with iron-deficiency anemia in gravidas by means of immunohistochemical method. Materials and methods. 198 placentas were examined. The immunohistochemical procedure was performed using primary antibodies against Ki-67 and Bax antigen with imaging by a polymer system with diaminobenzidine dye. The number of Ki-67-positive nuclei of the chorionic villi trophoblast was counted, and for the Bax antigen, the optical density of the immunohistochemical staining was measured by means of microdensitometric method. Comparison of differences in mean trends was performed using the odd Student’s two-sided t-test (p≤0.05). Results and discussion. The number of Ki-67-positive trophoblast nuclei in acute chorioamnionitis with iron-deficiency anemia in gravidas was 56±3.8 ‰, and the relative units of optical density of immunohistochemical staining for protein Bax – 0.234±0.0012, in chronic – 59±3.6 ‰ and 0.2, respectively. The number of Ki-67-positive nuclei of the chorionic villi trophoblast was counted. Placentas with acute as well as chronic chorioamnionitis and basal deciduitis showed even higher averages (p <0.001). In acute basal deciduitis in anemia, the number of Ki-67-positive trophoblast nuclei was 56±3.2 ‰, the average optical density of immunohistochemical staining for protein Bax – 0.236±0.0016, in chronic – 57±3.7 and 0.249±0.0015, respectively. It should be noted that in chronic chorioamnionitis and basal deciduitis, these rates were higher than in acute. With the same regularity the average indicators of optical density of immunohistochemical staining on protein Bax in a trophoblast of chorionic villi at comorbid iron-deficiency anemia concerning an inflammation without anemia increase. We have shown that proliferative activity in iron-deficiency anemia varies with gestational age and placental prematurity, but iron-deficiency anemia in gravidas and chorionic tree maturation both individually and in combination lead to the intensification of these processes. We obtained a justification for the arithmetic mean thickness and volume of the placenta relative to observations of placenta with inflammation without anemia in this comorbid pathology. Conclusion. Iron-deficiency anemia in gravidas leads to the intensification of proliferative processes and Bax-dependent apoptosis in the trophoblast of the chorionic villi of the placenta relative to the placenta from physiological pregnancy. In acute as well as in chronic chorioamnionitis and basal deciduitis, the proliferative activity and apoptotic processes in the trophoblast of the chorionic villi of the placenta increase, while comorbid iron-deficiency anemia in gravidas intensifies only the processes of Bax-dependent apoptosis