Features of the course of pregnancy at the preeclampsia of varying severity at the present stage

Симанов, И В

doi:10.18821/2313-8726-2020-7-1-47-52

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“…Серед патологічних станів вагітних, схильних до несприятливого перебігу вагітності, значне місто належить прееклампсії (ПЕ), залізодефіцитній анемії (ЗДА) вагітних, запальним процесам у структурних компонентах посліду, насамперед хоріоамніоніту (ХА). Прееклампсія провокує ризик розвитку відшарування плаценти, масивних кровотеч, плацентарної недостатності, синдрому затримки росту плода, передчасних пологів та загалом підвищення перинатальної смертності до 12%, що у 3-4 рази перевищує популяційну [9]. У випадку ЗДА плацентарна недостатність має місце у 25%, слабкість родової діяльностіу 42%, гіпотонічна кровотеча в післяродовому періодіу 47%, гнійно-септичні втратиу 12%, що сприяє збільшенню ризику перинатальної загибелі плода [10].…”

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“…Загроза переривання вагітності мала місце у вагітних усіх груп, найчастіше із залізодефіцитною анемією. Науковці стверджують, що загроза передчасних пологів спостерігається у другій половині вагітності в кожної четвертої пацієнтки з помірною ПЕ і у кожної другоїз тяжкою [9]. У 2/3 матерів із ЗДА в анамнезі є відомості на неспри-ятливий перебіг вагітності та пологів [23].…”

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An analysis of the pathological states of pregnant women in ante-intranatal fetal death in kharkov during 2016-2019

Sherstiuk¹,

Zats²,

Naumova³

et al. 2021

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Background. In Ukraine among perinatal losses, a high proportion of stillbirth remains, the level of which depends on many factors, including the presence of somatic and genital pathology in a woman, pathological conditions during pregnancy, including eclampsia (PE), iron deficiency anemia of pregnant women (IDA), chorioamnionitis (CA). These conditions can be combined with each other, which increases the risk of fetal death during pregnancy or childbirth. Objective. To conduct a somatic and gynecological diseases, complications of pregnancy in pregnant women with preeclampsia (PE), iron deficiency anemia (IDA) and chorioamnionitis (CA), whose pregnancy ended in ante-intrapartum fetal death at 30-40 weeks of gestation. Methods. We investigated 58 cases of stillbirth at 30-40 weeks of gestation from pregnant women with PE (n = 16), IDA (n = 16), CA (n = 26) on the basis of the Communal non-profit enterprise "City Perinatal Center "Kharkov. The clinical data of the mothers, the protocols of the pathological examination of the placenta were studied. Results. Based on the study, it was found that in women whose pregnancy was complicated by PE and IDA, the most frequent types of somatic pathology were hypertensive disorders (32% and 12.5%, respectively) and chronic diseases of the digestive system. (25% and 12.5%, respectively), among gynecological diseases, uterine leiomyoma and endocervicosis were more common, among complications of pregnancy and childbirth - premature birth (50% each, respectively) pathology of the placenta (50% and 68.8%, respectively) and disorders of the content amniotic fluid (31.3% and 18.8%, respectively).The extragenital pathology in pregnant women with CA was presented with the infectious diseases (30.7%), an acute respiratory viral infections (19.2%), the cardiovascular pathology (11.5%), and the chronic inflammatory diseases of various localization (7.6%). The most frequency gynecological pathology were inflammatory genital diseases (23.21%). The pregnancy and labor were often complicated with the placental pathology (50%), premature birth (38.5%), preeclampsia (19.2%), and anemia (19.2%). During pregnancy, placental dysfunction diagnosed only in 31.3% of cases with PE, 25% with IDA and 3.8% with CA, but in pathological examination, morphological signs of placental insufficiency recorded in almost every case of all groups. Conclusion. In pregnancy, aggravated by PE, IDA or CA, the presence of extragenital pathology, gynecological diseases, and other complications of pregnancy were additional factors that increased the severity of placental insufficiency and fetal hypoxia, which was the cause of its death. Timely diagnosis of placental dysfunction and the implementation of therapeutic measures aimed at reducing the associated negative impact on the fetus can help reduce perinatal mortality.

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An analysis of the pathological states of pregnant women in ante-intranatal fetal death in kharkov during 2016-2019

Sherstiuk¹,

Zats²,

Naumova³

et al. 2021

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Immunohistochemical and Morphometric Characteristics of Chorionic Trophoblast and Decidual Cells of Fetal Membranes in Case of Ante-Intranatal Fetal Death

et al. 2021

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The aim: To identify immunohistochemical and morphometric features of chorionic trophoblast cells and fetal membranes derived decidual cells, which were obtained from stillbirths associated with pre-eclampsia, iron deficiency anemia, and acute chorioamnionitis. Materials and methods: The study included 58 fetal membranes of fetuses, who died in the ante-intranatal period. The membranes were divided into 6 obstetric history-based groups: premature (n = 8) and full-term (n = 8) stillbirths complicated by preeclampsia; premature (n = 8) and full-term ( n = 8) stillbirths complicated by iron deficiency anemia, premature (n = 10) and full-term (n = 16) stillbirths complicated by chorioamnionitis. A control group consisted of 8 membranes obtained from physiological pregnancies followed by the birth of a live full-term baby. Samples (rupture site) were probed with cytokeratin to identify the fetal trophoblast layer of the chorion and with vimentin for further identification of the decidual cells. The thickness of the trophoblastic layer, expression levels of cytokeratin and vimentin were determined. Results: A decrease of the cytokeratin expression by the chorionic trophoblasts and a thinning of the chorionic trophoblast cell layer due to an increasing gestational age were shown in case of the mentioned pathological conditions. In comparison with the control group, the level of vimentin expression by decidual cells was increased in case of full-term pregnancy complicated by preeclampsia, decreased in pregnancies complicated by chorioamnionitis, and remained unchanged in case of accompanying anemia. Conclusions: The changes in the studied immunohistochemical parameters are more pronounced in case of chorioamnionitis, which indicates more severe morphological and functional changes.

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Features of the course of pregnancy at the preeclampsia of varying severity at the present stage

Cited by 2 publications

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An analysis of the pathological states of pregnant women in ante-intranatal fetal death in kharkov during 2016-2019

An analysis of the pathological states of pregnant women in ante-intranatal fetal death in kharkov during 2016-2019

Immunohistochemical and Morphometric Characteristics of Chorionic Trophoblast and Decidual Cells of Fetal Membranes in Case of Ante-Intranatal Fetal Death

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