CLINICAL AND DIAGNOSTIC CHANGES IN INTRAUTERINE GROWTH RETARDATION

Berezhna V. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

. Intrauterine growth of the fetus depends on the placenta. Pathological changes in it are directly related to the support of fetal development and the predicted development of complications in the neonatal period. The placental factor, which manifests itself as dysfunction of the placenta, is a key element in the formation of intrauterine growth retardation. So, studying the adaptive and pathological changes in the placenta, it is possible to explain the reason that underlies the formation of fetal growth retardation. Purpose of the work. To assess the features of obstetric-gynecological, infectious history and to assess morphometric changes in the placenta to determine risk factors for intrauterine growth retardation. Results. Among the obstetric and gynecological diseases of women in the main group, chronic adnexitis was significantly more common in 12.2% (p=0.26), ovarian cysts – 7.3% (p=0.45), menstrual irregularities – 7.3% (p=0.45), with a predominantly combined pathology. Among obstetric pathology, the main share is occupied by acute respiratory viral infections or acute respiratory diseases (60.97%), anemia (43.9%), preeclampsia (29.27%) and the threat of preterm birth (60.98%). There is also a high incidence of bacterial carriage (9.75%, p=0.68 and 24.4%; p=0.057) and TORCH infection (51.2%). Morphometric examination of the placental tissue revealed a decrease in the number of vessels (3.17±0.28 and 3.16±0.06), their average diameter (13.74±0.61 μm and 11.7±0.28 μm), thinning of syncytiotrophoblast (3.11±0.03 μm and 4.12±0.02 μm), increase in syncytiocapillary membranes (32.34±0.4% and 16.2±0.23%). Conclusions. Our data showed that intrauterine growth retardation of the fetus may indicate a complex relationship between obstetric and gynecological diseases together with infection, which are combined and affect the formation of placental dysfunction, and then the adequate growth of the fetus.

obstetric and gynecological diseases, infection, placental morphometry, intrauterine growth retardation.

1. Miller SL, Huppi PS, Mallard C. The consequences of fetal growth restriction on brain structure and neurodevelopmental outcome. J Physiol. 2016;594(4):807-23.
2. Burton GJ, Jauniaux E. Pathophysiology of placental-derived fetal growth restriction. Am J Obstet Gynecol [Internet]. 2018;218(2):745-61. Available from: https://doi.org/10.1016/j.ajog.2017.11.577
3. Gromova AM, Berezhna VA. Etiologicheskiye i patogeneticheskiye aspekty zaderzhki vnutriutrobnogo razvitiya. Visnyk Ukrayinsʹkoyi medychnoyi stomatolohichnoyi akademiyi «Aktualʹni problemy suchasnoyi medytsyny». 2018;3(63):301-7. [in Russiаn].
4. Hromova AM, Berezhna VA. Akushersʹki ta antenatalʹni faktory ryzyku vnutrishnʹoutrobnoho obmezhennya rostu. Zaporizʹkyy medychnyy zhurnal. 2020;22(3):395-401. [in Ukrainian].
5. Chen A, Roberts DJ. Placental pathologic lesions with a significant recurrence risk – what not to miss! APMIS. 2018 Jul;126(7):589-601. DOI: 10.1111/apm.12796
6. Redline RW. Classification of placental lesions. Am J Obstet Gynecol [Internet]. 2015;213(4):21-8. Available from: http://dx.doi.org/10.1016/j. ajog.2015.05.056
7. Lash GE, Pitman H, Morgan HL, Innes BA, Agwu CN, Bulmer JN. Decidual macrophages: key regulators of vascular remodeling in human pregnancy. J Leukoc Biol. 2016 Aug;100(2):315-25. DOI: 10.1189/jlb.1A0815-351R
8. Avtandilov GG. Meditsinskaya morfometriya. Moskva: Meditsina; 1990. 384 s. [in Russian].
9. Pasiyeshvili NM, Lupoyad VS, Il’chenko VA, Moshko YuA. Platsentarnaya disfunktsiya (nedostatochnost’) i zaderzhka rosta ploda. Mízhnarodniy medichniy zhurnal. 2019;1:43-51. [in Russian].
10. Glukhovets BI, Glukhovets NG. Patologiya posleda. SPb: Graal’; 2002. 448 s. [in Russian].
11. Antipkin YuG, Zadorozhnaya TD, Parnitskaya OI. Patologiya platsenty (sovremennyye aspekty). Kiyev: 2016. 127 s. [in Russian].

«Bulletin of problems biology and medicine» Issue 4 (158), 2020 year, 96-100 pages, index UDK 618.33 - 071

10.29254/2077-4214-2020-4-158-96-100