Integration approach to study placental vessels in preeclampsia

Abstract

Introduction. Preeclampsia is key in obstetric pathology, which is one of the causes of maternal and perinatal morbidity and mortality. It is due to the difficulties of diagnosis, variable clinical picture, severity, and high risk of an unfavorable outcome. This problem requires special attention not only from obstetricians and gynecologists, but also from pathologists who make intravital morphological diagnosis ofplacenta in women with preeclampsia. The purpose of the study was to perform amorphological, morphometric, and immunohistochemical analysis of obliterative angiopathy in the vessels of placental stem villi with preeclampsia of varying severity. Materials and methods.We studied 60 placentas, 40 of which were from women having preeclampsia of varying severity, as well as 20 healthy placentas (the comparison group). For morphometric studies, an automated histological analysis system Leica Application Suite hardware and software module based on a Leica DM4000B microscope was used. The immunohistochemical study was carried out with markers CD34, VEGF-A, and endothelial NOS. Results. We established a directly proportional relationship between the degree of preeclampsia and the severity of arteriole lumen obliteration of the stem villi, and accordingly the degree of placental insufficiency. The most pronounced disorders of fetoplacental circulation were observed in combined severe preeclampsia and extragenital pathology. Conclusion. The data obtained allow us to confirm the significance of obliterative angiopathy in preeclamptic placentas as an integral component. Prevention of ischemic changes in the placenta, where obliterative angiopathy of the villus vessels plays a leading role, is an urgent medical problem that requires an objective approach to predict the condition of the newborn. Keywords: preeclampsia, placenta, obliterative angiopathy, morphometric, immunohistochemical study