Differential clinical and morphological approach to the study of placental calcification

A. Kaplin, T. Pavlova, Alevtina I. Fetisova, Karina R. Kaplina, K. E. Kelyamova
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Abstract

Objective: to detect possible causes of calcification of the placenta, identify patterns between excessive deposition of fibrinoid, calcium salts and various disorders in the mother-placenta-fetus system. Materials and methods. 6,089 afterbirths and placental tissue sections were examined, of which 193 specimens complying with the purpose of the study were further studied and divided into three groups (group of biological norm; afterbirths in which there is fibrinoid deposition without accompanying calcification; afterbirths with pronounced deposits of calcium salts). Each section of placental tissue was studied macro- and microscopically according to the method of A.P. Milovanov and A.I. Brusilovsky to reveal structural and functional changes. Statistical processing of the results was performed using methods of descriptive statistics, nonparametric methods: compilation of contingency tables, calculation of Pearson's χ2 test with Yates correction. Results. It was found that all the afterbirths studied had similar macroscopic characteristics. Microscopic examination revealed that calcification contributes to a more pronounced separation of the lobules of the maternal part of the placenta. Various inflammatory, alterative processes, as well as hemodynamic disorders in the placental tissue contribute to the deposition of calcium salts. Conclusion. The involutive processes observed in normal aging of the placenta become most pronounced in various pathological processes in the mother-fetus-placenta system. The study revealed a statistically significant relationship between the number of labor and the appearance of calcifications in the placental tissue. Large focal deposits of calcium salts were more often observed in women who gave birth not for the first time.
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胎盘钙化的鉴别临床及形态学研究
目的:探讨胎盘钙化的可能原因,确定纤维蛋白、钙盐过量沉积与母体-胎盘-胎儿系统各种疾病之间的关系。材料和方法。共对6089例产妇及胎盘组织切片进行检查,其中符合研究目的的193例标本进行进一步研究,分为三组(生物规范组;产后有纤维蛋白沉积,但未伴有钙化;有明显钙盐沉积的后代)。根据A.P. Milovanov和A.I. Brusilovsky的方法对胎盘组织各切片进行宏观和微观观察,以揭示其结构和功能的变化。采用描述性统计、非参数方法对结果进行统计处理:编制列联表、计算Pearson’s χ2检验并进行Yates校正。结果。结果发现,所研究的所有新生儿具有相似的宏观特征。显微镜检查显示,钙化有助于更明显的分离胎盘的母体部分的小叶。胎盘组织中的各种炎症、替代过程以及血流动力学障碍都有助于钙盐的沉积。结论。在胎盘正常衰老过程中观察到的对合过程在母亲-胎儿-胎盘系统的各种病理过程中最为明显。该研究揭示了产程次数与胎盘组织钙化之间的统计学意义。较大的局灶性钙盐沉积更常见于非第一次分娩的妇女。
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