肥胖母亲胎盘组织学和氧化应激状态的评价

Harith Al-Ali, L. Al-Allaf
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引用次数: 1

摘要

背景:肥胖是影响育龄妇女的最普遍的医学问题之一。目的:探讨肥胖母亲胎盘的变化及其与氧化应激的关系。方法:本研究是一项前瞻性病例对照研究,从2020年1月至2020年3月在伊拉克北部摩苏尔Al-Khansaa妇产教学医院分娩的60名单胎孕妇中获取胎盘。这些女性被分为三组:第一组:包括BMI在18-24.9 kg/ m2之间的(对照组)女性(N=20),第二组:(超重)包括BMI在25-29.9 kg/ m2之间的女性(N=20),第三组:(肥胖)包括BMI≥30 kg/ m2的女性(N=20)。每个病例分别从母侧和胎侧进行了两次胎盘活检,并在光镜下进行了组织学检查。此外,从所有研究组中取出新鲜胎盘标本(0.5gm)并冷冻,直到进行氧化应激分析。结果:2、3组胎盘盘组织学切片与1组比较,组织学改变不同。这些变化包括合胞打结、绒毛状血管减少、绒毛状纤维蛋白样坏死、滋养层基底膜增厚、细胞滋养层增生、绒毛周围纤维蛋白沉积、有核红细胞(NRBC)数量增加、间质纤维化、脉络膜增生、血管合胞膜(VSM)缺乏、绒毛状水肿、蜕膜炎、绒毛炎的特征以及胎盘血管中膜增厚。对三个研究组胎盘匀浆中丙二醛(MDA)水平的生化分析显示,与1组相比,2组和3组的匀浆显著增加,表明氧化应激的存在。结论:与对照组相比,肥胖和超重组胎盘匀浆中MDA水平明显升高,提示氧化应激的作用。
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Evaluation of the histology and the oxidative stress status in the placentas of obese mothers
Background: Obesity becomes one of the most universal medical problems that affects women at reproductive period. Aim: To highlight the placental changes in obese mothers and to determine their relation to the oxidative stress. Methods: This work is a prospective casecontrol study in which placentas were obtained from 60 singleton pregnant women who delivered at Al-Khansaa Maternity Teaching Hospital, Mosul, Northern of Iraq, starting from January 2020 to March 2020. The women were classified into three groups: Group 1: includes (control) women who have BMI ranged between 18-24.9 kg/m 2 (N=20), Group2: (Overweight) includes women who have BMI ranged between25-29.9 kg/m 2 (N=20), Group 3: (Obese) includes women with BMI ≥30 kg/m 2 (N=20).Two placental biopsies were obtained from maternal side and fetal side of each case and submitted for histological examination via light microscope. In addition, Fresh placental specimens (0.5gm) had been taken from all study groups and frozen until the time of procedure for oxidative stress analysis. Results: The Histological sections of group 2 and 3 placental discs revealed different histological changes in comparison with those of group 1. These changes include syncytial knotting ,villous hypovascularity, villous fibrinoid necrosis, thickening of trophoblastic basement membrane, cytotrophoblastic hyperplasia, perivillous fibrin deposition ,increase in number of nucleated red blood cells (NRBC), stromal fibrosis, chorangiosis ,paucity of vasculosyncytial membrane (VSM), villous edema, features of deciduitis, villitis, and increase the thickening of tunica media of the placental blood vessels. The biochemical analysis of the level of malondialdehyde (MDA) in the placental homogenates of the three study groups revealed a significant increase in homogenates of group 2 and 3 in comparison with that in group 1 indicating the presence of the oxidative stress. Conclusion: this work reveals a marked increase in the level of MDA in placental homogenates of the obese and overweight groups in comparison with that of control group suggesting the role of the oxidative stress.
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