生理过程的妊娠早期绒毛膜绒毛血管化和伴有慢性子宫内膜炎的复发性流产

L. P. Peretiatko, Любовь Петровна Перетятко, N. V. Fateeva, Наталья Фатеева, R. Kuznetsov, Р А Кузнецов, A. Malyshkina, А И Малышкина
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摘要

的目标。研究妊娠早期无并发症过程中血管和血管生成的分期,并确定复发性流产和慢性子宫内膜炎中绒毛绒毛膜血管形成障碍。材料与方法。主要组为复发性流产合并慢性子宫内膜炎女性患者妊娠5-12周的绒毛绒毛膜(n=35);对照组:取自正式流产的临床健康女性的绒毛绒毛膜(n=30)。在形态学检查的基础上,对绒毛绒毛膜的血管化阶段进行了分析。结果。在子宫内膜慢性炎症相关的复发性流产中,绒毛绒毛膜的结构改变表现为从妊娠第5周开始的绒毛分化迟缓,在血管母索形成阶段(典型的6-7周)的血管发生延迟,并在随后的时期受到抑制。妊娠8-12周绒毛未见血管进一步分化,未形成分支血管生成。结论。绒毛分化、绒毛膜绒毛间质血管生成和血管生成障碍,以及潜在的子宫内膜慢性炎症,对进一步发育和妊娠的成功完成产生负面影响,已被证实。
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Vascularization of chorion villi in the first trimester of gestation with physiological course and in recurrent miscarriage with underlying chronic endometritis
Aim . To study stages of vasculo- and angiogenesis in uncomplicated course of the first trimester of gestation and to identify disorders in vascularization of the villous chorion in recurrent miscarriages and chronic endometritis. Materials and Methods . The main group – villous chorion of 5-12 weeks of gestation obtained from female patients with recurrent miscarriage and chronic endometritis (n=35); comparison group – villous chorion obtained from clinically healthy females in official abortions (n=30). On the basis of the results of morphological examination the analysis of stages of vascularization of villous chorion was carried out. Results . In recurrent miscarriage associated with chronic inflammation of the endometrium, structural changes of the villous chorion were detected manifested by retardation of differentiation of villi starting from the 5th week of gestation, by delay of vasculogenesis at the stage of formation of hemangioblastic cords typical of the 6-7th week with its inhibition in the subsequent periods. In villi of the 8-12th weeks of gestation no further differentiation of vessels was seen, hence, branched angiogenesis did not form. Conclusion . Disorders in differentiation of villi, in vasculo- and angiogenesis in the stroma of chorion villi with the underlying chronic inflammation of the endometrium that produced negative effect on further development and successful completion of gestation, were proved.
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