PECULIARITIES OF THE STRUCTURE OF THE PLACENTA IN FETUS GROWTH RETIREMENT ON THE BACKGROUND OF PLACENTAL DYSFUNCTION

Most pathological conditions caused not only by pathology of the placenta and placental bed, but also by the condition of the umbilical cord, lead to a prenatal deterioration of the condition of the fetus and do not have specific symptoms. The aim of our work was to study morpho-functional changes in the litter of healthy parturients and women with placental insufficiency and complicated pregnancy. Research materials and methods. A retrospective clinical study and evaluation of morphological features of placentas was conducted on the basis of the Department of Obstetrics and Gynecology of the Faculty of Postgraduate Education of the Ternopil National Medical University and the Ternopil Municipal City Hospital No. 2. In accordance with the set goal and tasks, the analysis of 30 placentas from physiological term births and 30 placentas from term births complicated by fetal growth retardation against the background of placental insufficiency was carried out. The morphological study was carried out in the laboratory of immunohistochemical and immunocytological studies of the Ternopil National Medical University named after I.Ya. Gorbachevskii of the Ministry of Health of Ukraine. Data analysis was performed using Statistica 10.0 statistical software package (USA), where the arithmetic mean and standard deviations were calculated. The study was approved by the Ethics Committee of the Ternopil National Medical University named after I.I. Gorbachevskii (protocol No. 61 dated 13.11.2020) and conducted within the framework of the National Development Program "Improvement of diagnosis and treatment of pregnant women with complicated somatic anamnesis" of the Department of Obstetrics and Gynecology, Faculty of Postgraduate Education, Ternopil National Medical University named after I.Ya. Gorbachevskii, state registration number N 0121U100153, performance period 2021-2023). Research results and their discussion. The analysis of clinical data showed that the groups of subjects did not differ in age, frequency of gynecological and somatic pathology, except for pregnancy complications. Visual inspection of the fetal surface in the main group revealed varicose veins almost twice as often as in the control group, edema 22.33% more often, fossilized placenta 53.33% more often, cysts 26.67% more often. Histologic examination revealed hemodynamic disturbances of varying intensity in the vast majority of observations in the main group. Parenchymal thrombosis of the umbilical vein occurred. In the villous chorion, uneven blood supply was observed - areas of ischemia and foci of angiomatosis of the villi with their hyperemia. Focal metaplasia, degeneration and necrosis of epitheliocytes were observed in placental amnion. One of the probable causes of placental dysfunction is a violation of differentiation and maturation of chorionic villi. Evidence for this is the finding of immature villi in a full-term pregnancy. Conclusions. Thus, in physiological pregnancy the loose type of blood supply of the placenta is more often observed, while in placental dysfunction the mixed and trunk type of vascular branching prevails. Placental dysfunction is accompanied by reliable pathological morphological manifestations with predominance of dystrophic-destructive changes. Dysfunction of the placenta is accompanied by reliable morphological manifestations with the prevalence of dystrophic changes and blood circulation disorders.