Morphological changes in the placenta as an indicator of the effectiveness of preventive measures in pregnant women with a high risk of fetal growth restriction

Background. Many of the factors that influence placental formation are modifiable and can be corrected by pre-conception care, which plays an important role in the prevention of placental insufficiency. Aim. To assess the effectiveness of pre-conception care and treatment and preventive measures in women at high risk of placental insufficiency and fetal growth restriction based on a pathomorphological study of the placenta. Materials and methods. An analysis of 733 pregnancy and birth histories was performed, including ultrasound protocols and conclusion of the results of pathological and histological examination of the placentas. Five groups were identified: A (n=87) pre-conception care was carried out, B (n=195) were admitted for observation for a period of 8–16 weeks, C (n=191) – for a period of 16–24 weeks, D (n=148) – after 25 weeks in the absence of therapeutic and preventive measures earlier. Control group included 112 healthy pregnant women. Results. The most pronounced pathological changes were in the placenta of women of group G. In women of group A, changes in the placenta were comparable to those in the control group, which indicates the success of the measures taken in the prevention of placental insufficiency. In women of subgroup B timely correction of abnormalities and risk factors also contributed to the favorable pathomorphological and functional state of the placenta and the favorable course and outcome of pregnancy. Conclusion. The study demonstrated that pre-conception care and early preventive measures in women at high risk of fetal growth restriction significantly reduce the frequency and severity of pathological placental changes, promoting favorable pregnancy outcomes. The most pronounced abnormalities were observed in women who started prenatal care in the later stages, highlighting the importance of early diagnosis and individualized pregnancy management.