V.V. Kaminskyi, MD, professor, corresponding member of the NAMS of Ukraine, head of the Obstetrics, Gynecology and Reproductology Department of the National Medical Academy of Postgraduate Education named after P.L. Shupyk, chief specialist in Obstetrics and Gynecology at the Ministry of Health of Ukraine, director of the Kyiv City Center for Reproductive and Perinatal Medicine
O.G. Boichuk, PhD, applicant at Obstetrics, Gynecology and Reproductology Department of the NMAPE named after P.L. Shupyk
T.V. Kolomiichenko, PhD, senior researcher at Obstetrics, Gynecology and Reproductology Department of the NMAPE named after P.L. Shupyk
O.I. Yeshchenko, PhD, senior researcher at Laboratory of Pathomorphology, SI “Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”
S.M. Kylykhevych, PhD, researcher at Laboratory of Pathomorphology, SI “Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”
MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL FEATURES OF THE PLACENTA OF WOMEN WITH FUNCTIONAL DISORDERS OF LIVER AFTER ASSISTED REPRODUCTIVE TECHNOLOGY
In recent years, a leading role in placental development disorders vascular factors is given, which leads to an imbalance of placental insufficiency.
It has been studied 20 placentas from women after assisted reproductive technology with non-alcoholic fatty liver disease and 20 placentas from women after assisted reproductive technology without liver disease (control group).
Methods: organometrical, macroscopic, general histological and immunohistochemical: indirect streptavidin-peroxidase method of detecting the expression of e-NOS (endothelial nitric oxide synthases) level, antibody Thermo Scientific Company (UK) on the manufacturer’s protocol. The prevalence and intensity of the reaction was assessed by semiquantitative method on a scale from 0 to 3 points.
According to study results, in women with liver pathology after assisted reproductive technology observed increase in placental weight. In 50% of placentas marked foci relative immaturity of the dissociated cotyledons type, poor circulation on the background of compensatory reactions of moderate severity. Morphometric observed with single dominance of villous capillaries, which are located centrally, which leads to a significant reduction in the number syncytiocapillary membranes and reduces specialized terminal villi, in violation of the permeability of the placenta. Significantly increased the number intervillous and fetal fibrinoid, glued fibrinoid villi, syncytial knots, heart attack, reduced intervillous space and the bloodstream, thinned epithelium villi, increased compensatory angiomatosis vessels. These changes reflect the impaired circulation and permeability of the placenta, impair its functionality and are the pathological background against which develop obstetric and perinatal disorders.
The study authors conclude that the absence or reduction of e-NOS expression in the most functionally important structures in the majority (60%) placentas of women with hepatobiliary pathology induced during pregnancy, indicating a lack of compensatory reaction, endothelial dysfunction, macro- and microcirculations processes and, as a result, decrease of placental functional capabilities.