Clinical and morphological features of the placenta in acute intrauterine hypoxia during childbirth

Objective. To evaluate the clinical and morphological features of the placenta in the development of acute intrauterine hypoxia during childbirth. Subjects and methods. The retrospective study enrolled 62 women. All the cases were divided into two groups: a study group included 35 women in whom fetal hypoxia verified by the umbilical cord arterial pH value (<7.12) developed during childbirth; a comparison group consisted of 27 women with a pH of >7.12. All the patients underwent pathomorphological examination of the placenta. Results. The pathomorphological study analyzed more than 30 umbilical cord and placental parameters associated with the risk of fetal hypoxia during childbirth. There were significant differences in the detection rate of the signs of parenchymal placental insufficiency (p = 0.05), in the frequency of combined changes with the predominance of moderate and severe terminal villous hypercapillarization and pathological villus tree immaturity (p <0.03). Conclusion. In physiological pregnancy, compensatory placental capabilities contribute to the high resistance of a fetus to acute oxygen deficiency. Placental morphofunctional disorders that may have no clinical manifestations in the antenatal period and in the stressful situation of childbirth are a determinant of decompensation with the development of clinically important fetal hypoxia.

blood pH, pathomorphological examination of the placenta, fetal hypoxia