Pathomorphological features of placenta in patients with different clinical phenotypes of spontaneous preterm births

Aim. Investigation of morphological features of the placenta in patients with spontaneous preterm birth depending on the clinical phenotype of labor. Materials and methods. Histological and immunohistochemical examination of placenta of 93 patients with spontaneous preterm labor was performed. The expression of antibodies to type I collagen, and antibodies to the products of collagen metabolism (carboxy-terminal telopeptide of type I and propeptide of type I procollagen) was assessed. The data of the group of patients with premature rupture of membranes (PROM) (n=71) and of the group of patients with spontaneous onset of preterm labor with unruptured fetal membranes (n=22). Results. The signs of infectionpredominatedin theplacentasofpatientswith PPROMcomparedtopatients with spontaneous onset of preterm labor- 55/71(77.5%) and 11/22(50%), respectively (p=0.02). The median duration of the latency period in patients with funiculitis was 350.0±51.1 hours (95% CI: 309.8-540.9 hours). Immunohistochemistry data showed a significant decrease in the expression of propeptide of type I procollagen in fetal membranes of patients with PPROM. Conclusion. Infection of the placentas in women with PPROM is a result of a long latency period. Prolongation of latency period for more than 14 days should be avoided because of high risk of fetal infection. Impaired processes of collagen synthesis play a significant role in the pathogenesis of PPROM.

preterm labor, premature rupture of membranes, latency period, placenta, immunohistochemistry, chorionamnionitis, collagen