Pregnancy and delivery in women with undifferentiated connective tissue dysplasia: clinical and morphological aspects

Cover Page
Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract


Aim. This study aimed to identify peculiarities of the course of pregnancy, delivery, and morphology of the placenta in women with undifferentiated connective tissue dysplasia (UCTD).

Materials and Methods. The main group included 60 pregnant women with UCTD, and the control group was composed of 30 somatically healthy women with physiological course of pregnancy. All patients were examined as regards the use of general clinical and laboratory methods. Moreover, 65 placentas were subjected to complex morphological examinations, including organometry, macro- and microscopic examinations, and immunohistochemistry.

Results. Pregnancy and delivery in women with UCTD encounter various complications, such as threat of premature birth and miscarriage, pre-eclampsia, prenatal amenorrhea, and placental insufficiency manifested as fetal growth restriction syndrome and confirmed in the course of morphological examination. The structural basis of chronic placental insufficiency is associated various pathologies of the umbilical cord and disorders in maturation of the villous chorion with the underlying weak adaptive and compensatory processes. Connective tissue dysplasia in fetal membranes is manifested as disorders in histo- and cytoarchitectonics and in increased expression of matrix metalloproteinase-9 by amniocytes and cytotrophoblast cells.

Conclusion. UCTD produces unfavorable effect on the course of pregnancy and delivery. The results of the clinical and morphological examinations demonstrate the multiorgan characteristics of injuries in the mother-placenta-fetus system, which necessitates further studies for the determination of complex prophylactic measures.


Full Text

Restricted Access

About the authors

Olga P. Saryeva

V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood

Author for correspondence.
Email: saryevaolga@mail.ru
ORCID iD: 0000-0001-8255-2877
SPIN-code: 1436-3998
Scopus Author ID: 24391739500
ResearcherId: A-9996-2017

Russian Federation, Ivanovo

MD, PhD, Researcher of the Pathomorphology and Electronic Microscopy Laboratory

Aleksej P. Vahromeev

Shuya Central Regional Hospital

Email: saryevaolga@mail.ru
ORCID iD: 0000-0002-8366-6830

Russian Federation, Shuya

MD, obstetrician-gynecologist

Violetta V. Parejshvili

Gorodkov Ivanovo Scientific and Research Institute of Maternity and Childhood

Email: parejshvili@bk.ru
ORCID iD: 0000-0002-1497-1006
SPIN-code: 5207-8290
ResearcherId: В-2407-2017

Russian Federation, Ivanovo

MD, PhD, Professor of the Department of Obstetrics and Gynecology

References

  1. Kadurina TI, Gorbunova VN. Displaziya soyedinitel’noy tkani. Saint-Petersburg: ELBI-SPb; 2009. (In Russ).
  2. Martynov AI, Nechaeva GI. National recommendations of the Russian scientific society of internal medicine for diagnostics, treatment and rehabilitation of patients with connective tissue dysplasia. Medical News of North Caucasus. 2016;11(1):2-77. (In Russ). doi: 10.14300/mnnc.2016.11001
  3. Komissarova LM, Karachayeva AN, Kesova MI. The course of pregnancy and labor in connective tissue dysplasia. Obstetrics and Gynecology. 2012; (3):4-8. (In Russ).
  4. Styagkina SN, Chernenkova ML, Vinokhodova EM, et al. Currency of the problem dysplasia of connective tissue in gynecology and obstetrics. Advances in Current Natural Sciences. 2014;(9):21-3. (In Russ).
  5. Kan NE, Tyutyunnik VL, Amiraslanov EYu, et al. Obstetric complications and undifferentiated connective tissue dysplasia. Clinical and Experimental Surgery. Petrovsky Journal. 2015;(2):47-52. (In Russ).
  6. Kan NE, Sannikova MV, Amiraslanov EYu, et al. Clinical predictors in prognosis of premature rupture of membranes. Voprosy Ginekologii, Akusherstva i Perinatologii. 2013;12(3):12-8. (In Russ).
  7. Smolnova TYu, Adamyan LV. Time course of changes in the phenotypic signs of connective tissue dysplasia at different ages: the urgency of the problem in obstetrics and gynecology. Obstetrics and Gynecology. 2013;(4):74-9. (In Russ).
  8. Fadeeva TS, Molokanova MV, Pavlov OG. The influence of the severity of undifferentiated connective tissue dysplasia on pregnancy. Journal of New Medical Technologies, eEdition. 2019;(3):12-3. (In Russ). doi: 10.24411/2075-4094-2019-16395
  9. Khodzhayeva ZS, Gurbanova SR. Clinical and pathogenetic rationale for the use of magnesium preparations in pregnant women with isthmic cervical insufficiency and undifferentiated connective tissue dysplasia. Obstetrics and Gynecology. 2011; (3):57-63. (In Russ).
  10. Fadeeva TS, Geymerling VE, Yudina AS. The role of the degree of undifferentiated connective tissue dysplasia during childbirth and early postbirth period. Journal of New Medical Technologies, eEdition. 2019;(4):7-12. (In Russ). doi: 10.24411/2075-4094-2019-16427
  11. Saryeva OP, Peretyatko LP, Vakhromeev AP, et al. Pathomorphology of extraplacental membranes in their premature rupture and undifferentiated connective tissue dysplasia in women. Arkhiv Patologii. 2019;81(4):26-32. (In Russ). doi: 10.17116/patol 20198104126
  12. Kan NE, Klimantsev IV, Dubova E.A., et al. Placental insufficiency in pregnant women with undifferentiated connective tissue dysplasia. Obstetrics and Gynecology. 2013;(3):54-57. (In Russ).
  13. Kesova MI. Pregnancy and labor in women with connective tissue disorders. Bulletin of Pirogov National Medical & Surgery Center. 2011;2(6):81-4. (In Russ).
  14. Zheleznaya AA, Wustenko VV, Mezhova OK, et al. Importance undifferentiated connective tissue dysplasia in obstetric practice. Medical and Social Problems of Family. 2015;20(3-4):55-67. (In Russ).
  15. Tyshkevich OS, Kravchenko EN. Displaziya of connecting tissue is the actual problem of modern obstetrics. Literature review. Mother and Baby in Kuzbass. 2014;(3):4-8. (In Russ).
  16. Dubova EA, Klimantsev IV, Pavlov KA, et al. Ekspressiya matriksnykh metalloproteinaz v tkani platsenty zavisit ot vyrazhennosti nedifferentsirovannoy displazii soyedinitel’noy tkani. Byulleten’ Eksperimental’noy Biologii i Meditsiny. 2013;156 (7):123-7. (In Russ)
  17. Sukhikh GT, Kan NE, Tyutyunnik VL, et al. The role of extracellular inducer of matrix metallo-proteinases in premature rupture of membranes. The Journal of Maternal-Fetal and Neonatal Medicine. 2016;29(4):656-9. doi: 10.3109/14767058. 2015.101 5416

Supplementary files

Supplementary Files Action
1.
Fig. 1. Intermediate immature villi. Hematoxylin and eosin staining, ×100

Download (39KB) Indexing metadata
2.
Fig. 2. Edema, separation of fibers, and depletion of the compact layer of the membranes. Semi-fine section. Staining with methylene blue, azure II, and basic fuchsin, ×1000

Download (31KB) Indexing metadata
3.
Fig. 3. Vacuolated cytotrophoblast. Semifine section. Staining with methylene blue, azure II, basic fuchsin, ×1000

Download (36KB) Indexing metadata
4.
Fig. 4. Expression of matrix metalloproteinase-9 by amniocytes and cytotrophoblast cells. Im-munohistochemical staining method, ×400

Download (26KB) Indexing metadata

Statistics

Views

Abstract - 0

PDF (English) - 0

PDF (Russian) - 0

Article Metrics

Metrics Loading ...

PlumX

Refbacks

  • There are currently no refbacks.

Copyright (c) 2021 Saryeva O.P., Vahromeev A., Parejshvili V.



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies