Morphological and immunohistochemical parameters of chron-ic placental insufficiency in preeclampsia

Aim. To determine the morphological parameters of chronic placental insufficiency in pregnancy complicated by preeclampsia and in women with chronic arterial hypertension (CAH).

Materials and Methods. Historical data and peculiarities of pregnancy and childbirth in women with hypertensive disorders were analyzed in this work. A review histology of 40 placentas in moderate preeclampsia, 40 placentas in severe preeclampsia, and 35 placentas of women with CAH and associated preeclampsia was performed. The control group consisted of 20 placentas of women with uncomplicated pregnancies and without hypertensive disorders. Immunohistochemical examinations were performed on paraffin sections according to standard methods using primary goat antibodies to annexin V (R-20, sc-1929) and rabbit antibodies to erythropoietin (H-162, sc-7556) in a working dilution of 1:200 with the Super Sensitive IHC polymer detection system.

Results. The results of the pathomorphological examination of the placentas of women with hypertensive disorders showed two forms of chronic placental insufficiency. The defining form of placental insufficiency in women with CAH and associated preeclampsia was fetoplacental insufficiency while that in preeclampsia of moderate and high severity was the uteroplacental form of chronic placental insufficiency. On the basis of the study of the dynamics of the expression of annexin V and erythropoietin, the morphological parameters of placental compensatory potential and placental hemostasis disorders in hypertensive disorders in pregnant women were determined.

Conclusion. The diagnostic morphological criteria for fetoplacental insufficiency in women with hypertensive disorders are a combination of maternal and fetal malperfusion with obliterative angiopathy of stem villi vessels. For the uteroplacental form, the criteria are the obliterative angiopathy of spiral arteries, placental hypoperfusion with the development of local hypoxia, and hemostatic disorders in the form of thrombosis of the intervillous space and villi infarcts.