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

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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.

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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

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

Russian Federation, Ivanovo

Aleksej P. Vahromeev

Shuya Central Regional Hospital

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

MD, obstetrician-gynecologist

Russian Federation, Shuya

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

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

Russian Federation, Ivanovo

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Supplementary files

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2. Fig. 1. Intermediate immature villi. Hematoxylin and eosin staining, ×100

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3. 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

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4. Fig. 3. Vacuolated cytotrophoblast. Semifine section. Staining with methylene blue, azure II, basic fuchsin, ×1000

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5. Fig. 4. Expression of matrix metalloproteinase-9 by amniocytes and cytotrophoblast cells. Im-munohistochemical staining method, ×400

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


Media Registry Entry of the Federal Service for Supervision of Communications, Information Technology and Mass Communications (Roskomnadzor) PI No. FS77-76803 dated September 24, 2019.



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