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SM ISO690:2012 BABENCO, Elena, SERBENCO, Anatol, SINIŢÎNA, Lilia, VATAMAN, Vladimir. Particularităţi morfopatologice ale placentei la pacientele cu valvulopatii mitrale dobândite
. In: Buletin de Perinatologie, 2012, nr. 3, pp. 68-73. ISSN 1810-5289. |
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Buletin de Perinatologie | ||||||
Numărul 3 / 2012 / ISSN 1810-5289 | ||||||
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Pag. 68-73 | ||||||
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Relevance. Cardiovascular diseases are observed in 1% of pregnant women and are the major cause of maternal
and perinatal mortality. Acquired valvulopathy makes up about 80% out of the cardiovascular system diseases.
Morphopathologic examination of placenta is one of the informational sources on the causes of fetal hypoxia, premature
birth, intrauterine growth retardation, etc. At the same time, morphopathologic changes in placenta of pregnant women
with circulatory insuffi ciency due to an acquired valvulopathy remain almost unresolved.
The aim of the study. Comparative analysis of morphopathologic changes in placentas of pregnant women with
circulatory insuffi ciency due to an acquired valvulopathy.
Materials and methods. The study included 35 placentas, which were divided into groups depending on the degree
of circulatory failure and without it. Placentas were examined macroscopically and hystopathologically using routine
methods of staining with hematoxylin-eosin and pikrofuksin according to van Gieson. The changes revealed were
treated with different statistical methods using STATISTICA 7.0. 61.0 EN of the StatSoft. Inc company (USA) (2006).
Results. Macroscopically, in placentas of pregnant women with circulatory failure there have been identifi ed
disorders of the form, placenta circumvallate, the cysts of chorionic plate in place of the umbilical cord attachment,
additional cotyledons, heart attacks, focal calcifi cation. It was also revealed the disorder of the umbilical cord
attachment, sometimes with the presence of amniotic folds. Hystopathologically there it was identifi ed a number of
structural changes that have been grouped into several categories: infl ammation processes, dyscirculatory changes,
disorders in maturation of chorionic villi and compensatory-adaptive changes. Along with these changes, there were
identifi ed dysplastic changes in the chorionic villi and vessels. Statistical analysis revealed a strong correlation
between the disorders of chorionic villi maturation and dyscirculatory changes (r = 0,79), and a moderate correlation
between the disorders of chorionic villi maturation and infl ammatory processes (r = 0,65). A high level of differences
in changes in placentas from women with circulatory failure and without was found during the clustered analysis at
Euclid distances.
Conclusions. Cardiovascular disorders in pregnant women lead to different structural changes in placenta, the
most pronounced of which are dyscirculatory changes and disorders in chorionic villi maturation, which are increasing
with a more pronounced degree of circulatory disorders in pregnant women (p <0b05). The revealed strong correlation
between the disorder in the maturation of chorionic villi and dyscirculatory changes indicate the important role of the
latter for fetal development and is one of the links in the pathogenesis of intrauterine growth retardation. In groups of
patients with circulatory disorders the cases of perinatal mortality were not registered, which is apparently related to a
high level of compensatory-adaptive processes, which in this study made up 77%. |
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Cuvinte-cheie valvulopathy, circulatory insufficiency, placenta |
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