Immunohistochemical Study of Trophoblasts Cellular Regulation Processes in Chorioamnionitis and Basal Deciduitis Combined with Iron-Deficiency Anemia in Gravidas

2021 ◽  
Vol 6 (5) ◽  
pp. 76-82
Author(s):  
V. V. Ilika ◽  
◽  
O. V. Garvasiuk ◽  
O. V. Ilika

The purpose of the study is to establish quantitative parameters of cell proliferation and apoptosis in the trophoblast of the chorionic villi in chorioamnionitis and basal deciduitis combined with iron-deficiency anemia in gravidas by means of immunohistochemical method. Materials and methods. 198 placentas were examined. The immunohistochemical procedure was performed using primary antibodies against Ki-67 and Bax antigen with imaging by a polymer system with diaminobenzidine dye. The number of Ki-67-positive nuclei of the chorionic villi trophoblast was counted, and for the Bax antigen, the optical density of the immunohistochemical staining was measured by means of microdensitometric method. Comparison of differences in mean trends was performed using the odd Student’s two-sided t-test (p≤0.05). Results and discussion. The number of Ki-67-positive trophoblast nuclei in acute chorioamnionitis with iron-deficiency anemia in gravidas was 56±3.8 ‰, and the relative units of optical density of immunohistochemical staining for protein Bax – 0.234±0.0012, in chronic – 59±3.6 ‰ and 0.2, respectively. The number of Ki-67-positive nuclei of the chorionic villi trophoblast was counted. Placentas with acute as well as chronic chorioamnionitis and basal deciduitis showed even higher averages (p <0.001). In acute basal deciduitis in anemia, the number of Ki-67-positive trophoblast nuclei was 56±3.2 ‰, the average optical density of immunohistochemical staining for protein Bax – 0.236±0.0016, in chronic – 57±3.7 and 0.249±0.0015, respectively. It should be noted that in chronic chorioamnionitis and basal deciduitis, these rates were higher than in acute. With the same regularity the average indicators of optical density of immunohistochemical staining on protein Bax in a trophoblast of chorionic villi at comorbid iron-deficiency anemia concerning an inflammation without anemia increase. We have shown that proliferative activity in iron-deficiency anemia varies with gestational age and placental prematurity, but iron-deficiency anemia in gravidas and chorionic tree maturation both individually and in combination lead to the intensification of these processes. We obtained a justification for the arithmetic mean thickness and volume of the placenta relative to observations of placenta with inflammation without anemia in this comorbid pathology. Conclusion. Iron-deficiency anemia in gravidas leads to the intensification of proliferative processes and Bax-dependent apoptosis in the trophoblast of the chorionic villi of the placenta relative to the placenta from physiological pregnancy. In acute as well as in chronic chorioamnionitis and basal deciduitis, the proliferative activity and apoptotic processes in the trophoblast of the chorionic villi of the placenta increase, while comorbid iron-deficiency anemia in gravidas intensifies only the processes of Bax-dependent apoptosis

2021 ◽  
Vol 19 (4) ◽  
Author(s):  
О.А. Tiulienieva ◽  
I.S. Davydenko ◽  
A.V. Hoian ◽  
S.M. Yasnikovska

Iron deficiency anemia in pregnancy (IDAP) is one of the most pressing problems ofmodern obstetrics, its frequency in different regions varies in a wide range of 28 –85%. Pregnant women with iron deficiency anemia undergo gestational immaturityin utero-placental bed due to insufficiency of cytotrophoblastic invasion. It is knownthat defective gestational rearrangement of the utero-placental arteries, especiallytheir myometrial segments, is the morphological basis for increasing pressure inthe intervillous space. Immunohistochemical technique for von Willebrand factor inutero-placental bed and myometrium allows to assess the processes of angiogenesisand vasculogenesis, endothelial dysfunction, early and late thrombosis, features of thegestational reorganization of spiral arteries in utero-placental bed.Purpose of the work: to determine the features of von Willebrand factor immunoexpressionin the endothelium of myometrial vessels in the projection of the utero-placental bed iniron deficiency anemia in pregnancy at 37 – 40 weeks of gestation.Material and methods. 58 biopsies of utero-placental bed and myometrium weremorphologically studied after being obtained during caesarean section, observations ofphysiological pregnancy and gestation in conditions of the I - II degree IDAP withoutclinical signs of placental insufficiency. On histological sections were performed: 1)immunohistochemical method for von Willebrand factor; 2) histochemical method forfibrin and collagen fibers by NZ Slinchenko; 3) staining with hematoxylin and eosin.Results. Observations of myometrial biopsies in the projection of utero-placental bedduring pregnancy against a background of IDAP showed a significant increase in theintensity of staining of endotheliocytes of all vessel types: in arteries of women with IDAP of the I degree optical density of staining was 0.451±0.0024 ODU, in conditionsof the II degree IDAP – 0,458±0.0022 ODU; in venous vessels in IDAP of the Idegree optical density was 0,393±0,0026 ODU, in veins of women with IDAP of theII degree – 0,405±0,0022 ODU; in vessels of microcirculation in IDAP of the I degreeimmunoexpression of von Willebrand factor was 0,394±0,0022 ODU, and during IDAPof the II degree – 0,398±0,0025 ODU.Conclusions. During pregnancy against a background of iron deficiency anemia,the utero-placental bed and myometrium have morphological signs of gestationalimmaturity. The growth of von Willebrand factor immunoexpression in endothelialcells, the manifestation of enhanced endothelial cell desquamation and thrombosis atdifferent stages, detected in different types of myometrial vessels, should be regardedas prerequisites for hypoperfusion of utero-placental bed and the development of thedisorders of venous outflow from the placental bed in the uterus.


2021 ◽  
Vol 11 (2) ◽  
pp. 270-276
Author(s):  
Olena Tiulienieva ◽  
Igor Davydenko ◽  
Viallanta Tiulienieva ◽  
Olena Marchuk ◽  
Tetiana Shelest ◽  
...  

The study of placental lactogen by immunohistochemistry in histological sections of the placenta during physiological pregnancy and on the background of iron deficiency anemia in the aspect of chronic placental insufficiency. It is established that during gestation against the background of iron deficiency anemia decreases the production of placental lactogen by syncytiotrophoblast of the chorionic villi and correlates with the state of the blood of the pregnant woman. The optical density of immunohistochemical staining for placental lactogen of the free trophoblast reflects the degree of maturation of the chorionic tree of the placenta in iron deficiency anemia in pregnant women. Chronic placental insufficiency caused by immaturity of the chorionic villi can be compensated at the level of metabolism.


2021 ◽  
Vol 11 (3) ◽  
pp. 258-265
Author(s):  
Olena Tiulienieva ◽  
Igor Davydenko ◽  
Viallanta Tiulienieva ◽  
Olena Marchuk ◽  
Tetiana Shelest ◽  
...  

The authors of the article investigated the quantitative parameters of the placental chorion tree during physiological pregnancy and gestation against the background of iron deficiency anemia. It has been established that iron deficiency anemia in pregnant women inhibits the development of the placental chorionic tree, which is explained by the formation of chorionic villi (through trophoblastic and free processes) and violation of the transition of terminal villi to terminal "specialized" villi. The diagnosis of chronic placental insufficiency during pregnancy on the background of iron deficiency anemia can be verified morphologically based on quantitative indicators of assessment of the structure of the placental chorionic tree - the percentage of terminal villi should be higher than 43% and the percentage of terminal "specialized" villi lower than 15%.


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