Premature delivery and placenta. A morphological study.

A complex morphological examination of the placentas of the prematurely delivered newborns revealed that in a part of them there was a complex of changes detectable either by a naked eye immediately after delivery or by the use of light and electron microscope, respectively. The changes observed were characteristic of premature maturation of placenta, some changes, however, were similar to those present in the placentas of the term delivered intrauterine growth retarded newborns. The most important were the following changes: underweight of placenta, placental infarctions, capillary haemangioma, increased amount of fibrinoid, small and focal circulatory defects, reduction of the microvillous border and of the pinocytic activity of the syncytiotrophoblast, focal to diffuse thickening of the basal membrane with an increased number of collagen fibrils and fibroblasts in the stroma of terminal villi. These changes resulted in deterioration of the intrauterine state of the foetus and in premature delivery of frequently intrauterine growth retarded newborn. Such changes did not occur in all placentas under study. They indicate, however, the possibility of the occurrence of chronic placental insufficiency in a part of the pregnant women treated for the imminent premature delivery. From this follows the necessity of monitoring the placental functions and the state of the foetus with a subsequent differential approach to the therapy of such patients.