Gorikov I N, Andrievskaya I A, Ishutina N A, Dovzhikova I V
Far Eastern Research Center for Physiology and Pathology of Respiration, Blagoveshchensk, Russia.
Arkh Patol. 2019;81(4):43-47. doi: 10.17116/patol20198104143.
To study a change in the architectonics of fetal surface veins of the placenta and the structure of the latter in cytomegalovirus infection in pregnant women.
Placentas were studied and divided in 3 groups: 1) 35 placentas from women with physiological pregnancy; 2) 37 placentas from women with an exacerbation of latent cytomegalovirus infection and with chronic compensated placental insufficiency; 3) 30 placentas from those with an exacerbation of latent cytomegalovirus infection and with chronic subcompensated placental insufficiency. After X-ray contrasting the fetal surface veins of the placenta and collecting its sections for morphological analysis, the changes in the blood vessels were compared with the structure of the villous chorion.
As compared with Group 2, Group 3 showed reductions in placental weights and placental areas, as well as cotyledon asymmetry and a preponderance of anatomical forms with weak vascular contrasting along with the more frequent emergence of areas of varicosity, contraction, and inflammation of the umbilical vein, as well as the placental fetal surface veins. The investigators more often detected collagenization, fibrinoid degradation, and the increased stromal volume of the stem villi, fibrinoid deposition around the latter, and decreases in the proportion of the intervillous space and syncytiotrophoblast; dilatation of the veins and narrowing of the arteries of the stem villi; pronounced plethora of terminal villi and their avascular forms, intermediate immature villi, chorioamnionitis, deciduitis, pseudonecrosis, calcifications, as well as hemorrhages in the intervillous space.
In the development of subcompensated placental insufficiency in women who have experienced an exacerbation of latent cytomegalovirus infection in the second trimester of pregnancy, an important role is assigned to anatomical and pathological changes in the umbilical, fetal surface, and villous chorionic veins, which indicate the development of fetoplacental hypertension, the deceleration of blood flow, and the longer contact of the pathogen with the endothelium and syncytiotrophoblast.
研究孕妇巨细胞病毒感染时胎盘胎儿面静脉的构筑学变化及其结构。
对胎盘进行研究并分为3组：1）35例生理妊娠妇女的胎盘；2）37例潜伏性巨细胞病毒感染加重且伴有慢性代偿性胎盘功能不全妇女的胎盘；3）30例潜伏性巨细胞病毒感染加重且伴有慢性亚代偿性胎盘功能不全妇女的胎盘。对胎盘胎儿面静脉进行X线造影并取其切片进行形态学分析后，将血管变化与绒毛膜绒毛结构进行比较。
与第2组相比，第3组胎盘重量和面积减小，叶状胎盘不对称，血管造影较弱的解剖学形态占优势，脐静脉以及胎盘胎儿面静脉出现静脉曲张、收缩和炎症区域的频率更高。研究人员更常检测到主干绒毛的胶原化、纤维蛋白样降解、间质体积增加、其周围的纤维蛋白样沉积、绒毛间隙和合体滋养层比例降低；主干绒毛静脉扩张和动脉狭窄；终末绒毛明显充血及其无血管形式、中间未成熟绒毛、绒毛膜羊膜炎、蜕膜炎、假坏死、钙化以及绒毛间隙出血。
在妊娠中期潜伏性巨细胞病毒感染加重的妇女发生亚代偿性胎盘功能不全的过程中，脐静脉、胎儿面静脉和绒毛膜绒毛静脉的解剖学和病理学变化起着重要作用，这些变化表明胎儿胎盘高血压的发展、血流减速以及病原体与内皮细胞和合体滋养层的接触时间延长。
