ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 10 of 50
УЖМБС 2021, 6(3): 85–95
Experimental Medicine and Morphology

Histomorphological Characteristics of the Placenta in Women with Obesity and Preeclampsia

Zelinka-Khobzey M. M., Tarasenko K. V.

Reducing the incidence of preeclampsia is an important issue in modern obstetrics, as preeclampsia is still remaining one of the leading causes of maternal and perinatal morbidity and mortality. This problem is especially relevant for pregnant women with concomitant obesity, since they are at high risk for preeclampsia. Placental ischemia can result in the development of endothelial dysfunction and, as a consequence, can lead to the emergence of gestational endotheliosis, which is a leading pathogenetic segment in the preeclampsia pathogenesis. The purpose of the study is to investigate the histomorphological features of the placenta in women with physiological body weight and concomitant class II obesity in preeclampsia, who took the therapeutic and prophylactic complex, designed to prevent preeclampsia in pregnant women with class II obesity. Materials and methods. We studied 25 placenta samples from women with physiological body weight and class II obesity, whose pregnancy was complicated with the development of preeclampsia. 5 study groups were formed: group I consisted of women with class II obesity, whose pregnancy was complicated by preeclampsia; group II included women with physiological body weight, who developed preeclampsia; group III included women with class II obesity, who took the therapeutic and prophylactic complex; group IV involved women with class II obesity who did not receive the therapeutic and prophylactic complex, and group V was the control one. A comprehensive assessment of the structural characteristics of the placenta included macroscopic diagnosis, organometry and examination histology. Results and discussion. Dominant and clinically significant histological parameters of the structure of pathologically altered placental tissue from women whose pregnancy was complicated by the preeclampsia development have been found out. Pathomorphological changes in the tissue of the studied placentas and their severity indicate a significant impairment of placental circulation that initiates the development of processes of adaptation and compensation along with the lack of compensatory-adaptive reactions. Conclusion. We have revealed involutive-dystrophic compensatory processes and moderate compensatory responses within the gestational normal limits without fixing pathological morphological changes in placental tissue in placental samples from women with concomitant class II obesity, who received the therapeutic and prophylactic complex (acetylsalicylic acid, L-arginine, calcium preparations) and semisynthetic diosmin in order to prevent preeclampsia; no pathological morphological changes in placental tissue were detected. No cases of preeclampsia associated with endothelial dysfunction in pregnant women with concomitant class II obesity, who received therapeutic and prophylactic complex, proves its effectiveness in managing this cohort of patients

Keywords: preeclampsia, placenta, endothelial dysfunction, obesity, therapeutic and prophylactic complex

Full text: PDF (Ukr) 652K

  1. Vashchenko VL, Likhachov VK, Taranovska OO. Perebig vagitnosti ta yiyi zavershennya u zhinok grupy vysokogo ryzyku po vynyknennyu preeklampsiyi [The course of pregnancy and its completion in women at high risk of preeclampsia]. Aktualni problemy suchasnoyi medytsyny: Visnyk Ukrayinskoyi medychnoyi stomatologichnoyi akademiyi. 2020; 20(1): 106-110. [Ukrainian].
  2. Lipatov IS, Tezikov YuV, Lineva OI. Patogeneticheskie mehanizmy formirovanija placentarnoj nedostatochnosti i prejeklampsii [Pathogenetic mechanisms of the formation of placental insufficiency and preeclampsia]. Obstetrics and gynecology. 2017; 9: 64-71. [Russian].
  3. Sidorova IS, Nikitina NA. Osobennosty patogeneza endotelyoza pry preeklampsyy [Features of the pathogenesis of endotheliosis in preeclampsia]. Akusherstvo i ginekologiya. 2015; 1: 72-78. [Russian]
  4. Shatylovyya KL. Systemy maty-platsenta-plid pry preeklampsiyi [Mother-placenta-fetus system in preeclampsia]. Vrachebnoe delo. 2017; 8. [Ukrainian]
  5. Zelinka-Khobzey MM, Tarasenko KV. Endotelialna dysfunktsiia, yak patohenetychna osnova akusherskykh uskladnen u vahitnykh z ozhyrinniam [Endothelial dysfunction in pregnant women with obesity as pathogenetic basis of maternal and neonatal complications]. Visnyk problem biolohii i medytsyny. 2019; 1(2): 34-40. [Ukrainian]
  6. Chabanova NB, Mataev SI, Vasil'kova TN. Rol' sistemnogo vospalenija v razvitii oslozhnenij beremennosti u zhenshhin s ozhireniem [The role of systemic inflammation in the development of pregnancy complications in women with obesity]. Akusherstvo i ginekologija. 2017; 10: 12-17. [Russian].
  7. Tarasenko KV, Gromova AM, Pikul KV, Lysenko RB, Nesterenko LA. Pathogenesis of insulin resistance in pregnant women with obesity. Wiadomosci lekarskie. 2018; 71(4): 801-6. PMID: 30099414
  8. Predyktory, profilaktyka, diahnostyka ta likuvannya hipertenzyvnykh rozladiv vahitnosti: Klinichnyy protokol z akusherskoyi dopomohy [Predictors, prevention, diagnosis and treatment of hypertensive disorders of pregnancy: clinical protocol on obstetric care]. Data skladannya 01.11. 2018. [Ukrainian]
  9. Wubale Y, Tolera A. Gross morphological study of placenta in preeclampsia mothers. Anatomy Journal of Africa. 2017; 6(2): 977-981.
  10. Medhi B, Tatwade Y. Gross Morphological Changes in Placenta of Hypertensive Pregnancy. Scholars Journal of Applied Medical Sciences. 2018; 6(5): 2029-2035.
  11. Ezeigwe CO, Okafor CI, Eleje GU, Udigwe GO, Anyiam DC. Placental Peripartum Pathologies in Women with Preeclampsia and Eclampsia. Obstet Gynecol Int. 2018 Sep 20; 2018: 9462938. PMID: 30327674. PMCID: PMC6171203.
  12. Chhatwal J, Chaudhary DN, Chauhan N. Placental changes in hypertensive pregnancy: a comparison with normotensive pregnancy. Int J Reprod Contracept Obstet Gynecol. 2018; 7(9): 3808-3813. doi: 10.18203/2320-1770.ijrcog20183799
  13. Shanmugasam K, Vaithy A, Samal R, Uma Devi K, Sowmya R. Histopathological study of placental changes associated with pre-eclampsia and eclampsia in a tertiary care centre of Puducherry. IP Arch Cytol Histopathol Res. 2019; 4(1): 57-60 doi: 10.18231/2456-9267.2019.0009
  14. Sahay B, Talukdar L, Sahay P, Datta D, Chaubey R. Comparative study between histological changes in placenta from pre-eclampsia cases and normal pregnancy with special reference to cytotrophoblastic cell hyperplasia, villous stromal fibrosis and fibrinoid necrosis. Int J Res Med Sci. 2016; 4: 4884-4888. doi: 10.18203/2320-6012.ijrms20163785
  15. Rana S, Diwan Y, Chauhan RS, Diwan D, Gupta A. Comparative study of histology of placenta in normotensive and hypertensive cases. J Med Sci Clin Res. 2017; 5(3): 18635-40. doi: 10.18535/jmscr/v5i3.60
  16. Ojha K, Rawal S, Jha A. Placental Pathology in Severe Pre-eclampsia and Eclampsia. Nep Med J. 2018; 1: 32-5.