MORPHOLOGICAL CHARACTERISTICS OF VASCULAR-STROMAL REMODELING OF HUMAN PLACENTA VILLOUS CHORION IN CONDITIONS OF CIRCULATORY HYPOXIA

Abstract

Objective - to study microstructural characteristics, angiogenic and vascular-stromal immunohistochemical markers of remodeling in the villous chorion of placenta in conditions of circulatory hypoxia of various severity levels. Material and methods. Histological and immunohistochemical study of the 54 term placentas was carried out. Twenty placentas were obtained from women suffering from non-operated CHD; 19 placentas - from women with corrected CHD and 15 - from women with normal pregnancy and delivery (controls). Monoclonal mouse antibodies raised against VEGF, CD34, SMA, Collagen III, and Collagen IV were used to carry out immunohistochemical reaction in specimens of placental tissue. Results. The paper demonstrated the histological structure of the chorionic villi obtained from women with normal pregnancy and structural characteristics of compensatory and adaptive response of placenta to hypoxic stress. The quantitative assessment of the expression of signaling protein molecules involved in the remodeling of the placental barrier demonstrated that the structural and functional restructuring of placental villi depended on hypoxemia and its intensity in pregnant women. Markers of structural and functional deadaptation of the chorionic villi in conditions of uncorrected circulation hypoxia caused by CHD were established. The signs of placental compensatory-adaptive processes activation in cases of surgical correction of the heart defect before pregnancy were identified. Conclusions. The compensatory and adaptive processes in placenta and adequate level of reparation of damaged placental tissues are vital condition of physiological course of pregnancy and childbirth. The violation of structural and functional remodeling of villous chorion in conditions of circulatory hypoxia contributes to the development of placental insufficiency, increases the risk of perinatal pathology of the fetus and the newborn. Adaptive remodeling of neoangiogenesis and extracellular matrix of placental villi contributes to gestation prolonging and live full-time birth.

Keywords

placenta / extracellular matrix of terminal villi / angiogenesis / immunohistochemical study / congenital heart disease

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RIGHTS & PERMISSIONS

Rudiuk L.A., Reshetnikova O.S.