MORPHOFUNCTIONAL FEATURES OF THE PLACENTA IN PREGNANT WOMEN WITH TUBERCULOSIS

Abstract

Objective: To study the morphology of the placenta in pregnant women with TB Methods: The morphology of the 26 placentas was evaluated in this study, out of which 15 were from women with various forms and localizations of TB (main group), while 11 were from healthy pregnant women (control group). The placentas were evaluated macroscopically. Central and peripheral zones of the placenta and umbilical cord were sampled and embedded in paraffin. Histological slides were stained with hematoxylin-eosin and examined using an Olympus CX-21 microscope with a Universal Infinity Optical System (UIS2). Results: Women in the main group were significantly more commonly underweight (p<0.01) compared to the control group. They also showed a significantly higher frequency of decompensated chronic placental insufficiency (PI), increased share of immature intermediate differentiated villi, dystrophic and degenerative changes in the placenta (foci of dystrophic calcification, afunctional syncytial nodules), and circulatory disorders (ischemic necrosis, fibrinoid in the intervillous space). Foci of calcification and infarctions in the villi embedded in fibrinoid were also significantly more common in the main group. Compensatory changes included pronounced angiomatosis, hypervascularization of villi, an increase in the number of terminal villi, the formation of synticiocapillary membranes, and functional syncytial nodules Conclusion: TB in pregnant women leads to morphological and functional changes in the placenta (delayed villous maturation, disorders of the uteroplacental circulation) and the development of more severe forms of chronic PI. The compensatory changes in the placenta might not sustain the required level of its blood supply, which results in deterioration of the perinatal outcomes (intrauterine growth restriction – IUGR).