Morphological Features of the Liver of Full-Term Stillbirths Developing in Conditions of hypertensive disease of the mother

The hypoxic condition of the fetus and a newborn is one of the leading causes of perinatal morbidity and mortality. One of the leading factors bringing to deficiency of fetal oxygen is hypertension of pregnant women, which often causes premature birth and has a high percentage of perinatal mortality. In addition, the presence of arterial hypertension in a pregnant woman can lead to a number of severe conditions, including: a detachment of the normally located placenta, progressive placental insufficiency, fetal growth retardation syndrome, and in severe cases, asphyxia and fetal death. Disorders of intrauterine development of the fetus in conditions of chronic fetoplacental insufficiency in pregnant women together with arterial hypertension naturally lead to various deviations in the state of newborns health. The purpose of this work was to identify the morphological features of the liver of full-term stillbirths, subjected to the influence of chronic intrauterine hypoxia, which was due to mother's hypertension of the II stage. The material of the study was the liver tissue of stillbirths with a gestation period of 37-40 weeks. The entire study material is divided into two groups. The group I included stillborn children, from healthy mothers (12 cases), who died due to acute violation of umbilical-placental blood circulation and birth trauma. The group II was stillbirths (25 cases), affected by chronic intrauterine hypoxia, resulting from chronic placental insufficiency, which was due to mother's hypertension of the II stage. Body weight and liver weight of the stillbirths were determined by weighing. We measured the length of the stillbirths to calculate a coefficient that showed the ratio of liver weight to body weight. Morphologically, the liver was studied using histological (hematoxylin and eosin, picrofuxin by van Gison method) stains. We determined that stillbirths from mothers suffering from hypertonic disease of the II stage had a 14.7% deficit in body weight, a 6% deficit in body growth, a significant increase in the liver mass / fetal weight ratio by 28,95% compared with the control group. With a review microscopy of liver preparations of full-term stillbirths bore in conditions of chronic intrauterine hypoxia, we determined significant morphological changes in comparison with the control group. We noted multiple small foci of extramedullary hematopoiesis and periportal fatty vacuoles mostly in the central parts of the hepatocytes often observed in the state of hydropic dystrophy. These changes are most likely the result of chronic intrauterine hypoxia, which occurred during extragenital pathology of the mother. We also paid attention to the development of the stromal component in the liver in the stillbirths of group ІІ, which indicated the presence of sclerotic processes. In the liver of stillbirths of the group ІІ, we noted a combination of sclerotic processes with significant hemodynamic disturbances (in some vessels of the microcirculatory bed, signs of stasis of the formed elements of blood, their expressed expansion and fullness) in all cases. Thus, mother's hypertensive disease of the II stage has an adverse effect on both the parenchymal and the vascular stromal component of the liver of stillbirths. In this regard, the data which we have obtained should create alertness among neonatologists and gastroenterologists and indicate the need for dynamic monitoring of the hepatobiliary system in such children.