Morphological and immunohistochemical parameters of chronic placental insufficiency in preeclampsia

Aim. To determine the morphological parameters of chronic placental insufficiency in pregnancy complicated by preeclampsia, also in women with chronic arterial hypertension (CAH). Materials and Methods. The analysis of history data, peculiarities of pregnancy and childbirth in women with hypertensive disorders was carried out. A review histology of 40 placentas in moderate preeclampsia, 40 placentas in severe preeclampsia, and 35 placentas of women with CAH and associated preeclampsia was performed. The control group consisted of 20 placentas of women with uncomplicated pregnancy without hypertensive disorders. Immunohistochemical examinations were performed on paraffin sections according to standard methods using primary goat antibodies to annexin V (R-20, sc-1929) and rabbit antibodies to erythropoietin (H-162, sc-7556) in a working dilution 1:200 with Super Sensitive IHC polymer detection system. Results. Based on the results of pathomorphological examination of placentas of women with hypertensive disorders, two forms of chronic placental insufficiency were identified. The defining form of placental insufficiency in women with CAH and associated preeclampsia was fetoplacental insufficiency, and in preeclampsia of moderate severity and in severe one – utero-placental form of chronic placental insufficiency. Based on the study of the dynamics of expression of annexin V and erythropoietin, morphological parameters of the placental compensatory potential and placental hemostasis disorders in hypertensive disorders in pregnant women were determined. Conclusion. Diagnostic morphological criteria for fetoplacental insufficiency in women with hypertensive disorders are a combination of maternal and fetal malperfusion with obliterative angiopathy of stem villi vessels; in the utero-placental form – obliterative angiopathy of spiral arteries, placental hypoperfusion with the development of local hypoxia and hemostatic disorders in the form of thrombosis of the intervillous space and villi infarcts.