Morphological changes in placenta of lung tuberculosis mothers

The aim of the research was to study the features of the morphogenesis of placenta in pregnant women suffering from pulmonary tuberculosis, according to the nature of the pathological process and the treatment. Patients and methods. The investigation of 173 placentas of the third trimester's deliveries was made. There were four patient's groups: two groups consisted of pregnant women with tuberculosis: the first one - 104 women who received antituberculous therapy and second one - 19 pregnant women who had refused from treatment. The control groups consisted of patients without tuberculosis but they had complication of pregnancy - preeclampsia (30), and the second control - healthy pregnant women (20). Results - It has been revealed that the mechanism of placental adaptation reactions in groups with tuberculosis and preeclampsia was the same. But it was different in the groups of patients who underwent antituberculous treatment and did not receive it. The compensated placental insufficiency has been diagnosed in all groups but subcompensated and decompensate insufficiency have been found only in the groups with tuberculosis and preeclampsia. In the study of the 3D density of axial capillaries of terminal villies the smallest density was observed in placenta of patients with preeclampsia - 29.4 ± 0.5 %, and in placenta of patients with tuberculosis, the 3D density of axial capillaries of terminal villi has also been reliably lower compared to the control group: 29.69 ± 0.82 %. In the control group it was 40.81 ± 1.03 %. The most significant pathologic changes (the inhibition of terminal villi's angiogenesis) were found in the group of patients with tuberculosis who had not been treated from it. The high relative density of terminal villi with vascular membranes - 56.2 ± 0.8 % was determined in the control group, in the first group it was 22.1 ± 1.8 %, in the second - 23.5 ± 0.8 %, in the third group - 32.4 ± 1.0 %, thus lung tuberculosis inhibits the formation of terminal villi with vascular membranes, it may negatively affect fetal trophic and tuberculostatic therapy is obviously not able to neutralize this effect. The adaptation was signed better in group of patients treated from tuberculosis during pregnancy and had cells mechanism.

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Yakimova A.V. - doctor of medical sciences, associate professor of the chair of obstetrics and gynecology, e-mail: yakimova@hotmil.com
Shkurupiy V.A. - doctor of medical sciences, professor, academician of RAMS, head of the chair of pathology, director, e-mail: sck@soramn.ru
Marinkin I.O. - doctor of medical sciences, professor, head of the chair of obstetrics and gynecology, rector, e-mail: rector@ngmu.ru