MORPHOLOGICAL FEATURES OF PLACENTAS IN PREGNANCIES WITH FETAL GROWTH RESTRICTION SYNDROME

Objective: To present the morphological features of placentas in pregnancies with hypertension and fetal growth restriction syndrome (FGRS) Methods: Eighty-six placentas in pregnancies with FGRS on the background of arterial hypertension are examined. Among them, there were 34 placentas from patients with chronic arterial hypertension (CAH), 24 placentas from patients with preeclampsia (PE), and 28 placentas from patients with PE in combination with CAH. All pregnant women underwent a Doppler ultrasound investigation. FGRS was diagnosed if uteroplacental-fetal circulatory disorders were combined with small for gestational age fetal size. Various types of hypertensive disorders were diagnosed in accordance with WHO recommendations. A comprehensive assessment of structural changes in the placentas included macroscopic examination, organometry and histological evaluation complemented by morphometry. Results: Placental hypoplasia, dominating magistral pattern of chorionic blood vessels, infarction foci, thrombosis of the intervillous space, and compensatory angiomatosis of the chorionic villi are the typical features of the placentas in pregnanсies with FGRS and the background hypertension. Histological signs of chorionic villi ischemia indicate placentation disorders and a decreased intensity of angiogenesis in the uteroplacental circulation. Conclusion: Hypertensive disorders during pregnancy associated with endothelial dysfunction lead to placental insufficiency (PI), causing FGRS.