The role of paraplacental tissues in fetal homeostasis

The amniotic sac and amniotic membranes are of great importance in the release of childbirth activity, the biomechanism of childbirth, as a factor that contributes to the physiological processes of smoothing and opening of the cervix. We studied the changes in the morphological structure of 30 amniotic membranes during premature rupture and 10 during timely rupture. A clinical-morphological study with premature rupture of the amniotic membranes was carried out taking into account changes in the vaginal discharge depending on the duration of the waterless interval. In contrast to membranes with premature spillage of amniotic fluid, with premature rupture of the amniotic membranes near their edge, pronounced swelling of all elements of the membranes is noted. With premature discharge of amniotic fluid and a minimal waterless interval, degenerative changes in the membranes in women with premature rupture occur much earlier. Destruction of epithelial cells and their degenerative changes were observed in the amnion. There is no clear border between the amnion and the smooth chorion. With a waterless interval of 8 or more hours, parietal deciduitis develops first, then chorioamnionitis. Placental basal and septal deciduitis and less often intervillosis join. When the water-free period increased for more than 10 hours, dystrophic changes of the epithelium were noted, marked transformation into a continuous cuticular formation. The detected changes in the amnion and chorion, with a minimal waterless interval, are characterized by the destruction of epithelial cells, degenerative changes, the absence of a clear border between the amnion and the chorion, changes in the intercellular space, swelling and thickening of the walls of blood vessels, which suggests that with their premature rupture, the most characteristic degenerative-dystrophic changes. Inflammatory reaction is joined when the waterless interval is lengthened.