MORPHOFUNCTIONAL CHARACTERISTICS OF PLACENTA AT CYTOMEGALOVIRUS INFECTION ACTIVATION DURING EARLY STAGES OF GESTATION

Abstract

The aim of the research is to identify the changes in placenta at the activation of cytomegalovirus infection in women at early stages of gestation. We have studied the features of morphofunctional state of placenta in comparison with α-fetoprotein in 20 women with the active form of chronic cytomegalovirus infection (confirmed by the presence of IgM in the blood serum or four times and more IgG antibodies titer growth in paired serums in dynamics in 10 days and by the presence of avidity index of more than 65%) who had a medical abortion at 8-10 weeks of pregnancy. The control group included 16 practically healthy seronegative to cytomegalovirus women at the same period of gestation. The histological research of placentas allowed to identify the disturbances of cytotrophoblastic elements transformation into syncytiotrophoblast, the delay of mesenchyme differentiation towards the formation of blood vessels endothelium, dystrophic changes of chorion structure (fibrosis, villi stroma necrosis). There were also degenerative changes in the maternal part of placenta conditioned by epithelium desquamation and subepithelial layer necrosis. Spiral arteries in most cases were spasmed. The suppression of α-fetoprotein production is a very important cause of identified gestation disturbances of trophoblast structures and endometrium differentiation at reactivation of cytomegalovirus infection. This is proved by its low level in the blood of women aborted at 8-10 weeks of gestation in comparison with the parameters in the control group (8.0±0.6 and 15.2±1.2 МЕ/ml, respectively, р<0.001). The obtained results prove the significant role of cytomegalovirus infection in the formation of dystrophic changes of chorion villi, insufficiency of uterine blood flow and the threat of abortion at early stages of gestation.