Immunohistochemical and morphological markers of susceptibility to prolonged and postterm pregnancies
Background: Prolonged pregnancy is an urgent problem, which is associated with a high percentage of complications in childbirth and perinatal mortality. A large number of morphological studies have shown the relationship of fetal disorders during post-term pregnancy with changes in the placenta. In recent years, interest in the immunohistochemical method for diagnosing prolonged pregnancy has increased significantly. However, the role of such markers as collagen and procollagen in the diagnosis of prolonged pregnancy, which play a main role in the formation of the placenta structure and its functioning, has not been studied. The aim of the study: To study the role of markers of NO-synthase, CD34, collagen and procollagen in the placenta with a tendency to prolonged pregnancy and post-term birth as clinical, morphological and immunohistochemical criteria for the diagnosis and prevention of postnatal disorders. Materials and methods: The material of the study was placenta biopsies obtained by standard morphological examination and divided into 3 groups depending on the time of delivery: 39-40 weeks; 40-41 weeks and over 41 weeks. An immunohistochemical study of the material was carried out for the degree of markers expression: CD34, NO-synthase, collagen and procollagen. For the purpose of statistical processing of the obtained data, Statistica 10.0 analytics software and Excel 2010 software were used. Results: No significant difference was found in the degree of expression of CD34, NO-synthase in the chorionic villus during full-term and prolonged pregnancy. A low level of expression of type I and type IV collagen was found at a delivery time of more than 41 weeks. Patients with a tendency to prolonged pregnancy were much more common: chronic compensated placental insufficiency, chorionic villous defect, chronic compensated placental insufficiency with acute decompensation. Conclusion: The markers CD34 and NO-synthase are not diagnostically significant, which makes it inappropriate to study them for the assessment of prolonged pregnancy. The revealed decrease in the level of expression of types I and IV collagen during prolonged pregnancy indicates that the placenta during prolonged pregnancy does not fully fulfill its functions.