Immunohistochemical markers and histological and morphological changes in the placenta of women, who gave birth to children with anencephaly
Objective: To study immunohystochemical markers and features of histological and morphological changes in the placenta of women who have given birth to children with anencephaly. Methods: 15 women with anencephaly in the fetus (the main group) and 20 women, who gave birth to practically healthy children (control group), were examined. All women were tested for tumor marker alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG), morphological examination of placenta and levels of apoptosis, definition expression Nkx-2.2 in vascular endothelial cells of the villous chorion of the placenta of women in norm, and with congenital malformation (CM) of the central nervous system (CNS), in particular - anencephaly in the fetus. Results: A feature of the histochemical characteristics of placenta in women who have given birth to children with anencephaly is the predominance of chronic compensated deficiency with manifestations of dyscirculatory disorders. Statistically significant reduction of Nkx-2.2 expression levels in the vascular endothelial cells of the villous chorion placenta of women who gave birth to children with anencephaly, confirms the role of this factor in the differentiation of nervous structures. An inverse correlation between the level of Nkx-2.2 expression in the placenta and the level of AFP in the blood serum of pregnant women at the beginning of the second trimester of pregnancy determines the level of AFP as the most significant marker of the development of anencephaly in the fetus. Conclusions: Based on the conducted studies it is possible to assume the participation of the placenta in the formation of abnormalities of the CNS of fetuses and newborns. Consequently, properly organized antenatal surveillance with mandatory definition of AFP level at 14 weeks of pregnancy will improve the quality of care for women at risk development of CM of the CNS of the fetus, in particular - anencephaly.