Clinical and morphological features of the placenta in extremely and deeply premature infants

The placenta is the connecting link between mother and fetus. The article is devoted to the problem of identifying pathological changes in the placenta for the diagnosis of various clinical conditions in a premature extremely immature child. The continuous sampling method examined 131 afterbirth (96 afterbirth of extremely premature infants with a gestational age of less than 28 full weeks and 35 afterbirth of premature infants from 28 to 32 weeks of gestation). A comparative analysis of the main morphometric parameters of the placenta was performed; the presence of inflammatory diseases of the placenta (chorioamnionitis; deciduitis; placentitis; funiculitis, villousitis, phlebitis of umbilical cord vessels); the presence of acute placental circulatory disorders, chronic decompensated placental insufficiency. The results obtained for each of the latter were entered into a common database and subjected to statistical processing. When comparing the main clinical and morphometric parameters of live and stillborn babies at gestation from 22 to 32 weeks, a significant difference was found in fetal weight, gestation period, placenta mass and umbilical cord mass. An intrauterine infection, manifested by villousitis and deciduitis, increases the probability of stillbirth by 3.3 times at 22 to 28 weeks of gestation. The presence of placental involution increases the risk of stillbirth by 17.3 times. Histological examination of the placenta is an important step in diagnosing the causes of stillbirth at 22 to 32 weeks of gestation.

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