MORPHOMETRIC CHARACTERISTICS OF PLACENTA IN WOMEN WITH PREECLAMPSIA AND OBESITY COMPARED TO WOMEN WITH NORMAL BODY WEIGHT.

OBJECTIVE: The aim: to investigate the morphometric characteristics of placentas in women with comorbidity of preeclampsia and obesity compared to women with physiological body weight, and to assess the efficacy of the prophylactic therapy course developed to prevent the occurrence of preeclampsia in pregnant women with obesity. PATIENTS AND METHODS: Materials and methods: 25 biopsy samples of placental tissue were taken from women between 37 and 40 weeks of gestation with a physiological body weight and with class II obesity. The women were divided into five groups of five women in each: the 1st group included women with physiological body weight without obstetric and somatic pathology; the 2nd group involved women with physiological body weight, whose pregnancy was complicated with preeclampsia; the 3rd group was made up of women with class II obesity whose pregnancy was complicated with preeclampsia; the 4th group consisted of women with class II obesity, who received the special prophylactic therapy course, and the 5th group included women with class II obesity, who did not receive the prophylactic therapy course. RESULTS: Results: The analysis of morphometric parameters of placenta samples taken from women with preeclampsia and obesity demonstrates a number of com-pensatory and adaptive changes in placenta under hypoxic conditions, and the most important of them include a significant decrease in the number and the mean diameter of the terminal villi, the reduction of volume of villious tree, an increase in the diameter of the capillaries of terminal villi. The morphometric parameters and histological structure in placenta samples from women with obesity, who received the special the prophylactic therapy course, as well as in placenta samples of the control group were similar to the gestational normative values. CONCLUSION: Conclusions: The morphometric investigation of placenta samples taken from women with comorbidity of preeclampsia and obesity has shown a significant decrease in the mean diameter of the terminal villi and an increase in the diameter of the capillaries of these terminal villi when compared with a group of women with preeclampsia and physiological body weight. The study has also demonstrated the distortion of the percentage ratio of the volume of the intervil¬lous space and the ratio of medium-calibre villi. The combination of these changes indicates a lack of adaptive capabilities in the placenta during preeclampsia under increasing hypoxic condition.

CHARACTERISTICS OF CD68+ AND CD163+ EXPRESSION IN PLACENTA OF WOMEN WITH PREECLAMPSIA AND OBESITY.

OBJECTIVE: The aim: To study the peculiarities of CD68+ and CD163+ macrophage expression in the placentas of women with obesity who developed preeclampsia by applying immunohistochemical method. PATIENTS AND METHODS: Materials and methods: The study included 20 placentas taken from women who delivered full-term live-birth babies. The women were divided into 4 groups of 5 individuals each: women with physiological body weight (1st group); women with class II obesity (2nd group); women with physiological body weight and preeclampsia (3rd group); women with class II obesity, who developed preeclampsia (4th group). RESULTS: Results: The analysis of the expression level of CD68+ and CD163+ decidual macrophages shows the predominance of CD68+ pro-inflammatory profile over CD163+ anti-inflammatory profile in women of all groups. Evaluation of CD68+ and CD163+ expression levels of Kashchenko-Hofbauer cells in the stroma of the terminal villi of the placentashows that the expression level of CD68+ macrophages is significantly higher in women with obesity and preeclampsia than in the control, or in women with obesity or preeclampsia. There was a reverse tendency to the polarization shift in Kashchenko-Hoffbauer cells in the stroma of the terminal villi towards the predominance of CD163+ macrophages over CD68+ macrophages in all groups of women. CONCLUSION: Conclusions: The imbalance in anti-inflammatory and pro-inflammatory profile of placental macrophages with a predominance of the latter can lead to the development of preeclampsia.

ASSESSMENT OF ENDOTHELIAL DYSFUNCTION IN PREGNANT WOMEN WITH OBESITY AND PREECLAMPSIA.

OBJECTIVE: The aim: To assess the values of endothelial vascular growth factor (VEGF) in blood serum and circulating endothelial microparticles CD32+CD40+ in the peripheral blood of pregnant women depending on the severity of obesity and presence of preeclampsia. PATIENTS AND METHODS: Materials and methods: the study included 122 pregnant women divided into groups in accordance with their height and weight parameters and presence of preeclampsia. We studied the serum VEGF concentration by enzyme-linked immunosorbent assay, carried out the count of CD32+CD40+ circulating endothelial microparticles in the peripheral blood by using flow cytometry. RESULTS: Results: It has been found out the serum VEGF concentration in pregnant women with obesity decreases with rising level of obesity and the preeclampsia manifestation. In contrast to the decrease in this marker, there is an increase in the number of circulating endothelial microparticles CD32+CD40+ in the peripheral blood of pregnant women with obesity and preeclampsia. This pattern of these indicators points out the presence of endothelial dysfunction, which may contribute to occurrence of preeclampsia in pregnant women with concomitant obesity. CONCLUSION: Conclusions: The indicators of VEGF concentration and the count of circulating endothelial microparticles CD32+CD40+ in the blood serum can serve as reliable markers for evaluating the severity of endothelial dysfunction in pregnant women with concomitant obesity and preeclampsia.