The Use of Atomic Force Microscopy in Comprehensive Assessment of the "Mother-Placenta-Fetus" System in Obstetric and Endocrine Pathology during Pregnancy.

Atomic force microscopy is not very popular in practical health care, therefore, its potential is not studied enough, for example, in obstetrics when studying the "mother-placenta-fetus" system. Our study summarizes the possibilities of using atomic force microscopy for detection of various circulatory disorders and vascular changes at the microscopic level in the uterus (endometrium and myometrium), placenta, and umbilical cord in the main variants of obstetric and endocrine pathology. For instance, in the case of endocrine pathologies, changes in the form of stasis, sludge, diapedesis, ischemia, destruction and separation of endotheliocytes in villous blood vessels were found in the mother. The oxygen content in erythrocytes also naturally decreased in pathologies; poikilo- and anisocytosis were observed.

[Uteroplacental blood flow in maternal diabetes mellitus]. / Matochno-platsentarnyi krovotok pri sakharnom diabete u materi.

Various uteroplacental blood flow disorders, their diagnosis, and correction, especially if the maternal obstetric history is burdened by endocrinopathy, still remain an urgent obstetric problem. OBJECTIVE: To study blood flow in the vessel-red blood cell segment and to search for changes in both the vessels of the villous tree of the placenta and uterus and the properties of blood corpuscles, by using modern microscopy methods (scanning probe microscopy, atomic force microscopy). MATERIAL AND METHODS: For macroscopic and microscopic examinations, fragments of the placenta, umbilical cord, and uterus were taken; venous blood samples were collected from patients without endocrinopathy, with gestational diabetes mellitus (GDM) or type 1 and type 2 diabetes mellitus (DM) prior to delivery. The data were statistically processed using both parametric (Student's t-test) and nonparametric (Fisher's exact test) methods. RESULTS: The authors found that microangiopathy and other metabolic changes in diabetes mellitus could lead to villous stromal sclerosis, the appearance of intermediate villi, changes in blood vessel shape, relief tortuosity, depth, and area, endothelial cell destruction, stasis, and thrombosis. In these endocrinopathies, there were also changes in maternal red blood cells: their polymorphism was observed and geometric parameters and deformability were impaired. In this case, cell shape impairment correlated with the severity of the above described vascular complications. CONCLUSION: The use of modern microscopy methods makes it possible to diagnose uteroplacental blood flow changes even in early pregnancy and to prevent the progression of uteroplacental blood flow disorders and placental insufficiency.

[The mother-placenta-fetus system in diffuse toxic goiter: Morphopathological aspects].

OBJECTIVE: to compare the clinical and morphological parallels of the mother-placenta-fetus system in diffuse toxic goiter (DTG) through current morphological examinations. SUBJECTS AND METHODS: Sixty-five women whose pregnancy occurred with DTG were examined using both clinical and morphological studies (light, scanning electron, and atomic-force microscopies and macro- and microelement analysis); the placenta and uterus were investigated. RESULTS: Destructive changes and microrelief impairment, resulting from circulatory disorders (ischemia) and hemic hypoxia, were observed in the presence of DTG during pregnancy. Abnormal placental immaturity developed; the number of terminal villi decreased; sclerosis occurred. The magnitude of changes showed up to a greater extent in the myometrium, umbilical cord, and placenta of women, whose pregnancy occurred with DTG, and in patients with disease recurrence. In preeclampsia, plethora, stasis, and thrombosis were added to circulatory disorders. CONCLUSION: Not only the diagnosis itself of DTG, but also the type of its course and the pattern of obstetric disease, primarily preeclampsia, affect the state of structural components of the uteroplacental unit.