Stereological analysis of terminal villi, intervillous space and fibrinoid of adolescent placentas and birth weight of newborns.

Aim To determine stereological structural parameters of the parenchymal part of the placenta, placental weight and volume of adolescent pregnant women and their correlation with newborns' birth weight. Methods This prospective study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. Experimental group consisted of 30 placentas of pregnant women aged 13-19 years. Control group consisted of 30 placentas of pregnant women aged 20-35 years. Stereological analysis was performed. Results Volumetric density of terminal villi of adolescent placentas was significantly higher than the one of control group (p <0.0001). The volumetric density of fibrinoid of adolescent placentas was significantly lower than of the control group (p <0.0001). Total volume of terminal villi of adolescent placentas was significantly higher than of the control group (p<0.0001). The total volume of fibrinoid of adolescent placentas was significantly lower than of the control group (p<0.0001). Newborns of adolescent pregnancies had in average lower birth weight of 439.01 g compared to the newborns of the control group (p <0.00001). Conclusion Adolescent pregnancy affects placental structure, weight and volume. Newborns of adolescent pregnancy have optimal body weight.

Challenges in the Routine Praxis Diagnosis of Hydatidiform Mole: a Tertiary Health Center Experience.

INTRODUCTION: Hydatidiform moles (HM), presenting as complete (CHM) and partial (PHM) form, are rare pregnancy disorder. Diagnosis is based on clinical presentation, ultrasound imaging findings and pathological examination of products of conception. Protein p57, encoded by CKDN1C gene, is paternally imprinted and maternally expressed gene and provides quick insight in genetic basis of HM and allows distinction of CHM from all other conceptions. compare the preevacuational and pathohistological diagnosis with outcome of p57 immunostaining. MATERIAL AND METHODS: All cases of HM diagnosed between January 2011 and December 2015 were included in this research. Maternal age, gestational age and input diagnosis data were recored. p57 immunostaining was performed in order to evaluate the diagnosis based on tissue slides examination. RESULTS: There were 198 cases of histologically confirmed HM, 185 PHM, 12 CHM and one case of undefined HM. Mean maternal age in the CHM group was 24,7 and in the PHM group 26,9 years, with no significant differences among these two groups (p=0,27). For CHM mean gestational age was estimated at eight and for PHM 9,2 gestational weeks. Pregnant woman older than 40 years present significant earlier compared with younger woman (p<0,01), and those younger than 20 years tend to present at the beginning of the second trimester more often than older women (p<0,05). In the CHM group, 9 (75%) input diagnoses were mola in obs, and 3 (25%) of them were signed as abortion, unlike the PHM where 126 (67%) were qualified as abortion, 35 (19%) as blighted ovum, and 26 (14%) were suggestive for molar pregnancy. p57 immunostaining results confirmed all pathohistological diagnosis of CHM whereas 8% of PHM demonstrated divergent p57 expression. CONCLUSION: PHM, compared with CHM, represent a greater diagnostic challenge for both gynecologist and pathologist even when presenting in more advanced pregnancies.

Influence of maternal anemia during pregnancy on placenta and newborns.

INTRODUCTION: Sideropenic anemia is a common pregnancy disorder. Depending on severity, maternal anemia can significantly influence morphometric characteristic of placental tissue, pregnancy course and outcome. OBJECTIVES: to estimate if maternal anemia a) results with significant placental changes; b) influence on newborn weight, length and vitality. PATIENTS, MATERIAL AND METHODS: Research included 100 women and their newborns, 50 anemic, and 50 women in the control group. Sixty placentas were collected, placental mass and volume was determined, and blood vessels of terminal villi were stereologically analyzed. Newborns mass and body length, and Apgar scores within 1 and 5 minutes after delivery were recorded. THE RESULTS: Placentas of anemic pregnant women showed significant increase of terminal villi blood vessels (224.18 vs. 197.00 cm3; p < 0.0001), but total placental mass and volume did not differ significantly. Anemic mothers' newborns were significantly shorter (51.76 vs. 55.54 cm; p < 0.0001), smaller body mass (3048.00 vs. 3615.60 g; p < 0.0001) and delivered one week early (38.2 vs. 39.2 GW; p < 0.0001), but not significantly poorer vitality (p > 0.05) comparing with the control group. CONCLUSION: Sideropenic anemia increase placental maturity, that could be a possible cause of earlier spontaneous delivery among anemic women. The anemic mothers' newborns are shorter and lower body mass, but not poorer vitality index.

Stereological analysis of terminal villi of the placentas of pregnant woman with sideropenic anemia.

Iron deficiency, causing maternal sideropenic anemia, is one of the most frequent nutritive disorder that develops during the pregnancy. We collected 30 placentas from anemic mothers and 30 placentas from mothers belonging to the control group. Terminal villi (magnification 10x) and terminal villi capillaries (magnification 40x) were stereologically analyzed and numerically determined.In the placentas from anemic mothers we noted the values a) terminal villi: volume density 0,43 mm0, surface density 24.13 mm-1, total volume 185.57 cm3 and total surface 10.27 m2; b) capillaries of terminal villi: volume density 0.53 mm0 and total volume 224.18 cm3. In the placentas from mothers belonging to the control group we observed the following values a) terminal villi: volume density 0.44 mm0, surface density 22.27 mm-1, total volume 200.17 cm3 and total surface 10.15 m2; b) capillaries of terminal villi: volume density 0.42 mm0 and total volume 197.00 cm3. Compared with the control group anemic mothers' placentas have a significant higher values of surface density of terminal villi (p<0.05), volume density (p <0.01) and absolute volume (p<0.0001) of terminal villi capillaries, and significant lower values of absolute volume of terminal villi (p<0.05).In anemic mothers' placentas, the total volume of terminal villi changes disproportionately to the total surface of terminal villi with statistically significant increase of terminal villi capillaries compared with control group. 

Talc pleurodesis in pleuropulmonary diseases treatment.

AIM: To determine the efficiency and safety of talc pleurodesis in treating the malignant pleural effusion and recurrent spontaneous pneumothorax. METHODS: The study included 54 patients with malignant pleural effusion and recurrent spontaneous pneumothorax, who underwent talc pleurodesis using the "talc slurry" method of pleural talc obliteration. RESULTS: Pleurodesis was successful in 52 (96%) patients. The average duration of thoracic drainage was 4.4 days. Procedure complications included higher body temperature, pneumonia and pleural effusion separation. All of the patients had satisfying radiological findings at the point of discharge and three months later. There was no death outcome related to the procedure of pleurodesis itself. CONCLUSION: Our study has proved the efficiency and simplicity of talc pleurodesis in treating symptomatic malignant pleural effusions and cases with recurrent spontaneous pneumothorax.Appropriate patient selection and compliance with surgical principles during the procedure make this method safe, efficient and successful in treating pleuropulmonal diseases. Large particle talc should be used for pleurodesis because of the minimum risk of complications.

Influence of maternal anemia during pregnancy on placenta and newborns.

INTRODUCTION: Sideropenic anemia is a common pregnancy disorder. Depending on severity, maternal anemia can significantly influence morphometric characteristic of placental tissue, pregnancy course and outcome. OBJECTIVES: to estimate if maternal anemia a) results with significant placental changes; b) influence on newborn weight, length and vitality. PATIENTS MATERIAL AND METHODS: Research included 100 women and their newborns, 50 anemic, and 50 women in the control group. Sixty placentas were collected, placental mass and volume was determined, and blood vessels of terminal villi were stereologically analyzed. Newborns mass and body length, and Apgar scores within 1 and 5 minutes after delivery were recorded. THE RESULTS: Placentas of anemic pregnant women showed significant increase of terminal villi blood vessels (224,18 vs. 197,00 cm(3); p<0,0001), but total placental mass and volume did not differ significantly. Anemic mothers' newborns were significantly shorter (51,76 vs. 55,54 cm; p<0,0001), smaller body mass (3048,00 vs. 3615,60 g; p<0,0001) and delivered one week early (38,2 vs. 39,2 GW; p<0,0001), but not significantly poorer vitality (p>0,05) comparing with the control group. CONCLUSION: Sideropenic anemia increase placental maturity, that could be a possible cause of earlier spontaneous delivery among anemic women. The anemic mothers' newborns are shorter and lower body mass, but not poorer vitality index.

Quantitative research of capillaries in terminal villi of mature placentae.

Advanced maternal age is known to be a risk factor for placental dysfunctions. The most common obstetric complications among older women would be considered as follows: gestational diabetes; pre-eclampsia; placenta praevia; preterm premature rupture of membranes and the risk of preterm delivery. The aims of research were to determine the impact of maternal age on the structure of terminal villi. The study was conducted on 60 human placentae of term pregnancy divided into two groups: the control group (30 placentae in pregnant women of age between 20 and 34) and the experimental group (30 placentae in pregnant women of 35 years of age and older). Stereological methods were applied to determine the volume density, surface density, total volume and total capillary surface area in terminal villi of placenta. The mean value of volume density of capillaries in terminal villi of placentae in older pregnant women is: Vvkks = (0,376 +/- 0,033) mm(0), and the mean value of total volume is: Vkks = (157,047 +/- 25,022) cm(3). The mean value of surface density is: Svkks = (64,783 +/- 2,543) mm(-1), and the mean value of total surface area is: Skks = (29,959 +/- 7,873) m(2). Volume density of capillaries in terminal villi of placentae is significantly lower in older pregnant women (p<0.001) in comparison to the younger pregnant women. The total volume, surface density and total capillary surface area in terminal villi of placentae are also significantly lower in older pregnant women (p<0.005) in comparison to the younger pregnant women. Statistically significant lower values of volume density, total volume, surface density and total capillary surface area indicate that there is a decreased metabolic transfer between mother and foetus.

[Stereological analysis of syncytiotrophoblast in resorption villi of placentas of young and older pregnant women]. / Stereoloska analiza sinciciotrofoblasta resorpcijske resice posteljice trudnica mlade i starije zivotne dobi.

AIM: To determine quantitative parameters of volume density and absolute volume of syncytiotrophoblast in resorption villi of control and experimental group, compare the results and search for correlation between structural parameters of resorption villi and pregnancy age. METHODS: The research was performed on 60 human placentas of term pregnancy: 30 placentas of pregnant women of age 20 - 34 (control group), and 30 placentas of pregnant women of age 35 and older (experimental group). Stereological analysis was performed on multipurpose testing system M42 with 40 times objective magnification. RESULTS: Average volume density of syncytiotrophoblast in resorption villi of experimental and control group was Vvss = (0,489 ± 0,032) mm0 and Vvsm = (0,389 ± 0,078) mm0 , respectively. Statistical analysis of results using Student t-test indicated a significantly higher volume density of syncytiotrophoblast of resorption villi in the experimental than in the control group (p < 0,001). Absolute volume of syncytiotrophoblast in resorption villi of the experimental and control groups was Vss = (205,250±40,894) cm3 and Vsm = (178,386 ± 44,413) cm3, respectively. We have found a significantly higher absolute volume of syncytiotrophoblast in resorption villi in the experimental than in the control group (p < 0,005). CONCLUSIONS: Statistically significant higher values of volume density and absolute volume of syncytiotrophoblast in resorption villi of placentas in older pregnant women represent a compensatory mechanism as a response to decreased metabolic exchange between a mother and a fetus.

[Length and surface density of the resorption villi's blood vessels in smokers placentas]. / Duljinska i povrsinska gustoca krvnih zila resorpcijske resice placente trudnica pusacica.

This study was conducted with intention to reveal the quantitative values of feto-maternal nutrition exchange in smokers placentas, considering the great importance of harmful influence of smoking in pregnancy. The study was done on 90 human placentas. We have divided them into three groups: 30 placentas of moderate smokers, 30 placentas of heavy smokers and control group (non-smokers). Stereologic analysis was done with multipurpose test system M42. Pregnant smokers (both moderate and heavy) had significantly lower length density of the blood vessels compared to the control group. Significantly higher surface density of the blood vessels was found in the pregnant heavy smokers. The least absolute length density of the resorption villi's blood vessels was in the pregnant heavy smokers and it was significantly lower compared to pregnant moderate smokers and control group. In the group of the pregnant heavy smokers there was statistically higher average absolute surface of the blood vessels. The intensity of smoking effects the structural changes of the placenta. Intensity of smoking during pregnancy had a great impact on the proportion of the morphologic changes of the placentas. It leads to hypoxia, which in turn may be the cause of fetal growth and developmental retardation.

[Morphological research of fibrinoid and intervillous space of human term placenta in relation to the age of pregnant woman]. / Morfoloska istrazivanja fibrinoida i intervilusnog prostora humane zrele posteljice u odnosu na zivotnu dob trudnice.

Fibrinoid and intervillous spaces of the mature human placenta were morphologically and quantitatively examined in pregnant women of different ages. The aim of this research was to compare the results and to confirm if there is some quantitative difference between fibrinoid and intervillous spaces of placenta related to the age of pregnant women. The examined group of women were of age between 20 and 45 years, and they were divided into two groups: 1) pregnant women 20-35 year old; 2) pregnant women over 35 years old. The volume density and absolute volume of fibrinoid and intervillous space of placenta were stereologically examined. Volume densities of fibrinoid and intervillous space of placentas in older pregnant women compared to younger is significantly increased. Absolute volumes of fibrinoid and intervillous space of placentas in younger and older pregnant women are not significantly different.

Stereological analysis of mature human placenta of pregnant women of different age.

The normal placentas, regular pregnancies and deliveries were structurally examined. The aim of this research was to compare the results and to confirm if there were some difference in the structure of placenta related to the age of pregnant women. We examined 30 human placentas. The examined group of women were divided into two groups: 1) pregnant women 20-35 years old; 2) pregnant women over 35 years old. The stereological method was used. The volume density, absolute volume, the surface density and absolute surface of terminal villi of placentas in younger and older pregnant women were not significantly different. The volume density, absolute volume, the surface density and absolute surface of the other placentas villi in younger pregnant women compared to older ones, were significantly increased (p<0.001). The volume density of fibrinoid of placentas in older pregnant women compared to younger ones was significantly increased (p<0.02). The surface density, absolute volume and absolute surface of fibrinoid in these two examined groups of pregnant women were not significantly different. The volume density of intervillous space of placentas in older pregnant women compared to younger ones was significantly increased (p<0.05). Absolute volumes of intervillous space of placentas in these two examined groups of pregnant women are not significantly different.

[Stereologic analysis of chorionic villi and fibrinoids in the mature human placenta in pregnant women of various ages]. / Stereoloska analiza horionskih resica i fibrinoida zrele humane posteljice kod trudnica razlicite zivotne dobi.

The terminal and other chorionic villi and fibrinoid of the mature human placenta were morphologically and quantitatively examined in pregnant women of different ages. The aim of this research was to compare the results and to confirm if there is some difference in the structure of placenta related to the age of pregnant women. We examined 30 human placentas, regular pregnancies and delivery. The examined group of women were of age between 20 and 45 years, and they were divided into two groups: 1) pregnant women 20-35 years old; 2) pregnant women over 35 years old. Relative and absolute variables were stereologically examined and compared as follows: the surface density and absolute surface of terminal and other villi and fibrinoid. No significant differences in surface density of terminal villi and fibrinoids in older or younger pregnant women's placentas. Surface densities of the other placentas villi in younger pregnant women compared to older are significantly increased. Absolute surface of terminal villi and fibrinoid in these two examined groups of pregnant women are not significantly different. Absolute surface of the other placenta villi in younger pregnant women compared to older pregnant women is significantly increased.