The profile of villous chorion vascularization in primary placental insufficiency

Abstract

Introduction. Placentation and autochthonous vascularization during the early period of intrauterine development in primary placental insufficiency are important stages in the establishment of embryo-haemochorial circulation. Vascular and angiogenesis dysfunctions in the early period of gestation are essential in the development of changes in placental vascular status with severe repercussions on pregnancy outcome in the first trimester of gestation. The purpose of the work. Evaluation of vascular density by the application of the anti-CD31 antibody in the chorio-villar germinal site in short-term dysregulated pregnancies. Material and methods. 184 cases were divided into 2 groups: stagnant pregnancies (SP (L1 = 144 cases) and early spontaneous abortion (ESA) (L2 = 40 cases). Control material: pregnancies resolved at social indications/desire (A) (n = 18) distributed according to gestational term (3-5 weeks), (6-9 weeks), and (10-12weeks). The estimation of the histomorphological features was performed by applying the classical conventional method with hematoxylin-eosin (H.E.), and the immunohistochemical evaluation of the vascular density in the chorio-villar profile with the help of the endothelial marker anti-CD31. The statistical relationships between fetal conceptus assessment forms, gestational term, and age were analyzed. Results. Distribution of pregnancies by profile: (SP) – 78.2% vs (ESA) – 21.8%, with vascular disturbances attested in 100% of cases by increasing the density of avascular chorionic villi in the case of stagnant pregnancies in 75% of cases. The application of immunoexpression with anti-CD31 at the level of the stroma of the chorionic villi determined PVI with a maximum mean in the control group (91.51±0.71) vs the ESA and SP groups (82.29±12.96 and 57.47±6.53, respectively). The index of vascularization with lumen (IV/L+) and vascularization index without lumen (IV/L-) were statistically significantly different (p = 0.011) for (SP). Applying the student t-test revealed statistically significant differences for PVI in most groups, except PSD vs SP at the age of 10-12 gestation of weeks (w.g.) At the same time, there are statistically significant differences between the means of vessels with lumen within PSD and SP (t31 = 5.500, p = 0.000005), and the means of vessels without lumen registered statistically significant differences in the PSD and SP groups (t12 = 3.862, p = 0.002). Conclusions. Pregnancy evolution depends on the degree of vascularization, as well as on the quality of the vascular network. Disruption of placental vasculature is one of the basic links in the development of primary placental insufficiency during placentation.