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Документ Features of the functional morphology of the placenta in case of premature amniotic fluid discharge(Полтавський державний медичний університет, 2023) Hromova, A. M.; Mitiunina, N. I.; Shafarchuk, V. M.; Martynenko, V. B.; Prylutska, N. O.; Liakhovska, T. Y.; Громова, Антоніна Макарівна; Мітюніна, Ніна Іванівна; Шафарчук, Валентина Михайлівна; Мартиненко, Віталій Борисович; Прилуцька, Неоніла Олексіївна; Ляховська, Тетяна ЮріївнаPremature discharge of amniotic fluid creates conditions for ascending infection of the placenta, fetus and newborn, disruption of uteroplacental blood circulation with the subsequent development of fetal distress. The placenta is one of the first barriers that help limit exposure to harmful substances. Dysfunction of the placenta can contribute to complications that increase the morbidity and mortality of both the fetus and the newborn. The study aimed to determine the morphological features of the placenta in case of premature discharge of amniotic fluid. Ninety placentas of women with the premature and timely discharge of amniotic fluid were examined using a standardized method of organo- and morphometry. In 42% of cases, there was a central attachment of the umbilical cord, in 35% (24/69) – lateral and in 1% – membrane. The length of the umbilical cord was 61.6±8.3 cm, and the distance from the place of the membranes to the edge of the placenta was 14.36±3.8 cm. In 41% (28/69) placentas, the course of the vessels was main, in 40% (27/69), it was mixed and in 20% (14/69) dispersed. The intervillous space with the premature discharge of amniotic fluid was empty in only three observation cases (4%). In other cases (96%), it is uneven, in some places sharply narrowed, up to its complete disappearance (the focus of acute infarction). In 10 observations (15%), the intervillous space was centrally expanded with the accumulation of blood and the formation of haemorrhages. In others, it is filled with single erythrocytes and exfoliated syncytial elements. In 8 observations (12%) in the intervillous space, single and concentrated accumulations of segmented nuclear leukocytes were found - focal intervillitis. Early signs of "ageing" of the placenta with the premature discharge of amniotic fluid and disruption of uteroplacental blood flow were revealed. The presence of "infarctions" of the placenta, partial thrombosis, and uneven blood vessels contributed to a synchronous increase in fetal distress.Документ The role of paraplacental tissues in fetal homeostasis(Полтавський державний медичний університет, 2023) Hromova, A. M.; Mitiunina, N. I.; Shafarchuk, V. M.; Martynenko, V. B.; Prylutska, N. O.; Ketova, O. M.; Krutikova, E. I.; Громова, Антоніна Макарівна; Мітюніна, Ніна Іванівна; Шафарчук, Валентина Михайлівна; Мартиненко, Віталій Борисович; Прилуцька, Неоніла Олексіївна; Кетова, Олена Миколаївна; Крутікова, Елла ІванівнаThe amniotic sac and amniotic membranes are of great importance in the release of childbirth activity, the biomechanism of childbirth, as a factor that contributes to the physiological processes of smoothing and opening of the cervix. We studied the changes in the morphological structure of 30 amniotic membranes during premature rupture and 10 during timely rupture. A clinical-morphological study with premature rupture of the amniotic membranes was carried out taking into account changes in the vaginal discharge depending on the duration of the waterless interval. In contrast to membranes with premature spillage of amniotic fluid, with premature rupture of the amniotic membranes near their edge, pronounced swelling of all elements of the membranes is noted. With premature discharge of amniotic fluid and a minimal waterless interval, degenerative changes in the membranes in women with premature rupture occur much earlier. Destruction of epithelial cells and their degenerative changes were observed in the amnion. There is no clear border between the amnion and the smooth chorion. With a waterless interval of 8 or more hours, parietal deciduitis develops first, then chorioamnionitis. Placental basal and septal deciduitis and less often intervillosis join. When the water-free period increased for more than 10 hours, dystrophic changes of the epithelium were noted, marked transformation into a continuous cuticular formation. The detected changes in the amnion and chorion, with a minimal waterless interval, are characterized by the destruction of epithelial cells, degenerative changes, the absence of a clear border between the amnion and the chorion, changes in the intercellular space, swelling and thickening of the walls of blood vessels, which suggests that with their premature rupture, the most characteristic degenerative-dystrophic changes. Inflammatory reaction is joined when the waterless interval is lengthened.