HISTOLOGICAL FEATURES OF THE PLACENTA IN IRON DEFICIENCY ANEMIA

Аннотация

Morphological features of the structure of the placenta in women with iron deficiency anemia were identified depending ontheseverity and duration ofthe disease. Kеywоrds:iron deficiency anemia, placenta, placental insufficiency. INTRОDUСTIОN Data from the World Health Organization (WHO) clearly demonstrate that iron deficiency anemia in pregnant women occurs in both developing (35-80%) and the most developed countries (14%) [4]. The consequences of iron deficiency anemia in pregnant women on the body are not only a deterioration in the quality of life of the pregnant woman and her general well-being, but also a negative impact on the condition of the placenta, and accordingly on the intrauterine development of thefetus [1,2,3]. MАTЕRIАLSАNDMЕTHОDS The study of 94 placentas with iron deficiency anemia was carried out according to a standardized scheme [3], which included macroscopic analysis, material excision, histological examination of excision fragments using transmission and light microscopy. Fragments measuring 1.0 x 1.0 cm were cut from different parts of the placenta (central, paracentral, peripheral) for light microscopy, then histological processing was carried out in the Excelsior ES apparatus with subsequent embedding in paraffin. After microtomy, sections of a given thickness of4-5 μm were stained withhematoxylin and eosin, examinedin a light microscope «TORIC – T CETI». For transmission electron microscopy, 1.0 mm placental fragments were fixed in a three-component mixture (25% glutaraldehyde - 2 ml, 2% formaldehyde, freshly prepared from paraformaldehyde - 4.8 ml, 0.1 M phosphate buffer, pH 7.2 - 50 ml). After fixation with 1% OSO4, dehydrated and embedded in a resin mixture. After preparing microtome semi-thin sections of 0.25 - 0.5 μm, they were stained with toluidine blue and viewed in an electron microscope of the JEM and Philips companies in order to identify the frequency and spectrum of morphological variations in the placenta, as well as to study the effect of iron deficiency anemiaat the ultrastructural level. RЕSULTSАNDDISСUSSIОN The studies showed that the placenta weight in all groups with iron deficiency anemia was reduced proportionally to the increase in the severity of anemia. The umbilical cord attachment was paracentral. In the placentas of women with anemia before pregnancy, an increase in the area with infarcts was noted. In placentas without clinically expressed pathology, compensatory processes were observed, in the form of plethora of the villi in parallel with signs of pathological changes in the form of sclerosis and fibrinoid necrosis. When examining the placentas of women in whom anemia was diagnosed during pregnancy, compensatory processes were revealed in the form of plethora of the villi, expansion of the capillary surface and the presence of pinocytotic vesicles and invaginations in endothelial cells. This picture was most clearly expressed in mild www.wordlyknowledge.uz ILMIYMETODIK JURNAL JOURNAL OFIQRO –ЖУРНАЛ ИҚРО –IQRO JURNALI –volume 15,issue01,2025 ISSN:2181-4341, IMPACT FACTOR( RESEARCH BIB )–7,245,SJIF–5,431 and moderate anemia. Along with compensatory-adaptive processes, the presence of sclerosis and disturbance of rheological properties of blood were noted, which were manifested in the formation of fibrinoid thrombi in the intervillous space and necrosis of the villi [1,2]. When examining the placentas of women who had anemia before pregnancy, signs of chronic placental insufficiency were revealed in the form of degeneration of villi into sclerotic or fibrinoid-altered ones and an increase in the number of immature villi. Signs of circulatory disorders were diapedetic hemorrhages, stasis and thrombosis. Hemolysis of erythrocytes was detected in individual vessels. In antenatal and early neonatal losses, given equal conditions of the mother's body, signs of decompensated chronic placental insufficiency came first. In perinatal losses, an increase in the fibrinoid area, the number of vessels with an obliterated lumen and a sclerotic wall was noted. The syncytiotrophoblast area was sharply limited due to the presence of numerous infarcts. The number of afunctionally contiguous villi was reduced proportionally to the increase in pathologically immature, sclerotic and fibrinoid-altered villi. When studying the placentas of women who received antianemic treatment before pregnancy, morphological signs of compensatory processes were identified, aimed at improving metabolism and maintaining the synthetic properties of the placenta, expressed in the plethora of villi, the preservation ofthesyncytiotrophoblast andendoplasmicreticulum with changes in mitochondria. Sometimes it is difficult to diagnose the cause of iron deficiency, or your doctor may be concerned that there is a problem other than iron deficiency causing the anemia. These may include inherited blood disorders called thalassemiasin which red blood cells also appear small and pale, hemoglobinopathies