Ultrasound features of the placenta and pathological and histological characteristics of the afterbirth in tobacco-smoking pregnant women
ORIGINAL PAPERS
Abstract
Introduction. Among the risk factors for the development of violations of the fetoplacental system is smoking, which is one of the most important preventable factor in poor pregnancy outcomes for both mother and fetus. Pregnant smokers significantly more often compared to non-smokers revealed signs of placental insufficiency (p <0,001). The thickness of the placenta in the group of pregnant smokers was significantly less (p <0,034) in comparison with non-smokers. Two times higher calcification in placentas of pregnant smokers compared with non-smokers (p <0,002). One-third of pregnant smokers is determined by the diameter of the umbilical cord below the fifth percentile with an accuracy of p <0,001 compared with non-smokers. Long-term effects of products of tobacco smoke on the placenta leads to the progression of these signs of placental insufficiency: the placenta calcification in 75% of cases are detected in women who reported smoking throughout the pregnancy, which was significantly higher than in the group of women who quit smoking during the first trimester of pregnancy (p <0,021). Aim and tasks. То а ssess the ultrasound and patho-histological characteristics of the placenta, umbilical cord and amniotic fluid in pregnant woman who smoke tobacco for different durations. Materials and methods. Ultrasaund examination of the placenta in smokers and non-smokers at 30–34 weeks of gestation. In a group of women who smoked throughout their pregnancy, a patho-histological study of the placenta was conducted, describing macroscopic changes and the microscopic appearance of histological samples of the placenta, which confirmed the abnormalities identified during ultrasound examination. Conclusion. Р lacental insufficiency authentically more often found in the group of women who smoke throughout pregnancy than in women who quit smoking during the first trimester of pregnancy (p <0,022). It is shown that the quitting smoking has a positive effect on reducing the rate of development formed under the influence of smoking violations, including the frequency and severity of signs of placental insufficiency. To improve the diagnostic value of ultrasound screening justified the introduction of the study of the additional parameter of assessment provisional organs of the diameter of the umbilical cord, a reduction which reflects the degree of influence of components of tobacco smoke on the fetoplacental system.
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