The architectonics of fetal placental veins in second-trimester cytomegalovirus infection

Gorikov, Igor; Andrievskaya, Irina; Ishutina, N. A.; Dovzhikova, I. V.

doi:10.17116/patol20198104143

Cited by 9 publications

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“…Also, our results do not indicate an association between the presence of latent CMV infection and the prevalence of certain pregnancy complications, such as pregnancy-induced hypertension, birth weight, spontaneous rupture of membranes, placental abruption, or placenta previa. Although previous studies showed an association between CMV infection and placental lesions, for example, with the CMV infection potentially causing atherosis in the placentas of women with preeclampsia [80] or disturbing placental vein architectonics [32], not all studies reported a correlation between latent CMV infection and preeclampsia. Thus, studies from some authors argued for an association between latent CMV infection and preeclampsia [55,56,58,60,62,63,65,66], while studies from others did not report the presence of this association [57][58][59]61,64].…”

Section: Discussionmentioning

confidence: 96%

“…than in healthy people [26,27]. After primary infection, the latent CMV infection induces changes in the host's immune system at the level of T lymphocytes [28], monocyte innate immune response [29,30], cytokine production, [31] and in several tissues, such as placenta veins [32], blood clot formation [33], HLA-G molecule expression [34], and vessel walls [35]. As most of these biomarkers were found to be associated to some degree with pregnancy complications in recent studies, we could speculate that latent CMV infection influencing the level of some biomarkers could also have an impact on the occurrence of certain pregnancy complications.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Latent Cytomegalovirus Infection on Spontaneous Abortion History and Pregnancy Outcomes in Romanian Pregnant Women

Mocanu,

Stoian,

Daescu

et al. 2024

Microorganisms

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Cytomegalovirus (CMV), a DNA virus that belongs to the Orthoherpesviridae family, infects 40–100% of people. Primary/non-primary CMV infection during pregnancy could cause fetal disabilities. After primary infection, CMV causes a latent infection and resides in cells of the myeloid compartment (CD34+, monocytes). Few studies have analyzed the impact of latent CMV infections on miscarriage history, pregnancy complications, and neonatal outcomes. Methods: Serum samples from 806 pregnant women (28.29 ± 4.50 years old) who came for a consultation at the Timisoara Clinical Emergency City Hospital between 2008 and 2010 were tested for anti-CMV IgM/IgG antibodies, and data about demography, obstetrical history, pregnancy complications, birth, and neonate were collected. The data were compared between the groups with and without latent CMV infection, and statistical significance was calculated. Results: We did not find a difference regarding cesarean section (OR = 0.916, p = 0.856), placental abruption (OR = 1.004, p = 1.00), pregnancy-induced hypertension rate (OR = 1.078, p = 1.00), secondary sex ratio (0.882, p = 0.857), APGAR score (p = 0.225), gestational age at birth (p = 0.434), or birth weight (p = 0.365). A borderline significant difference was found regarding the presence of miscarriage history: OR = 8.467, p = 0.051. Conclusions: The presence of latent CMV infection does not affect the likelihood of complications in healthy women. A borderline significantly higher prevalence of miscarriage history was found in women with latent CMV infection.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

The Impact of Latent Cytomegalovirus Infection on Spontaneous Abortion History and Pregnancy Outcomes in Romanian Pregnant Women

Mocanu,

Stoian,

Daescu

et al. 2024

Microorganisms

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“…В формировании хронической компенсированной и субкомпенсированной плацентарной недостаточности при обострении цитомегаловирусной инфекции (ЦМВИ) во втором триместре гестации важная роль отводится повреждению кровеносных сосудов фетоплацентарного комплекса [1]. Одним из клинически значимых методов исследования степени тяжести хронической плацентарной недостаточности при инфекционной и акушерской патологии у беременных является допплерометрический анализ [2].…”

Section: оригинальные исследованияunclassified

Changes in the blood flow in the uterine and umbilical arteries during the second trimester of pregnancy in exacerbation of bronchial asthma associated with reactivation of cytomegalovirus infection

Nakhamchen,

Gorikov,

Odireev

et al. 2023

Bûlletenʹ fiziologii i patologii dyhaniâ

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Aim. To evaluate changes in blood flow in the uterine and umbilical arteries in the second trimester of gestation in women with exacerbation of bronchial asthma associated with reactivation of cytomegalovirus infection (CMVI).Materials and methods. Using Doppler analysis, 115 patients were examined at 21-24 weeks of pregnancy, uncomplicated and complicated by exacerbation of mild to moderate asthma of cytomegalovirus etiology. The first group was represented by 30 seronegative women with uncomplicated pregnancy. The second group included 30 patients with mild asthma in the stage of exacerbation associated with CMVI, leading to chronic compensated placental insufficiency. The third group consisted of 30 patients with exacerbation of moderate asthma caused by CMVI reactivation, which initiated the development of chronic compensated placental insufficiency. The fourth group consisted of 25 women with moderate asthma in the acute stage against the background of the acute phase of CMVI, leading to the formation of chronic subcompensated placental insufficiency.Results. In women in the second group, in comparison with the first group, the following changes were determined: in the right uterine artery, the systolic-diastolic ratio (SDR) was, respectively, 2.75±0.07 and 2.04±0.03 rel. units (р<0.001), pulsation index (PI) – 1.15±0.04 and 0.76±0.02 rel. units (p<0.001), resistance index (RI) – 0.63±0.01 and 0.51±0.01 rel. units (p<0.001); in the left uterine artery, SDR was, respectively, 2.84±0.09 and 1.98±0.05 rel. units (p<0.001), PI – 1.20±0.05 and 0.74±0.03 rel. units (p<0.001), RI – 0.64±0.01 and 0.49±0.01 rel. units (p<0.001); in the absence of statistically significant differences in the indicators of SDR in the umbilical artery – 3.62±0.09 and 3.41±0.06 rel. units, respectively (р>0.05), PI – 1.23±0.03 and 1.19±0.03 rel. units (p>0.05) and RI – 0.73±0.01 and 0.70±0.01 rel. units (p>0.05). In the third group, in comparison with the second one, vascular resistance did not differ significantly in the right, left uterine arteries and the umbilical cord artery. In patients of the fourth group, in contrast to the third one, higher values of resistance to blood flow were observed: in the right uterine artery – SDR (3.41±0.07 and 2.87±0.07 rel. units, p<0.001), PI (1.48±0.07 and 1.18±0.03 rel. units, p<0.001), RI (0.70±0.01 and 0.65±0.01 relative units, p<0.001); in the left uterine artery – SDR (3.33±0.11 and 2.88±0.09 rel. units, p<0.01), PI (1.45±0.05 and 1.19±0.05 rel. units, p<0.001), RI (0.70±0.01 and 0.68±0.01 rel. units, p<0.01); and also in the umbilical artery – SDR (4.39±0.13 and 3.65±0.12 rel. units, p<0.001), PI (1.45±0.04 and 1.24±0.03 rel. units, p<0.001), RI (0.79±0.01 and 0.72±0.01 rel. units, p<0.001).Conclusion. In the pathogenesis of reduced blood flow in the basin of the uterine and umbilical arteries in women with exacerbation of moderately severe asthma of cytomegalovirus etiology, leading to the development of chronic subcompensated placental insufficiency, compared with uterine cord hemodynamics in asthma in the acute stage, caused by reactivation of CMVI in the second trimester of gestation, which initiates the formation of a chronic compensated form of placental dysfunction in the third trimester of pregnancy, an important role is played by viral stimulation of vasoconstrictor responses.

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“…In subgroup 3b, a greater number of vessels were found that did not provide outflow of blood from cotyle- В патогенезе внутриплацентарных гемодинамических расстройств важная роль отводится нарушению транспортной функции вен плодной части органа и кровеносных сосудов стволовых ворсин, участвующих в поддержании функционального состояния системы мать-плацента-плод [1]. Ведущими этиологическими причинами плацентарной дисфункции у беременных является реактивация хронической цитомегаловирусной (ЦМВИ) и герпесвирусной инфекции (вирус простого герпеса -ВПГ 1 и 2 типа) [2,3], инициирующих угнетение синтеза гормонов [4], нарушение строения венозной стенки [5] и гематоплацентарного барьера [6]. Доказано, что при ЦМВИ, сочетающейся с ВПГ 1 и 2 типа, у женщин в период гестации в плаценте регистрируются более выраженные альтеративно-деструктивные изменения [7].…”

Section: Ingorikovunclassified

“…Нельзя исключать тот факт, что структурные нарушения эндотелия и мышечного слоя стенки сосудов проксимальных отделов ворсинчатого дерева инициируют: 1) повышение чувствительности рецепторов, их ответную реакцию на биологически активные вещества и вазоспастическую реакцию [14]; 2) ремоделирование стенки сосудов и соединительной ткани стволовых ворсин I и II порядка; 3) структурные изменения в мелких ворсинах в виде угнетения роста, пролиферации и миграции эндотелиоцитов, участвующих в формировании гематоплацентарного барьера. Триггерами вышеуказанных морфологических реакций являются: 1) возбудители инфекции [5]; 2) провоспалительные цитокины [3]; 3) прогрессирующая антенатальная гипоксия [15].…”

Section: результаты исследования и их обсуждениеunclassified

Morphological structure of cotyledons with non-contrasted blood vessels in the placenta of women who had an exacerbation of mono- and mixed-cytomegalovirus infection in the second trimester of pregnancy

Gorikov

2022

Bûlletenʹ fiziologii i patologii dyhaniâ

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Aim. To assess the morphological structure of cotyledons with non-contrasted blood vessels in the placentas in women who had an exacerbation of mono- and mixed cytomegalovirus infection (CMVI) in the second trimester of pregnancy.Materials and methods. The histometric parameters of the villi were studied with different visualization on X-ray phlebograms of blood vessels in 112 cotyledons of placentas in women with pregnancy, uncomplicated and complicated by mono- and mixed-CMVI (combination of CMVI and reactivation of chronic herpes virus infection type 1 HSV). The first group (control) included 36 cotyledons with a clear contrasting of the vascular bed in the placentas from women with an uncomplicated gestational period. The main group was represented by 76 cotyledons: subgroup 2a - 24 cotyledons, in which the bloodstream was not detected, in placentas from patients with exacerbation of mono-CMVI associated with chronic subcompensated placental insufficiency (CSPI); subgroup 2b - 16 cotyledons with blood vessels not diagnosed by X-ray phlebography, in placentas from women with mixed CMVI infection, initiating the development of CSPI; subgroup 3a - 21 cotyledons with non-contrasted bloodstream in placentas from patients with exacerbation of mono-CMVI and chronic decompensated placental insufficiency (CDPI); subgroup 3b - 15 cotyledons with a similar angiographic picture in placentas from women who had an exacerbation of mixed CMVI in the second trimester of gestation and CDPI. Identification of cotyledons with a clear visualization of blood vessels and with a non-contrasted vascular bed in the marginal part of the placenta was carried out by dosed administration of minium on linseed oil (1:3) through the vein of umbilical cord and assessment of the angiographic picture on X-ray, which were obtained using the RUM-20M apparatus with X-ray image amplifier Sapphire (Russia). For histological analysis, tissue pieces were taken in the same places before and after injection of the contrast mass into the bloodstream of the organ, on the damaged areas of which clamps were applied.Results. In the first group, the cotyledons had clear contours of the blood vessels and the vein draining them. Avascular villi (AV) accounted for 2.05±0.22%, villi with syncytiocapillary membranes (SCM) - 33.5±2.41%, villi with one (1) SCM - 77.1±2.07%, with two (2) SCM - 20.9±1.98% and with three (3) SCM - 1.42±0.09%. In subgroup 2a, compared with the first group, there was a deformation of the lumen of the vein of the stem villi of the I and II order, in which erythrocyte aggregates, single leukocytes and rarely thrombi were determined, as well as signs of edema and partial desquamation of endotheliocytes, fibrinoid and inflammatory changes in the vessel wall. The number of AV increased (by 6.87 times, p<0.001) and the number of villi with SCM decreased (by 2.05 times, p<0.001) with no significant differences between villi with 1, 2, and 3 SCM. In subgroup 2b, in comparison with subgroup 2a, moderate folding of the endothelium, areas of its partial desquamation, AV (1.39 times, p<0.01) and villi with 2 SCMs (1.44 times, p<0.05) were more common against the background of a decrease in the concentration of villi with 1 SCM (by 1.19 times, p<0.05). In subgroup 3b, a greater number of vessels were found that did not provide outflow of blood from cotyledons (12, p<0.001) and had an arcuate shape (10, p<0.001) compared with subgroup 3a, where their number was, respectively, 3 (p<0.001) and 2 (p<0.001). A more pronounced folding of the endothelial lining was determined, as well as aggregates, neutrophils, lymphocytes and thrombi in the lumen of the vessels. There was an increase in the percentage of villi with 1 SCM (by 1.13 times, p<0.05), as well as a decrease in the frequency of occurrence of villi with 2 SCM (by 1.67 times, p<0.05) and 3 SCM (by 2.13 times, p<0.001). In cotyledons of subgroup 3b, in contrast to those of subgroup 2b, blindly ending vessels were more common (2 times, p<0.05), arcuate course of veins (2.5 times, p<0.05), lumen deformity, hyperchromia of the nucleus and total desquamation of cells, thrombi with calcification, complete and partial obliteration of the arterial lumen, inflammation, fibrinoid degradation of the muscular layer of vessels and the deposition of calcium salts in it, as well as AV (1.29 times, p<0.05) and villi with 1 SCM (1.40 times, p<0.001); less often villi were detected with SCM (1.35 times, p<0.05), with 2 SCM (2.78 times, p<0.001) and 3 SCM (1.57 times, p<0.05).Conclusion. In women with exacerbation of mixed CMVI in the second trimester of gestation and CDPI, in contrast to patients with reactivation of mono-CMVI leading to CDPI, angiodestructive and angioobstructive processes, as well as inhibition of angiogenesis, are more pronounced in cotyledons with non-visualized blood vessels. This increases vascular resistance and blocks the flow of the contrast mass during its dosed injection into the vascular bed of the placenta.

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The architectonics of fetal placental veins in second-trimester cytomegalovirus infection

Cited by 9 publications

References 1 publication

The Impact of Latent Cytomegalovirus Infection on Spontaneous Abortion History and Pregnancy Outcomes in Romanian Pregnant Women

The Impact of Latent Cytomegalovirus Infection on Spontaneous Abortion History and Pregnancy Outcomes in Romanian Pregnant Women

Changes in the blood flow in the uterine and umbilical arteries during the second trimester of pregnancy in exacerbation of bronchial asthma associated with reactivation of cytomegalovirus infection

Morphological structure of cotyledons with non-contrasted blood vessels in the placenta of women who had an exacerbation of mono- and mixed-cytomegalovirus infection in the second trimester of pregnancy

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