Bocharova T. Pathological anatomy of afterbirth in primary and secondary uterine inertia.

Object of a research: afterbirth of the women, whose labor has become complicated by uterine inertia. The purpose of a research: research morphofunctional features of the afterbirth with the primary and secondary uterine inertia, from the standpoint of the mother - placenta - fetus system unity. Methods of a research and equipment: the macroscopic, organometric, histological, morphometric, histochemical, immunomorphological, radioimmunological method to identify the concentration of hormones and the statistical method Theoretical and practical results: These data cast a light on the new links of the etiology and pathogenesis of the uterine inertia, reveal the essence of the pathomorphological changes in the afterbirth, which contribute to the development of the hormonal misbalance in the mother - placenta - fetus system unity. The comprehensive analysis of the structural abnormalities in the afterbirth with uterine inertia can serve as scientific grounds for a series of treatment and preventive measures, directed, first of all, at improved prevention of this obstetrical pathology. Besides, we have identified morphometric features of placentas from women with primary and secondary uterine inertia that will make it possible to use them in the practical activities of pathologists. Novelty: For the first time, we have conducted a comprehensive hormonal research in the mother - placenta - fetus system with uterine inertia by means of measuring concentration of sex hormones in mother's and fetus's blood, as well as by immunomorphological examination of the afterbirth. It has been established that the mother's blood lacks oestradiol and contains excessive progesterone. This provides for the prolonged pregnancy and impedes the organism's physiological preparation for the labour. Furthermore, the immunomorphological research revealed the decreased production of decidual prolactin and chorionic somatomammotropin in the placenta, this being the proof of the explicit placenta deficiency, also proved histologically. Stages of use: the data obtained in the work can be used in teaching process at pathological anatomy departments and at the departments of obstetrics and gynaecology in the higher educational establishment of medical type, and in practical work of pathological departments of the medical establishments. Sphere of use: medicine, pathologic anatomy.