Zvierieva I. The impact of maternal-fetal infection on morphofunctional state of the pulmonary artery and aorta in fetuses and newborns

In this study, for the first time a comprehensive morphological assessment of the aorta and pulmonary artery of fetuses and newborns from mothers with infectious disorders in a comparative aspect with the action of acute perinatal hypoxia was performed using archival material (data from autopsy protocols), sectional and experimental material. It was first established that under the impact of acute perinatal hypoxia the vessels under investigation had structural damage to the endothelial lining, realized by the vertical location of endothelial cells on a loose, fuzzy contours of the basement membrane, followed by desquamation of endothelial cells in their lumen, followed by swelling of their nuclei (in cases where at least two hours elapsed between exposure to acute asphyxia and death), karyolysis and cell death by colliquative necrosis. At the same time, desquamative changes were significantly more pronounced in the pulmonary artery. The adhesive properties of endothelial cells were reduced in comparison with the group of infectious disorder. The obtained changes can be interpreted as a morphological manifestation of endothelial dysfunction due to acute asphyxia. It was proven for the first time that the influence of maternal infectious disorder on the morphological condition of the aorta and pulmonary artery of dead newborns was also manifested by structural changes of endothelial cover in the form of endothelial dysfunction, but its severity was much less pronounced. Also, this study showed for the first time that when exposed to infectious disorder of the mother, along with signs of endothelial damage, there were signs of regeneration and repair, manifested by proliferation of preserved endothelial cells with increasing morphofunctional activity (according to cytophotometric studies). For the first time it was proven that in the walls of the vessels under investigation the effect of infectious factor was also manifested by sclerotic changes. For the first time an immunohistochemical study showed that the expression of proinflammatory markers TNF-α and IL-6 was significantly higher in offspring born to infected mothers than similar rates in newborns and rats under acute perinatal hypoxia, indicating the permeability of maternal antibodies to the fetus and the implementation of intrauterine infection. In this dissertation it was demonstrated for the first time that morphological changes in the aorta and pulmonary artery of fetuses and newborn rats born to females with subacute prolonged infectious-inflammatory process caused by E. coli, S. aureus and K. pneumoniae had a single tendency, differing only in severity. K. рneumoniae was shown to have the most aggressive effect.