ANALYSIS OF PATHOMORPHOLOGICAL CHARACTERISTICS OF THE PLACENTAL STRUCTURE IN CASES OF PRENATALLY DIAGNOSED FETAL CONGENITAL HEART DISEASE

Objective: The purpose of the study was to determine placental pathologic changes associated with live-born premature and small-for-gestational-age (SGA) infants in cases of prenatally diagnosed fetal congenital heart disease (CHD). Materials and methods: A comparative retrospective analysis of the results of pathologic examination of placentas was carried out in the cohort of 115 cases with fetal CHD, that was formed prenatally and divided into groups depending on the gestational age at delivery and birth weight of newborns. Group 1 consisted of 15 cases with premature and/or SGA infants. Group 2 consisted of 100 newborns with birth weight ≥ the 10th percentile. Results: Examination of placentas in the general cohort showed small for gestational age in 59.1% of cases, abnormal shape in 53%, infarctions in 15.6%, delayed maturation of the vascular tree in 13.3%, meconium staining of the membranes in 8 .7%, massive fibrin deposition in 7.8%, multiple calcifications in 2.6% of cases. There were differences in the placental weight between the groups: the values less that the 3rd percentile and the 10th percentile were in 80% vs 40%, 93.3% vs 54%, in group 1 and group 2, respectively (p<0.01). It was found that the odds ratio for giving birth to premature and/or SGA babies with CHD, when placental weight was less that the 3rd and the 10th percentile, was 6.0 and 11.9, respectively. Conclusion: According to the results of the pathologic examination of the placenta in cases of congenital heart disease, multiple macro-and microscopic signs of pathological changes were found in the fetus. A significant association between small placental weight and the birth of SGA or premature infant with cardiac pathology indicates the need to expand the scope of prenatal ultrasound examination for searching the markers of placental dysfunction in the diagnosis of fetal cardiac anomalies. © A group of authors, 2024.