1. Biophysical Properties Of Amniotic Fluid And Morphological Characteristics Of The Placenta In Primiparous And Multiparous Women Living At Different Altitudes In Kyrgyzstan

Belov G.V., Karimova N.A., Beyshenbieva G.J.

ABSTRACT

Background & Purpose of the study: Infant mortality remains at a high level in Kyrgyzstan. The most unfavorable situation is in multiparous women living in highlands. The purpose of the work to determine the comparative characteristics of the surface-active properties of amniotic fluid and placental structure in nulliparous and multiparous women, who live in the lowlands, midlands and highlands. Method: The surface tension of amniotic fluid was measured and organometric, histologic, morphometric studies of 57 placentas were performed. Results: Macroscopic measurements showed that in nulliparous women, weight, diameter and thickness of the placenta tend to increase with an increase in the height of residence. In multiparous women as compared to primiparous women the size of placenta decreases, insignificantly in lowlands and significantly at medium and high elevations. Also highlands multiparous showed a significant shortening of umbilical cord. Most primiparous women have a central attachment of the umbilical cord regardless of the altitude of residence. In multiparous women from the midlands and highlands there is a considerable frequency of the paracentral and marginal attachment. The microscopic structure of the placenta had specific characteristics in primiparous and multiparous women, which grew more intense with increasing altitude of residence. Pathologic villous immaturity in primiparous was observed in only one case (the highlands), in multiparous this condition was seen with a frequency of 10% in the lowlands to 42.8% in the highlands. In primiparas from highlands surface activity was significantly reduced. In multiparous women from lowlands SA levels of amniotic fluid did not differ significantly from those of primiparous women. In the midlands and highlands the shifts in SA were more pronounced in multiparous than primiparous women. Besides, a 33% decrease of the amniotic fluid SI in multiparas from high-mountain areas suggests immaturity of the lungs of newborns. Conclusion: Signs of placental insufficiency and subsequent development of respiratory distress syndrome in infants of multiparous women from highlands were revealed.

Key-words: Placenta, Morphometry, Amniotic fluid, Surface tension, Fetoplacental insufficiency, High altitude, Multiparas.

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