Comparative clinical and placental pathologic characteristics in pregnancies with and without SARS-CoV-2 infection.

OBJECTIVES: To compare the clinical and morphological characteristics of the "mother-placenta-fetus" system in high risk pregnant women of three groups: no SARS-CoV-2 infection, mild SARS-CoV-2 infection, and severe SARS-CoV-2 infection. METHODS: A case-control study was performed for all deliveries, at 28 weeks' gestation or greater, who had standard indications for placental pathologic examination. Three groups were formed: (1) control group (no SARS-CoV-2 infection), (2) mild SARS-CoV-2 infection, (3) severe SARS-CoV-2 infection. High-risk pregnancies were registered in all cases in the study groups. The examination of the placenta and the selection of fragments of placental tissue were carried out in accordance with the consensus recommendations of the Amsterdam Placental Workshop Group. The sections were subjected to standard processing and stained with hematoxylin and eosin according to the standard protocol. All cases were reviewed by two pathologists, which did not know any information on pregnancy outcome and clinical data. Statistical analysis was performed using SPSS, p<0.05 was considered statistically significant. RESULTS: Women with severe SARS-CoV-2 infection had an increased rate of multimorbidity including diabetes, chronic hypertension and obesity (p<0.01) compared with the other groups. Placentas at severe COVID-19 course were damaged by both chronic and acute injuries, in comparison to the mild and control groups (p<0.001). Also an important finding in severe COVID-19 was diffuse necrosis of the villous trophoblast - homogenization, diffuse circular eosinophilic masses surrounding the chorionic villi. CONCLUSIONS: Women with multimorbidity are an "at-risk" subgroup for severe SARS-CoV-2 infection and greater likelihood of both placental damage and perinatal hypoxic-ischemic events. These results suggest that patient education, SARS-CoV-2 disease monitoring and preventive measures would be of benefit to this group.

Morphology of the Ovaries in Condition of Inhalation Intoxication with Dust-Saline Aerosols of the Aral Sea in Female White Rats.

BACKGROUND: After some clinical studies of the reproductive health of the female population of the Aral Sea region, we concluded that it is necessary to confirm by experiment the theory of the direct influence of dust-saline aerosols of the Aral Sea on the reproductive system of female individuals. AIM: The purpose of this work is to study the effect of dust-saline aerosols of the Aral Sea on the folliculogenesis process in rats at inhalation intoxication. METHODS: Inhalation in rats was carried out for 30 days for 4 hours a day for 5 days a week in special inoculating cylindrical chambers with the extra-chamber placement of animals in individual boxes and dynamic aerosol delivery. Morphological changes were assessed using electron microscopy. RESULTS: Ultrastructural changes in the ovaries of the experimental study group were characterised by the pathology of all structures of the cortical substance of the organ. The accumulation of lutein pigment, the utilisation of lipid inclusions and the destruction of the complete cell reflected the pathology of estrogen production-an important factor in the postovulatory phase of the ovarian cycle. CONCLUSIONS: Taking into account the proven effect of dust-saline aerosols on the production of estrogen, the violation of the postovulatory phase of the ovarian cycle, we trace the mechanism of folliculogenesis disturbance. This confirms the data of our previous studies on primary and secondary infertility in women living in the Aral Sea region and the necessity of creation and development of preventive measures for the inhabitants of the region.

Comparative Assessment of Women's Reproductive Health in the Areas Bordering With the Aral Sea Region.

AIM: We examined 435 women of Aktobe region and 328 women of South Kazakhstan region, living in areas bordering the Aral Sea region during the study and comparative assessment of the impact of climatic and anthropogenic factors of Aral region on the reproductive health of the female population. MATERIAL AND METHODS: The survey based on the comprehensive clinical-functional and laboratory studies accounting the regional and environmental ecological factors. Survey subject was the area of 2 settlements of Aktobe region and 1 settlement of South Kazakhstan region. RESULTS: In all three areas it was revealed that the examined women had the later menarche. There is a trend towards younger age for menopause. The women of South Kazakhstan region often suffer from the pelvic inflammatory disease. CONCLUSION: Perinatal losses, the case of spontaneous interruption and stagnant pregnancy in history, which can be repeated, one in three women has in the zone of ecological disaster.

The Health Status of the Reproductive System in Women Living In the Aral Sea Region.

In order to assess women's reproductive health in the Kyzylorda region (the Aral Sea) of Kazakhstan, 1406 women were involved in an integrated clinical-functional and laboratory examination, given regional and environmental ecological factors. The high level of endocrine gynecological pathology is indicated in the examined women. In both examined zones, there is a late menarche over 16 years old, which is 39%. It is indicated a trend towards younger age of menopause onset. Inflammatory diseases of the female genital organs affect a third of the examined women. In the zone of ecological disaster, every fourth woman has fetal losses, cases of spontaneous pregnancy termination and/or non-developing pregnancies in anamnesis, which can be repeated many times.