[A morphometric evaluation of the maturity of the blood-blood barrier in the human placenta]. / Morfometryczna ocena dojrzalosci bariery krew-krew w lozysku czlowieka.

Computer aided analysis of microscopic picture was used to morphometric examination of 506 placentas from normal pregnancies at 30 to 42 gestational weeks. Following parameters of the terminal villi: diameter and its number within 1mm2, the length, the thickness, the number of epithelial plates in 1mm2, the number of epithelial plates for the villus within 1mm2, seem to be the morphological signs of maturity of the blood-blood barrier in the placenta. In previous studies it has been found that in pregnancies with hypertension or abnormalities in KTG, parameters of blood-blood barrier respond earlier stages of the pregnancy. A maturity of the placental barrier correlates with some somatic features of a foetus and a newborn. Our results show that between 30 and 42 gestational week some parameters of the placental barrier have a linear increase and others grow rapidly between 35 and 38 gestational age and after 38 gestational age do not change. According to obtained results, we drew a conclusion, that between 30 and 42 gestational age there are rapid morphological transformations of the structures formed placental barrier and that morphometry of the human placenta may be used as a more objective and accurate method to estimate gestational age.

Salvage hemipelvis radiotherapy with fertility preservation in an adolescent with recurrent vulvar carcinoma.

BACKGROUND: To preserve fertility, hemi-pelvis irradiation was chosen for locoregional groin recurrence of vulvar cancer in an adolescent. CASE: A case of squamous cell vulvar carcinoma in uncommonly young patient is presented. First surgical management (local excision of T1N0M0 tumor of the right labia minora) was performed at the age of 16.5 years. Further therapy included wide local resection of recurrent local lesion, two subsequent ipsilateral groin dissections of nodal metastases (with extranodal spread at the first instance), and ipsilateral pelvic lymphadenectomy. The patient was administered external beam irradiation of 45 Gy to the hemi-pelvis followed by 10.8 Gy boost to the right inguinal region. After 6.5 years from the completion of radiotherapy the patient is free of disease. She managed to conceive but the labor was premature and the infant died in its 7th week of life. CONCLUSION: In this case salvage hemi-pelvic irradiation for groin metastases of vulvar cancer has proved to be an effective treatment, allowing preservation of hormonal and obstetric functions. Partial post-irradiation damage of the uterus might have caused premature labor. Thus, special obstetric care is advisable in such situations.