IMMUNOHISTOCHEMICAL EVALUATION OF VIMENTIN IN ENDOTHELIUM OF VESSELS OF UTERO-PLACENTAL BED DURING THE IRON DEFICIENCY ANEMIA IN PREGNANCY
Authors: Tiulienieva О. А. , Davydenko І.S. , Yasnikovska S.M. , Tiulienieva V.O. 
Published: July 2022

Iron deficiency anemia in pregnant women (IDA) is a pressing problem in modernobstetrics, the frequency of which reaches 85 %. In previous studies, we have found thatduring gestation against a background of IDA placental bed of the uterus morphologicallyhas signs of gestational immaturity, the severity of which correlates with the degree ofanemia. Vimentin is the main intermediate protein of cytoskeleton, which is expressed inendothelial and other cells of the mesenchyme. Vimentin mediates tissue processes suchas cell adhesion, migration, invasion, angiogenesis and vasculogenesis. In order to verifythe previously obtained data on morphometric parameters of hemodynamics in placentalbed of the uterus depending on the degree of IDA and elucidation of morphogenesis ofutero- placental form of placental insufficiency due to gestational immaturity, we usedthe method of immunohistochemical visualization of vimentin in endothelium of variousvessels of utero- placental area.Purpose of the work – to determine the features of immune expression of vimentin in thevascular endothelium of the uterine- placental region in iron deficiency anemia in theapect of chronic placental insufficiency at 37-40 weeks of gestation.Materials and methods. 140 biopsies of utero- placental bed were morphologically studied,obtained during caesarean section, observations of physiological pregnancy and gestationagainst a background of IDA I-III degree in terms of chronic placental insufficiency. Theconcentration of hemoglobin in the blood of the pregnant woman was the criterion of IDAseverity degree according to medical records. According to A.P. Milivanov classificationof chronic placental insufficiency (1999), the uterine- placental form of it was diagnosedby Doppler examination followed by detection of morphological equivalents.Results. An increase of vimentin immunoexpression indices as a marker of preservationof a part of leiomyocytes at incomplete gestational transformation, which correlates withthe degree of gestational immaturity of uteroplacental area (UPA) and anemia and is themost essential at pregnancy with clinical signs of UPA against a background of IDA, wasmarked in all cases of pregnancy against a background of IDA in the walls of the spiralarteries. For endothelial cells of the venous vessels, this trend of increasing optical densityof staining for vimentin is characteristic only for IDA I and II degrees, while against thebackground of IDA III degree with signs of placental isufficiency indices of vimentinimmunoexpression are lower than those in physiological pregnancy. In the endothelialcells of the vessels of the microcirculatory tract there is a moderate decrease in the opticaldensity of staining for vimentin in cases of IDA I and II degrees without signs of placentalisufficiency, but in observations with UPA against a background of anemia II degreea slight increase was noted. At IDA III degree the level of vimentin immunoimaging is1,5 times lower in comparison with physiological pregnancy. These features are probablydue to the attenuation of the processes of angiogenesis and vasculogenesis in the uterineplacental area in IDA II-III degrees, as well as the increase in dyscirculatory phenomenaand damage the vascular endothelium.Conclusions. During pregnancy against the background of iron deficiency anemia, theplacental bed morphologically has signs of gestational immaturity. The revealed featuresof vimentin immunoexpression in endothelial cells of different types of vessels give thepossibility to consider that morphological preconditions are formed for hypoperfusionof the uterine- placental area and the development of disturbances of the venous outflowfrom the placental bed of the uterus as predictors of uteroplacental form of chronicplacental insufficiency.