PATHOMORPHOLOGICAL MANIFESTATIONS OF IMPAIRED PLACENTAL-FETAL INTERACTION IN MENSTRUATION-ASSOCIATED IRON DEFICIENCY ANEMIA
Keywords:
anemia, iron deficiency anemia, pregnancy, heavy menstruation, abnormal uterine bleeding, FIGO, placental insufficiency, iron deficiency, maternal and fetal healthAbstract
Iron deficiency anemia (IDA) represents a significant global health issue affecting a considerable proportion of women of reproductive age, particularly more than 40% of pregnant women. Iron is essential not only for hematopoiesis but also plays a critical role in cellular respiration, functioning of enzyme systems, angiogenesis, and myelination of fetal neural tissue. The requirement for iron substantially increases during pregnancy, thereby heightening the risk of iron deficiency states, which may lead to placental insufficiency and complications during pregnancy.
Particularly important is the investigation of pathomorphological changes in the mother-placenta-fetus system among women with menstruation-associated IDA due to chronic heavy menstrual bleeding (HMB). In our study, marked pathological alterations in the umbilical cord vessel structures were identified, characterized by ischemia, sclerosis, and disruptions in endothelial architecture, confirmed by light and electron microscopy. The endothelial cells demonstrated degenerative changes, loss of normal surface relief, and destructive processes, indicating significant metabolic and vascular perfusion disturbances.
These morphological alterations significantly affect the functionality of the fetoplacental complex, highlighting an increased risk of fetoplacental insufficiency, intrauterine growth restriction, and other perinatal complications. The identified changes carry crucial prognostic implications and underscore the importance of timely diagnosis and correction of iron deficiency states in women of reproductive age.
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