Ultrasound features of the formation of the maternal-placental complex in cases of hyperandrogenism as observed during the first and second trimesters of pregnancy

Abstract

An excess of maternal androgen adversely affects the implantation process and contributes to uterine circulatory disturbances and myometrium vessel sclerosis. Placental insufficiency is typically diagnosed at the end of the second trimester of pregnancy or at the beginning of the third trimester, when the treatment is not effective. Many researchers have attempted to use early sonographic diagnostics to identify placental failure in various pathological states. Nevertheless, the peculiarities of the formation of the fetal-placental complex during the first and second trimesters are still undefined. In this study, we traced the process of placental formation under conditions of excess maternal androgen using ultrasound and Dopplerometry. Morphological examinations of the сhorion and placental tissue were undertaken to сompare any changes. Unfavorable chorion locations, heterogeneous chorion tissue structures, and marginal sinus dilatations were revealed by ultrasound. According to a Dopplerometric investigation, a statistically significant increase in peripheral vessel resistance in cases of hyperandrogenism was identified compared with healthy pregnancies. The negative influence of hyperandrogenism on placental formation was confirmed by morphological data (including the presence of immature decidual cells, defective villi that covered the epithelium, and the dissociative development of cotyledons).