Protsenko E. S.

INFLUENCE OF IRON-DEFICIENCY ANAEMIA OF MOTHER ON THE ULTRASTRUCTURE OF LIVER OF FETUS AND NEWBORN

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About the author:	Protsenko E. S.
Heading	EXPERIMENTAL MEDICINE
Type of article	Scentific article
Annotation	The severity of the changes occurring in the body of the fetus during maternal IDA, determined by the duration and intensity of the oxygen deficiency. Fetus revealed intrauterine hypoxia, malnutrition, anemia. These newborns have half the reserves of iron compared to children born to healthy womens. Severe iron deficiency anemia in the following months and years of life may involve a breach hemoglobin formation, growth retardation, mental and motor development, memory loss, behavioral disorders, chronic hypoxia, decreased immune status indicators, increased susceptibility to infections. In experimental and clinical studies have shown adverse effects of iron deficiency in mother on the formation of the immune, endocrine, cardiovascular and reproductive systems. Morphological state of intracellular structures of fetal liver with maternal IDA today remains insufficiently known. The aim of this study is to establish the influence of mother’s IDA of varying severity on the ultrastructure of liver cells of fetuses and newborns. The studies were conducted in liver of 44 intrapartum deceased fetuses from mothers with IDA. Depending on the severity of maternal anemia were formed following study groups: I - fetuses from mothers with anemia I (mild) severity (15 cases); II - fetuses from mothers with anemia II (average) severity (14 observations); III - fetuses from mothers with severe (III severity) anemia (15 cases). The control group consisted of 12 intrapartum dead fetuses of similar gestational age from healthy mothers who have died as a result of acute disturbance of uteroplacental and umbilical circulation. An autopsy of fetuses and newborns was performed in the perinatal center of Kharkov, Regional Clinical Hospital №1 and children's postmortem department of Sumy. In the control group detected histologically stored gulches of the structure of the liver. In the central veins of the liver lobules founded moderately severe hyperemia and moderate expansion of the capillaries. The study of submicroscopic organization of liver cells from newborns from healthy mothers significant violations of membrane structures were not detected. Ultrastructure of hepatocytes of newborns from mothers with mild iron deficiency anemia was moderately expressed degenerative changes in organelles of hepatocytes, consisting of the enlightenment of the mitochondrial matrix, the expansion in cisternae of granular endoplasmic reticulum, reducing the quantity of ribosomes, polysomes, glycogen granules, as well as the appearance of the plate in the cytoplasmic complex of small inclusions lipids. Stellate macrofagocytes were metabolically active and contained well developed ultrastructure. Changes in the ultrastructure of hepatocytes of newborns from mothers with iron deficiency anemia of moderate severity was notable for polymorphism. In some part of the hepatocyte occurs nuclear chromatin condensation, loosening and focal lysis of the nuclear membrane, disorganization and shortening of cristae of mitochondria, as well as the emergence of centers of destruction outer membrane and cristae. In certain hepatocytes was observed fragmentation of membranes in granular endoplasmic reticulum and reduction in the amount of ribosomes, polysomes and glycogen granules free lying in the cytoplasm. Stellate macrofagocytes show signs of degenerative process. In hepatic cells of newborns of mothers with severe iron deficiency anemia compensatory changes were replaced by focal destruction of the external membranes and cristae of mitochondria and membranes of granular and smooth endoplasmic reticulum. Electron microscopic studies revealed that the depth and severity of degenerative and destructive processes in the liver cells increases in proportion to the severity of iron deficiency anemia in mother. The observed changes indicate a depletion of compensatory-adaptive mechanisms of the liver under the influence of a long-term chronic fetal hypoxia. Conclusions. 1. Light degree of maternal iron deficiency anemia provoke moderately expressed degenerative disorders in ultrastructure of hepatocytes of newborns. Stellate macrofagocytes were metabolically active. 2. Changes in the ultrastructure of hepatocytes of newborns from mothers with iron deficiency anemia of moderate severity was notable for intensification of dystrophic process and the appearance of signs of its evolution into a destructive phase. 3. Compensatory changes in hepatic cells of newborns from mothers with severe iron deficiency anemia replaced by focal destruction of external membranes and cristae of mitochondria and membranes of granular and smooth endoplasmic reticulum. 4. The depth and severity of degenerative and destructive processes in the liver cells increases in proportion to the severity of iron deficiency anemia of mother. 5. The trigger mechanism for the development of degenerative and destructive processes in the liver is mitochondrial dysfunction. It is promising to study the effect of maternal pre-eclampsia in ultrastructural changes of liver of fetuses and newborns.
Tags	iron-deficient anaemia, fetus, liver, ultrastructure of hepatocytes, mitochondrial disfunction
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Publication of the article	«World of Medicine and Biology» №2(50) 2 part 2015 year, 153-158 pages, index UDK 616.36 – 053.1 – 091.8 – 02:[618.3 – 06:616.155.194.8]