gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Prenatal changes of the fetus and the placentadevelopment induced by tobacco smoking



Tobacco smoking is so widespread that the most of the developing fetuses are under influenceof the factors presented in the smoke but there are no well defined markers estimating thisdanger. Thus the aim of this study is to point possibilities of the tobacco smoking influencemeasurements concerning the fetus and the placenta changes during the prenatal period. Theultrasonographic and magnetic resonance imaging studies documented that active and passivesmoking of the pregnant women retards the fetal growth. This intrauterine growth retardationis the result of the slower growth rate of the limbs bones and the skull and also the lower volumeof some organs e.g. brain, kidneys. Observed the higher blood flow in the fetal middle ce-rebral artery and lower in the uterine and umbilical arteries could reflect the brain protection.The tobacco smoke-induced structural changes of the placenta as increase of the villousendothelium thickness, increase of the collagen content in the stroma of the villi and lowernumber of blood vessels are recognizable at the end of the first trimester. The villi of thesmoker’s placenta have less microvilli, local necrosis of the syncytiotrophoblast appears,pinocytosis decreases, the villi are less branched. These placental structural changes decreasethe weight of placenta, influence the effectiveness of the substrates exchange through theplacental barrier, increase the risk of the placental abruption that among smokers is much higherthan among nonsmoking women. The analysis of the tobacco smoke elements (e.g. cotinine,heavy metals: cadmium, lead) in the meconium and in the umbilical blood give us possibilityto estimate the content of the cytotoxic factors influencing the fetus and the placenta.