Slobodian O.M., Lavriv L.P., Prokopiuk V.M., Moroz M.M.

Bukovinian State Medical University (Chernivtsi City, Ukraine)

Fetal topographical and anatomical features of some organs and structures of the body

Today one of the most important tasks of theoretical medicine is to develop the foundations of perinatal anatomy, because the problem of reducing perinatal morbidity and mortality can not be fully solved without in-depth study of embryogenesis and early fetogenesis, which largely determine the further development of the fetus and newborn [2]. The forming of the organs is a very complicated process which is not definitively studied nowadays. It is very important to study the structure of the organs and systems in association with the basic processes of morphogenesis, on the basis of the findings of embryogenesis [3]. Performing surgery on the fetal organs in the womb, an adequate conduct of sonographic studies, interpretation of the results of modern diagnostic techniques (ultrasound, CT, MRI) and fetal autopsies are based on objective anatomical data [1, 4-5].

Material and methods of research. 230 fetal specimens and 25 newborns without obvious signs of anatomical defects or abnormalities have been involved in the study. The study combined anatomical and morphostatistical methods assessing the credibility of the obtained results, so they meant making sequent topographical and anatomical sections, macromicropreparation, contrast X-ray, morphometry, computer 3-D modeling.

Results. According to the results of computer 3-D modeling of the parotid glands of the fetuses aged 6-10 -month, the most practical is a 3-D description as the trilateral pyramid , which lies in the retromandibular fossa and in the lateral area of the face, turned with its base to the zygomatic arch, its vertex going  downwards  - to the angle of the mandible. 8 -10 -month-old fetuses had some indurations in fascial cellular masses of the glandular bed, especially in the areas of close topographical and anatomical  interrelations of organs and structures. Between the outer capsule of the gland, surrounding vascular, nerve branches and fascial formations of the investigated area in 8-10 months fetuses there are tight adhesions that should be considered during the operative  interventions within the parotid- masticatory area in newborn infants.

The duodenum is exposed to the visceral surface of the liver and pancreatic head, right and left kidneys (early fetuses), sigmoid colon (late fetuses and newborns). Formation of the pancreas topography is determined by the right adrenal gland, caudate process of the liver and the left flexure of the colon. The shape of the pancreas  is correlated with that of the duodenum, which can be clearly seen in early fetuses (4-5 months).

In the dynamics of the development of the main trunks of the right, middle and left hepatic veins in the ontogenesis perinatal period, fetal organs are characterized by the absence of division into periods of rapid growth and periods of relative slowdown; there  is also an increase in their morphometric parameters. Dominant increase in the size of the hepatic veins during the perinatal period has general biological substantiation concerning the prevention of the liver swelling.

As a result of the morphometric characteristics of the duodenum , pancreas , bladder and rectum in the prenatal period of ontogenesis we found that they are characterized by two periods of accelerated development (5th and 8th – 10th - months) and the period and the relative slowdown (6th and 7th months). Thus, during the periods of accelerated development all possible parameters of the studied organs enlarge significantly compared to previous months. In 6 - and 7 -month-old fetuses not all but only 50% of the morphometric parameters of the duodenum, the pancreas, the bladder and the rectum anatomical parts are characterized by relative slow growth.

In conducting integrated multifactor regressive analysis of all possible parameters of the duodenum , pancreas , bladder and rectum some forms of diagrams, confirming periods of accelerated development and a period of relative slowdown were found. During the periods of rapid development of the pancreas (5th and 8th -10th months ) it was established that the charts are pyramid-shaped with their vertexes going upwards, a smoothed form of the diagrams (6th-7th months) of the multifactor regressive analysis reflects the slowdown in the growth of the pancreas. During the periods of rapid development of the rectum and bladder ( 5th and 8th -10th months) the pyramid-shaped diagrams with vertices going downwards are an integrative reflaction. The process of deceleration of the rectum and bladder growth is integratively reflected by the smoothed form of the chart during the 6 -month and by the pyramid-shaped diagram with its vertex going upwards in multifactor regressive analysis during the 7th month.

Conclusions. Active application of perinatal prevention of congenital defects requires up-to-date approaches and methods of embryonic growth study. Embryotopographic research, which takes into account specific and critical for some organs periods of their growth and some peculiarities of their interrelations with adjacent organs and structures, becomes especially important.

References:

1. Ахтемійчук Ю.Т. Встановлення перинатальних параметрів органів і структур – профілактика природженої патології / Ю.Т. Ахтемійчук, О.М. Слободян, Д.В. Проняєв // Перинатальна охорона плода: проблеми, наслідки, перспективи: матер. наук.-практ. конф. з міжнарод. участю (14 квітня 2011, м. Чернівці). – Чернівці, 2011. – С. 15-16.

2. Исследование закономерностей морфометрических параметров органов и структур в перинатальном периоде онтогенеза / [Ахтемийчук Ю.Т., Слободян А.Н., Проняев Д.В., Семьянив И.А.] // Морфология. – 2010. – Т. 137, № 4. – С. 22.

3. Лаврів Л.П. Морфологічні передумови розвитку приро­джених вад привушної слинної залози / Л.П.Лаврів, І.Ю. Олійник // Клін. анатом. та оператив. хірургія. – 2012. – Т. 11, № 1(39). – С. 91-94.

4. Нариси перинатальної анатомії / [Ю.Т. Ахтемійчук, О.М. Слободян, Т.В. Хмара та ін.]; за ред. Ю.Т. Ахтемійчука. – Чернівці: БДМУ, 2011. – 300 с.

5. Шахламов В.А. Основ­ные направления развития исследований по экспери­- ментальной гистологии и цитологии в третьем тысячелетии / В.А. Шахламов // Морфология. – 2002. – Т. 122, № 5. – С. 15-18.