ASSESSMENT OF BIRTH WEIGHT AND MORPHOMETRY OF PLACENTA IN PREGNANCY INDUCED HYPERTENSION IN SIKKIMESE POPULATION

Abstract

BACKGROUND AND OBJECTIVES: Birth weight is the simplest record of the new born and the most reliable indicator of foetal well-being. Low birth weight is a health hazard risking the new born to diseases in the perinatal period and failure to thrive in early childhood. The placenta, the mother and the foetus can be considered as a single entity and any adversity affecting one is bound to influence the others. The placenta is a complex organ responsible for the sustenance of the pregnancy and foetus in-utero. Pregnancy induced hypertension is the commonest complication which predisposes the foetus to birth asphyxia, intrauterine growth retardation and cardio-vascular changes and the mother to chronic hypertension and HELLP syndrome. The incidence is high in India with a fairly high number of cases in Sikkim. The study aims to evaluate the morphometric alterations of the placenta in PIH which would serve as a guide to assess the severity of the disease and analyze the cause of maternal and foetal mortality and morbidity. DESIGN AND SETTING: A prospective, analytical hospital based study. MATERIALS AND METHODS: Thirty women with PIH constituted the ``cohort{''} while 60 normotensive pregnancies constituted the ``control{''}. RESULTS: Mean placental weight was significantly lower in PIH (p-value0.014). The proportion of Low birth weight babies was significantly higher (p-value0.0001) in cases. CONCLUSIONS: Reduced perfusion to placenta in PIH permanently alters the structure and physiology of the foetus and atherosclerosis in the uterine arteries causes reduced blood flow in the inter-villous spaces causing reduced placental weight and intrauterine growth retardation.