Morphological study of placenta in hypertensive disorders in pregnancy

Abstract

Introduction: Hypertensive disorders are common complications of pregnancy. Thorough macroscopic and microscopic examination of the placenta provides much insight into the prenatal health of the baby and the mother. Objectives: 1. To study the morphological changes in the placenta in pregnant mothers. 2. Comparative study of morphological changes in the placenta among hypertensive and normotensive pregnant mothers. Methods: An Observational Prospective Cohort Study was performed. Detail clinical history taken and placentae were collected from both 40 hypertensive and 40 normotensive mother's delivered in labour room or operation theatre. Both macroscopical and histopathological examination was done. Findings were recorded and analyzed statistically. Results: The comparison of placental diameter, placental thickness, mean placental weight, placental volume, placental surface area between hypertensive and normotensive group showed statistically significant difference (p value < 0.05). Incidence of placental haematoma, infarction, basement membrane thickening of villi and syncytial knot in hypertensive group was 20%, 27.5%, 50% and 92.5% & in normotensive group was 5%, 10%, 12 % and 60% respectively. All cases in hypertensive group had placental fibrinoid necrosis of villi in comparison to 57.5% cases in normotensive group (p < 0.05). For fibrosis of villi and cytotrophoblatic proliferation p value was < 0.05 which was statistically significant. Mean placental thickness among the hypertensive group was 2.10 cm ± 0.431 (S.D) and 2.29 cm ± 0.282(S.D) among the normotensvive group (i.e. lower values in hypertensive group). The difference was found to be statistically significant in between the groups. p = 0.024 (< 0.05). Conclusion: Effects of hypertensive disorder in pregnancy reflect in gross and microscopic findings of placenta which may contribute to the further management of mother and baby.