STUDY OF MORPHOLOGY AND HISTOLOGY OF PLACENTA IN HYPERSENSITIVE MOTHERS

Abstract

Background: Hypertensive pregnancy may be responsible for vascular damage, enhanced systemic inflammation and insulin resistance in the placenta as oxygen and nutrient transfer is impaired and oxidative stress is generated affecting the placental growth and development. Placental growth pattern in hypertensive pregnancies shows a variable pattern owing to placental insufficiency. Method: The study was carried out on 80 sets placentae, mothers and their babies. The placentae were collected from Obstetrics & Gynecology Department of NSCB Medical College Jabalpur. Out of 80 placentae, 40 were from normal pregnant mothers and 40 from pregnancies complicated by PIH in previously normotensive women, serial number of placentae, mother and baby were same. placentae were  collected soon after the normal vaginal delivery or caesarian section along with 10 cm long stump of umbilical cord. Aims and objectives: The aim of this study was to determine whether maternal PIH would affect the morphology and histology of placenta and compare this with that of normotensive mothers. It was a cross-sectional comparative study carried out at the maternity ward and anatomy department of NSCB Medical College, Jabalpur. Result: A Macroscopic study of the placenta revealed placental weight, placental volume, diameter, placental thickness and number of cotyledons were less in study group. Mean placental weight in study group was 336gm and in control group was 425 (p<0.05). Mean placental volume in study group & control group were 236and352 ml respectively (p<0.05). Mean number of cotyledons were 14.7and 16 in study & control group respectively but not significant and mean diameter15.6 cms and17.05cms in study and control group. But in the present study placental thickness was not significant (p<0.539). There was a single umbilical artery present in one patient in PIH group.  All morphometric parameters of placenta weight, volume, diameter, thickness, no. of cotyledons were reduced.

Histological findings were cytotrophoblastic cellular proliferation, syncitial knot formation, fibrin plaque formation. In 20 percent cases, villi were hypovascular. The hypovascular villi have abundance of syncitial knots, usually lack vasculosyncitial membrane and increased stromal collagen. Conclusion: PIH adversely affect both morphology and histology of placenta.

Keywords: morphology, histology, placenta, hypersensitive & mothers.