3/ Issue 35/Aug 14, 2014 ... maternal deaths and there of fetal deaths. ... along with hemorrhage and infecton, that results in large number of maternal deaths and.
DOI: 10.14260/jemds/2014/3197
ORIGINAL ARTICLE PLACENTAL PATHOLOGY IN PREGNANCY INDUCED HYPERTENSION Sreechithra Kartha1, Usha Poothiode2, Jayalakshmy P. S3 HOW TO CITE THIS ARTICLE:
Sreechithra Kartha, Usha Poothiode, Jayalakshmy P. S. “Placental Pathology in Pregnancy Induced Hypertension”. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 35, August 14; Page: 9272-9278, DOI: 10.14260/jemds/2014/3197
ABSTRACT: BACKGROUND: Hypertensive disorders complicating pregnancy are common and form one of the deadly triad along with hemorrhage and infection, that results in a large number of maternal deaths and there of fetal deaths. Since all anabolites needed for foetal metabolism come from the mothers blood and foetal catabolites are passed back into the mothers circulation through the placenta, the examination of placenta gives a clear idea of what had happened with it, when it was in the mother, s womb and what is going to happen with the foetus in future. With this objective the present study was carried out. MATERIALS AND METHODS: Retrospective study was done for a period of 21 months from April1st 2008 to December 31st 2009..Fifty mothers with uncomplicated pregnancy (control group) and 100 mothers (test group) diagnosed as having pregnancy induced hypertension were selected from patients of our institution of the age range from 20-40 years, and parity –primi, para2 and 3.Placental morphometric parameters, gross and histopathological features were examined in both test and control groups. STATISTICAL ANALYSIS USED: Fishers exact test RESULTS: Placental morphometric parameters were significantly reduced in the control group. Acute atherosis, endothelial proliferation and fibrinoid necrosis were the significant histological findings noted in our study. CONCLUSION: Placental findings can be confirmatory of PIH, but its absence does not exclude the diseases. These findings will become more evident only when there is significant reduction in the uteroplacental bloodflow. KEYWORDS: Placenta, Pregnancy Induced Hypertension, Infarction, Syncytial knots, Acute Atherosis, Chorangioma. INTRODUCTION: Hypertensive disorders complicating pregnancy are common and form one of the deadly triad along with hemorrhage and infecton, that results in large number of maternal deaths and there of foetal deaths. Since all anabolites needed for foetal metabolism come from the mother, s blood and foetal catabolites are passed back into the mother’s circulation through the placenta, the examination of placenta gives a clear idea of what had happened with it, when it was in the mother’ s womb and what is going to happen with the foetus in future. The present study was carried out to analyze and study the morphometric features, gross and histological changes of placenta in pregnancy induced hypertension (PIH) irrespective of the severity of hypertension. Pregnancy induced hypertension (PIH) is defined as hypertension occurring after 20 weeks of gestation and completely resolves after delivery. MATERIALS AND METHODS: The present study was done for a period of 21 months from April 1st 2008 to December 31st 2009 at Department of Pathology, Government Medical College Kottayam, Fifty mothers with uncomplicated pregnancy and 100 mothers diagnosed as having pregnancy induced hypertension were selected from patients of our institutions.
J of Evolution of Med and Dent Sci/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 3/ Issue 35/Aug 14, 2014
Page 9272
DOI: 10.14260/jemds/2014/3197
ORIGINAL ARTICLE The age range was from 20-40 years, and parity –primi, para2 and 3.After delivery the placentae were taken in containers with 10% formalin. Immediate morphometric examination of placenta was made. Placentae were examined specifically for infarction, calcification, retroplacental hematoma and tumors like chorangioma. The umbilical cord was checked regarding the insertion, length and the number of vessels. After fixation, tissues were taken from the insertion of the umbilical cord, margins-3, 6, 9, 120 clock positions, centre of placenta, fibrotic area, infarcted area and the umbilical cord. Routine hematoxylin and eosin sections were made for the histopathological study. Placentae were studied as that of PIH patients (Test group) and normotensive mothers (Control group). RESULTS: The findings were studied under the headings-placental morphometry (Table I), gross anatomy (Table II) and histopathology which included villous (Table III) and stromal pathology (Table IV). Parameters Mean Fetal weight (kg) Mean Placental weight (gm) Mean Placental area (cm)2 Mean Placental volume (cm)3 Fetoplacental ratio
Hypertensive Control group group 2.1 2.9 370+/_68.2 570+/_49.62 221.2+/_30.2 283.3+/_27.2 397+/_59.9 567.9+/_79.8 6.5 5.7
Statistical significance (p value
