Title: Morphological Changes in Placenta in the Patients of Hypertension
Authors: Susheela Rana, Yogesh Diwan, Kuldip S Sood, Kunal Chawla, Deepa Diwan
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.110
Abstract
Aim: Placenta is a vital organ for maintaining pregnancy and promoting normal foetal development. In this study, morphology of placenta and insertion of umbilical cord with placenta was studied in hypertensive and normotensive patients and correlated with the foetal outcome.
Material and Methods: One hundred fifty placentae of normotensive and hypertensive patients were collected from the department of obstetrics and gynaecology in a premier institute in North India. Placentae were grouped depending upon the degree of hypertension and morphology of placenta (size, weight and volume), umbilical cord insertion with placenta noted. Foetal outcome and birth weight was also recorded. The data was statistically analyzed and p value <0.05 was considered significant.
Results: The mean birth weight was 2752.5±417.26 gm in normotensive and 2540 gm in hypertensive group. The marginal insertion of cord was 2% in normotensive group and 30% in severe hypertensive patients.
Conclusion: With progressive rise in hypertension in pregnancy, the birth weight of the foetus decreases.
Keywords: Placenta; hypertension; birth weight.
References
1. Collins P. Embryology and Development. In: Grays Anatomy. Eds. Banninter LH, Berry MM, Collins P, Ussek JE, Dyson M, Ellis H, Gabella G, Salmons S, Soames RW, Standring SM. Churchill Livingstone 38th Edn. 1955; 151-158.
2. Hamilton WJ and Mossman HW. Physiology of placenta. In: Human embryology (eds. Hamilton WJ, Mossman and Boyd) The Williams and Wilkins Company 4thEdn. 1978; 132.
3. Damania KR, Salvi SV, ratnaparki SK, Daftary SN. The placenta in hypertensive disorders of pregnancy. J Obstet&Gynecol of India 1989; 39: 28-31.
4. McCormic MC. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med 1985; 312: 82.
5. Thomson AM, Billewicz WZ, Hytten FE. The weight of the placenta in relation to birth weight. J Obst&Gyvecol of British Common Wealth 1969; 76: 865-872.
6. Aherne W, Dunhill MS. Quantitative anatomy of placenta. J Pathol&Endocrinol 1966; 91: 123-139.
7. Derek LJ. Fundamentals of obstetrics and gynaecology. In: Hypertensive disease in pregnancy (Toxaemias of pregnancy). Faber and Faber, London. 4thEdn. 1982; 17: 227.
8. Adair and Thelander H. A study of weight and dimensions of the human Placenta in its relation to the weight of new born infant. AmjObs&Gynaecol 1925; 10:172-205.
9. Rath G, Garg K and Sood M. Insertion of umbilical cord on the placenta in hypertensive mothers. J AnatSocInd 2000; 49(2): 149-152.
10. Udaina A, Bhagwat SS, Mehta CD. Relation between placental surface area, infarction and foetal distress in pregnancy induced hypertension with its clinical relevance. J AnatSocInd 2004; 53(1): 27-30.
11. Shanklin DR. The influence of Placental lesions on the newborn infant: Pediatric clinics of North America 1970; 17: 25-42.
12. Woods DL, Malan AF. The site of umbilical cord and birth weight. Brit J Obs&Gynaecol 1978; 85: 332-333.
13. Pretorius Dott, Chau C, Poeltler DM, Mendoza A, Cantezarite VA, Hollenbach KA. Placental cord insertion visualization with prenatal ultrasonography. J Ultrasound Medicine 1996; 15: 585-593.
14. DiSalvo DN, Benson CB, Laing FC, Brown DL, Frates MC, Douilat PM. Sonographic Evaluation of the placental cord insertion site. Am J Roentgenol. 1998; 170: 1295-1298.