Details
Category: Volume 06 Issue 03 March 2018
Hits: 1502

Title: A Prospective Study on Placental Changes in Pre-Eclamptic Women and Correlation of Severity of Hypertension with Placental Changes and their effect on Neonatal Outcome

Authors: Dr Priyanka Agrawal, Dr Subhash Kumar Agrawal, Dr Sarita Singh

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i3.19

Abstract

Context: Placenta forms a functional unit between mother and fetus. Preeclampsia is regarded as a risk factor in pregnancy and it leads to placental insufficiency.

This, in turn causes both maternal and fetal morbidity and mortality. The present study intends to compare morphological and histological changes of placenta in pre-eclampsia and correlate severity of hypertension with histopathological changes of placenta and correlate these changes with perinatal outcome.

Study Design: A descriptive type of study.

Place and period of study: Department of Pathology, Anaesthesiology and Gynecology, S.S.Medical College, Gandhi Memorial Hospital, Rewa(M.P.)  from   1stjuly 2016 to 30th June  2017.

Materials: 200 cases were taken. 90 cases were of Mild Preeclampsia, 78 cases were of Moderate and 32 cases were of Severe Preeclampsia were taken for this study.

Method: Samples were grouped in three groups on the basis of severity of Preeclampsia. All samples were studied morphologically and histologically.

Result: To summarise the results of this study was the birth weight and placental weight significantly decreases from moderate group of preeclampsia and also placental infarction, calcification, syncytial knot, basement membrane thickening and fibrinoid necrosis significantly increases from the moderate preeclampsia and is highest in severe preeclampsia.

Conclusion: In the present study all the morphological and histopathological variants of placenta are affected very less in cases of mild preeclampsia but there is a significant increase in the changes from the moderate group and the perinatal outcome was also comparatively poor in this group. Till now, antihypertensives are started when B.P. >160/110 mmhg, means from severe preeclampsia .But on the basis of the results of this study we recommend early initiation of antihypertensive treatment, it will be helpful in improving the perinatal outcome.

Keywords: Placenta, Preeclampsia, Morphology, Histopathology ,perinatal outcome.

References

  1. Hargitai B, Mortan T, Cox BM. Examination of Human Placenta. Journal Of Clinical Path 2004; 57:785-792.
  2. Udainia A, Jain ML. Morphological study of placenta in Pregnancy induced hypertension with its Clinical relevance. J Anat Soc India 2001 ;50: 24-7 .
  3. Benirschke K . The placenta : How to examine it and what you can learn . Contemp Obstet Gynaecol 1981 ; 17: 117-9 .
  4. Brown JCM, Veall N. The maternal blood flow in normotensive and hypertensive women. J Obstet Gynaecol Br Emp 1953; 60:141-147.
  5. Bewleys, Cooper D, Campbell S .Doppler investigation of uteroplacental blood flow resistancein the second trimester; a screening study for preeclampsia and intrauterine growth retardation. Int J Obstet Gynaecol 1991, 98:871-879.
  6. Landesmon R, Douglas RG, Holze E. The bulbar conjunctival vascular bed in toxaemia of pregnancy. Amj Obstet Gynecol 1954; 68:170-172.
  7. Stock MH, Anderson DF, Phernetham TM. Vascular response of the maternal placental vasculature. J Dev Physiol 1980; 2:339-346.
  8. Rath G, Garg K, Sood M. Insertion of umbilical cord on the placenta of Hypertensive mothers.J Anat Soc India 2005; 49:149-152.
  9. Majumdar S, Dasgupta H, Bhattacharya K, Bhattacharya A. A Study of Placenta in Normal and Hypertensive Pregnancies.J Anat Soc India 2005; 54:1-9. 102
  10. Myatt L. Role of placenta in preeclampsia. Endocrine. 2002;19:103–111. [pubmed]
  11. Bokhari ZH, Khalid A, Tazeen N, Bukhari MH. Histomorphometric study of maternal side of placenta in preeclampsia. Ann King Edward Med Univ. 2010;16:209–214.
  12. Vaibhav P, Anjankar, Parchand, Ashish: Placental Morphometryin Toxaemia of pregnancy. Journal of applied medical science 2014;205:2081
  13. Nobis P. Das U. Placental morphology in hypertensive pregnancy J Obset and Gynecol India 1991; 41: 166-169.
  14. Ahmed M, Daver RG. Study of placental changes in pregnancy induced hypertension. Int J Reprod Contracept Obstet Gynecol 2013;2:524-527 .
  15. Lyall F, Bulmer JN, Kelly H, Duffle E, Robson SC. Human trophoblast invasion and spiral artery transformation; Am J Pathol 1999;154:1105-1114.
  16. Saini P, Agrawal GC, Pankaj JP,Jian A. Comperative study of histopathological changes in human placenta of normotensive and hypertensive pregnancies. Ijmse 2017;4 :65-72.
  17. Ansari H, Singh A, Zaidi MT, Chandra N. Vasculosyncytial membrane in placental villi of normotensive and hypertensive pregnancies. J Anat Soc India 2011; 60:168-170.
  18. Manjusha S Dhavle, Ashwini R. Tangde, Bhagyashree P. Mundhe, Santosh G. Rathod, Rajan S. Bindu. Morphological study of placenta in pregnancy induced hypertension IJRMS 2017;5:3214-3217.
  19. Kalra VB, Aggrawal A, Sareen PM. Histopathological changes in placenta in toxaemia of pregnancy. J Obstet Gyneecol India 1985;35:86.
  20. Praveen M. Aabidha, Anne G. Cherian, Emmanuel Paul, Jasmin Halen. Maternal and fetal outcome in preeclampsia in a secondary care hospital in south india. J Family Med Prim Care 2015;4:257-260

Corresponding Author

Dr. Subhash Kumar Agrawal

Department of Anaesthsiology, S.S.Medical College, Rewa, MP 486001, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., mob 9589717934