Abstract
Objectives: PIH results in placental dysfunction. PIH in women can lead to abruption placentae, organ failure and cerebrovascular events while their fetuses have an increased risk of intrauterine growth retardation as well as IUD. This study analyses the role of PIH in bringing about the histomorphological changes in Placenta and subsequently maternal and fetal effects. Methods: The study was carried out over a 3 year period from Jan 2014-Feb 2017 in a tertiary care hospital as an observational case-control study. Two groups were formed each with 120 patients, one included the women diagnosed PIH while the other contained women with normal gestation. In order to assess the morphological parameters, placental specimens from term gestations (37–42 weeks) as well as from normal full term gestations were studied. Results: The study consisted of 120 normotensive women and equal number of women with PIH. Out of the latter group 79 were Hypertensive, 28 had preeclampsia and 13 were cases of eclampsia. 12% of the cases were found to have liver infarcts while 5% had renal failure, another 5% got postpartum haemorrhage. No maternal mortality was recorded in this study. 42 cases resulted in premature delivery while 11 intrauterine deaths were documented. IUGR caused low birth weight in majority of the cases at 38%. PIH cases had a mean placental weight of 407 g, much lesser than that of the control group placenta. Placental specimens from PIH group were observed with multifocal infarcts, fibrinoid necrosis, and retroplacental clots. Conclusion: The major role players remain preeclampsia and eclampsia on the maternal and foetal outcome. The fetomaternal complications and mortality can be minimized through regular antenatal checkups, multi-disciplinary treatment, timing of delivery and swift perinatal management.
Published Version
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