Gross Changes of Placenta in Pregnancy Induced Hypertension and its Clinical Relevance: A Cross-sectional Study

Abstract

Introduction: Placenta establishes connection between mother and foetus through umbilical cord. Pregnancy Induced Hypertension (PIH) is one of the most common complication of pregnancy. Gross study of placenta in PIH gives an insight into prenatal health of baby and mother, thereby preventing maternal as well as foetal morbidity and mortality. Aim: To study the gross changes of placenta in PIH cases with its clinical relevance. Materials and Methods: A prospective cross-sectional study was done at tertiary care hospital of Osmania and Gandhi Medical College, Telangana, India. The study was carried over for a period of six months (from October 2019 to March 2020) with a sample size of 50 placentae in PIH mothers aged between 20-35 years who were inpatients at the Obstetrics Department. They were followed until delivery. Postdelivery, the gross anatomy of the collected placentas was studied. Varied parameters of placenta, data of newborn and clinical picture of mother were compared with normal standards and statistically analysed by using Unpaired t-test. Results: Significant reduction of mean placental weight and mean foetal weight (p-value<0.0001) and significant increase in foetoplacental weight ratio was found. There was an average reduction of number of cotyledons by 23% in PIH cases when compared to normal placentae. An incidence of mean infarct areas of 9.6 and mean calcified areas of 13 were found on the maternal surface of placenta in PIH. An incidence of 68% of marginal type of placenta was observed in patients with PIH. Clinically, incidence of headache, pedal oedema, convulsions, visual disturbances and proteinuria were found. Conclusion: Gross study of placenta in PIH reflects maternal and foetal status and can be taken as confirmative evidence by radiologists to prevent Intra Uterine Growth Retardation (IUGR) and guide obstetricians during management of pregnant mother with PIH. Thereby, preventing the maternal and foetal morbidity and mortality.