Microanatomical analysis of hypertensive placentae - a retrospective case control study

Abstract

Abstract Background : Placenta is regarded as the byproduct of the birth process, but actually it is the mirror of maternal and foetal status. It often reflects the progress of many maternal conditions during pregnancy and is known to undergo changes both structurally and functionally in hypertensive pregnancy due to hypoxia. Aim: To compare the histopatological changes in hypertensive placentae with that of normal placentae. Materials and methods: A retrospective case control study was carried out on human placentae with 50 as study and 50 as control group . Placentae of study group were divided into three categories depending upon severity of hypertension. Tissues were microscopically studied for various histopathological changes. Results: Among severe pregnancy induced hypertension cases (PIH), 77.77% showed red infarction while 70.6% of eclampsia showed white infarction. 76.47%, 64.7% and 58.82% of eclampsia cases showed syncytial knots, fibrinoid necrosis and stromal fibrosis repectively. 70.6% of eclampsia cases showed cytotrophoblastic proliferation and calcification separately. Hyperplasia of tunica media was found in 20%, 50% and 58.82% of mild PIH, severe PIH and eclampsia respectively. Conclusion: Infarction, cyotrophoblastic cellular proliferation, syncytial knots, fibrinoid necrosis, stromal fibrosis, calcification and tunica media hyperplasia were seen with increased frequency in the study group as compared to control group. In study group, eclamptic placentae showed all the microscopic changes in significant number.This study of microscopic changes occurring in hypertensive placentae can be used to enhance our knowledge about the severity and progress of the disease. This can equip us to effectively manage the hypertensive pregnancies.