Placental histopathology in high-risk pregnancy

Abstract

Introduction: Placenta is a vital organ for the wellbeing of the fetus. Pregnancies with preganancy induced hypertension (PIH), diabetes, anemia etc. are associated with adverse neonatal outcome. Objective: This study explores the histopathological changes in the placenta of the mothers with conditions known to have an adverse effect on fetal well-being. Methods: The study was conducted at the Department of Obstetrics and Gynecology and Department of Pediatrics, Raipur. In the study, 96 placenta (with their membrane and cords) were included. Among 96 placenta, 72 were cases with maternal risk factors viz. bad obstetric history, maternal anemia, PIH, diabetes, history of handling, advanced age and 24 placenta were controls without significant risk factors and were studied for histopathological changes. Results: Women with a history of fetal-neonatal loss in the past showed more of chorioamnionitis (33%) in their placenta. Placental pathology of 20 anemic women was compared with non-anemic controls. Anemic mothers found to have more of infarction (60%), calcification (30%) and villous fibrosis (100%). Calcification was found in 33% of cases. Syncytial knots (p-0.001) and Cytotrophoblast proliferation (p<0.01) were statistically significant with females with PIH as compared to controls and the incidence of villous fibrosis with diabetic mother was statistically significant (p-0.04). Conclusion: In the present study, it was found that the placenta in anemic mothers showed evidence of uteroplacental ischemia and early senescence. Diabetic mothers showed signs of dysmaturity and increased fibrinoid necrosis with evidence of placental insufficiency responsible for increased morbidity in the newborn of diabetic mothers.