Placental morphology and fetal implications in pregnancies complicated by pregnancy-induced hypertension

Abstract

Background: Many disorders of pregnancy, which are associated with a high perinatal morbidity and mortality, are accompanied by gross pathological changes in placenta. Hypertensive disorders of pregnancy are common, and form one of the deadly triads along with hemorrhage and infection that greatly contribute to maternal mortality and morbidity. In addition, they are strongly associated with fetal growth restriction, prematurity, and contributing largely to perinatal mortality and morbidity. A study of placentae was done to find out the morbid and histological changes in placentae of hypertensive mothers and to correlate the findings with the birth weight of new born babies. Materials and Methods: Ninety placentae were studied. The weight of the placenta, placental fetal ratio, retroplacental hematoma, infarction, and histopathological findings were noted. Placental findings were correlated with fetal outcome. Results: The placental weight and fetoplacental weight ratio (5.38:1) was decreased in the hypertensive group. There was an increase in the incidence of infarction (28.8%) and retroplacental hematoma (15.5%) in the hypertensive group. Percentage of cytotrophoblastic proliferation of villi, >30% syncytial knots formation (64.5%), basement membrane thickening of villi (37.8%), and fibrinoid necrosis of villi (46.7%) increased in the placentae from pregnancy-induced hypertension group as compared to the normal group. Conclusions: Hypertensive disorders of pregnancy adversely influence the morphology of placenta. Fetal outcome is poor in the presence of infarction, retroplacental hematoma, basement membrane thickening of villi, and fibrinoid necrosis of villi. The pathological changes observed in the placentae of patients with hypertensive disorders of pregnancy adversely influence the perinatal outcome.