Placental Coefficient Research Articles

Doppler Indices of the Fetal Middle Cerebral and the Umbilical Arteries in Pregnancies at High Risk Followed Up for Suspected Fetal Growth Restriction

Background: Fetal growth restriction is related to compromised perinatal outcomes. The screening and prevention tools for fetal growth restriction like Doppler indices in high-risk groups compared with general antenatal populations. An evaluation of the correlation between Doppler indices and placental weight and birth weight of the neonate at term pregnancy in high-risk pregnancies is essential. For the early detection of fetal growth limitations in high-risk pregnancies, sensitive screening techniques are few. Objectives: To determine the most accurate indicator for predicting a poor perinatal outcome or intrauterine growth restriction by comparing and correlating the modifications in Doppler ultrasound studies of fetal circulation in general pregnant women with those of high-risk patients both with and without intrauterine growth retardation. Study design: A cross-sectional research including 81 healthy pregnancies and 19 high-risk patients at 31–40 weeks of gestation was conducted. The pulsatility index (PI) of the middle cerebral artery (MCA), the umbilical artery (UA), and the MCA PI to UA PI ratio were all analyzed. We compared the Doppler indices' mean values. Then these values were correlated with placental weight and birth weight of the offspring. Results: A significantly low birth weight and less fetoplacental ratio and placental coefficient ratio were found in high-risk cases than in normal pregnant women (P <0.05). A strong positive relationship was observed between the middle cerebral artery pulsatility index and placental weight, while negative relationship between the pulsatility index of the middle cerebral artery and the Feto-placental ratio (P < 0.05). In addition, a positive association was found between the pulsatility index of the middle cerebral artery and placental coefficient, whereas a negative correlation was observed between the Cerebro-placental ratio and Feto-placental ratio in high-risk cases (P <0.05). Conclusion: Low birth weight can be predicted using Doppler indices since there is a definite correlation between it and unfavorable perinatal outcomes. KEY WORDS: Placenta, birth weight, Doppler indices, Middle cerebral artery pulsatility index, Umbilical artery pulsatility index.

Stress-Sensitive Regulators of Fetal Neurodevelopment in HIV and Preeclampsia: An Immunocytochemical Appraisal of Placental OGT and T4 Levels.

Preeclampsia and HIV are a significant burden to maternal health globally, especially in low-middle income countries such as South Africa. In the KwaZulu-Natal province, SA antenatal HIV prevalence is 41.1%, while PE is 12%. PE and HIV infections are maternal stress and inflammation that impact placental function and fetal development. Therefore, this study investigated the impact of the comorbidity of PE and HIV on placental stress and neurodevelopment. Placentae were obtained from four cohorts of pregnant women: normotensive HIV negative, normotensive HIV positive, preeclamptic HIV negative, and preeclamptic HIV positive. The placental tissue sections were immunostained for OGT and T4. Our findings showed that the maternal weight, diastolic, and systolic blood pressures (BP) were higher in PE vs. the normotensive groups, irrespective of HIV status. In addition, significant changes were noticed in the placental weight, fetoplacental ratio, and placental efficiency coefficient. Our findings showed that the maternal weight, diastolic, and systolic blood pressures (BP) were statistically higher in the PE compared to the normotensive. No significant differences were observed between HIV positive and HIV negative groups. In addition, significant changes were noticed in the placental weight, fetoplacental ratio, and placental coefficient. Furthermore, considerable upregulation in the placental expression of OGT in both the conducting and exchange villi of PE and concomitant downregulation in HIV-positive patients compared with Normotensive and HIV-negative individuals, respectively. Our results provide inferential evidence on the dysregulation of OGT in the comorbidity of PE and HIV. This may mediate a compromised programmed outcome of an adverse maternal environment during pregnancy and consequently affect fetal development.

Морфологічні та імуногістохімічні особливості плацент у породіль з інфекціями, що передаються статевим шляхом, в анамнезі

Purpose - to explore and evaluate macroscopic, histological, morphological and immunohistochemical changes in the placenta, to study the peculiarities of the marker expression of endothelial cells CD34 in the vascular bed of the placental villous tree in women in labour with a history of sexually transmitted infections (STIs) after pregravid preparation before cycles of assisted reproductive technologies (ART). Materials and methods. The analysis of morphological and immunohistochemical examination as well as expression level of CD34 in 50 placentas from women in labour with a history of STIs was conducted. The Group I (main) - 25 placentas from the women in labour who underwent pregravid preparation before the ART cycle, obstetric and perinatal support and delivery in accordance with the medical and organizational algorithms developed by us, prognostic methods and treatment and preventive regimens; the Group II - 25 placentas from the women in labour who received generally accepted prognostic and therapeutic and preventive measures. Results. Histological examination of placentas from the women of the Group I demonstrated the manifestations of compensatory processes prevailed, and there was a much lower severity of pathological changes. The placental coefficient in the women of the Group I was probably higher than in women of the Group II, accounting for 0.17 versus 0.15. There was a decrease in the branching of blood vessels, as a result of which the capillaries occupied mainly the central and paracentral position. Dystrophic and necrotic processes, with the replacement of the chorion epithelium with fibroid masses, were manifested in a small number of terminal villi which belonged to the adaptive mechanisms. The largest area of CD34 expression in the villous chorion of the placenta was observed in the Group I and was 9.49±0.47%, in the Group II it was 1.29 times lower (7.34±0.15%; p<0.01). The highest optical density of CD34 expression in the villi chorion of the placenta was observed in the women of the Group II (0.22±0.01 r.u.), which was 1.25 times higher than in patients of the Group I (0.20±0.01 r.u.; p<0.01). Conclusions. In the case of pregravid preparation before ART cycles and in the case of complex correction of maladaptive disorders in the fetoplacental complex of pregnant women with a history of STIs, all structural mechanisms of placental adaptation are included, which allow to maintain the morphometric and diffusion parameters of the villous tree at the level of stable compensation, which is the most important adaptive tool that helps to maintain fetal viability. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.

Effects of intrauterine infection in different periods on the placenta and endometrial blood vessel formation of pregnant mice and the growth and development of fetal rats

Objective: To investigate the effects of intrauterine infection in different periods on the placenta and endometrial blood vessel formation of pregnant rats and the growth and development of fetal rats.Methods: According to the random number table method, 32 pregnant rats were divided into the early infection group, the mid-term infection group, the late infection group and the control group, with 8 rats in each group. On the 3rd, 9th and 15th day of pregnancy, lipopolysaccharide was injected intraperitoneally to construct intrauterine infection models. The pregnant rats in the control group were intraperitoneally injected with the same dose of 0.9% sodium chloride solution. On the 18th day of pregnancy, the inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], the blood vessel density of placenta and endometrium in the placental tissues of pregnant rats, dead fetus + absorbed fetus, the inflammatory factors IL-6, TNF-α and oxidation reaction indicators [malondialdehyde (MDA) and myeloperoxidase (MPO)] in the fetal rat lung and brain tissues were detected.Results: The changing trend of IL-6 and TNF-α levels in the placental tissues of pregnant rats with intrauterine infection in different periods was: the control group < the late infection group < the mid-term infection group < the early infection group, the differences were statistically significant (p <.05). The changing trend of fetal rat weight, placental weight and placental coefficient in the intrauterine infection groups in different periods was: the control group > the late infection group > the mid-term infection group > the early infection group, the differences were statistically significant (p < .05). The blood vessel density of placenta and endometrium, the mean number of fetuses, brain coefficient and lung coefficient in the late infection group were significantly increased in comparison with the early infection group and the mid-term infection group. The total number and the ratio of dead fetus + absorbed fetus, the levels of IL-6, TNF-α, MDA and MPO in brain and lung tissues were significantly reduced, and the differences were statistically significant (p < .05). The blood vessel density of placenta and endometrium, brain coefficient and lung coefficient of pregnant rats in the mid-term infection group were significantly increased in comparison with the early infection group, and the differences were statistically significant (p < .05). There was no statistically significant difference in the other indicators between the two groups (p > .05).Conclusions: Intrauterine infection in different periods can inhibit placental and endometrial angiogenesis, and affect the survival rate of fetal rats and the growth and development of brain and lung. The reason may be related to the aggravation of fetal inflammatory responses and oxidative stress. The earlier the intrauterine infection occurs, the severer the adverse effects on the fetal rats will be.

Study of Morphology of Placenta in Fifty Specimens

Introduction: The placenta is an important organ for keeping a pregnancy going and promoting normal foetal development. As a foetal organ, the placenta is subjected to the same stress and strain as the foetus. The growth of the foetus depends upon the location, functional capacity and integrity of the placental attachment. Aim: To study the morphology of the placenta in fifty placental specimens. Methods: The study was conducted in the Institute of Anatomy, Madurai Medical College, in collaboration with the Department of Obstetrics and Gynecology. A total of fifty placental specimens were collected and analyzed for shape, diameter, thickness, placenta weight, maternal and fetal cotyledons, and attachment of cord, vascular pattern, fetoplacental ratio and placental co-efficient. Results: In fifty placentae, 60% circular in shape; 38% oval in shape; 2% triangular in shape. The mean diameter is 17.7 cm. The diameter is increased in anaemia and decreased in prematurity. The average thickness is 1.993 cm. The thickness is increased in Diabetes mellitus and decreased in anaemia. The average number of maternal cotyledons is 17; increased in Diatebes mellitus and decreased in prematurity. The average number of fetal cotyledons is 59 and increased in Diabetes mellitus. The feto-maternal cotyledon ratio is 3.5:1. It is increased in prematurity and decreased in Diabetes mellitus. The average weight of the placenta is 471 grams. The placental weight is increased in Diabetes mellitus and decreased in prematurity. The fetoplacental weight ratio is 5.805 and is decreased in prematurity. The placental coefficient is 0.18 and is increased in prematurity. Conclusion: The examination of the placenta yields valuable information regarding the intra-uterine events and fetal outcomes. KEYWORDS: Placenta, Macroscopic Morphology, Pregnancy.

Salmonella Enteritidis foodborne infection induces altered placental morphometrics in the murine model

IntroductionSalmonella foodborne disease during pregnancy causes a significant fetal loss in domestic livestock and preterm birth, chorioamnionitis and miscarriage in humans. These complications could be associated with alterations in placental structure. This study was aimed to determine how a low dose of Salmonella Enteritidis during late gestation affects placental histomorphometric in mice. MethodsWe used a self-limiting enterocolitis murine model. BALB/c pregnant animals received a low dose of Salmonella Enteritidis (3–4 x 102 CFU/mouse) on gestational day (GD) 15. At day 3 post infection bacterial loads, serum cytokines expression and placental histomorphometrics parameters were analyzed. ResultsWe found that a sub-lethal infection with Salmonella induced a significant drop in fetal weight -to-placental weight-ratio and an increase in the placental coefficient. After bacterial inoculation maternal organs were colonized, inducing placental morphometric alterations, including increased placental thickness, reduced surface area, and diminished major and minor diameters. Also, foci of necrosis accompanied by acute leukocyte infiltration in decidual zone, reduction of vascular spaces and vascular congestion in labyrinth zone, were also evident in placentas from infected females on GD 18. Our data shows that placentas from infected mothers are phenotypically different from control ones. Furthermore, expression of IFN-gamma and IL-6 was up regulated in response to Salmonella in maternal serum. DiscussionOur findings demonstrate that a low dose of Salmonella during late gestation alters the placental morphometry leading to negative consequences on pregnancy outcome such as significant reduction in fetal body weight.

Placental pathology in intrauterine growth retardation

Several histopathological features are found more frequently in placentas from pregnancies complicated by foetal growth restriction (FGR), including villous infarction, maternal vascular changes and villous morphological alterations, although around one quarter of placentas associated with FGR lack any morphological abnormality on routine examination. So, our aim is to study various morphometric and morphological changes in placentae of small for gestational age babies. The correlation of various maternal parameters like height, age and parity with the foetal weight, placental weight, foeto-placental ratio (F/P) and placental coefficient (PC) and lastly to know whether each diseases process has any specific change in placentae.A prospective randomised control study was conducted from August 2016 to August 2018 in the Department of obstetrics and gynaecology JSS Hospital Mysore Karnataka. The total number of deliveries during this period were 3430. Out of which 397 babies were diagnosed of having Intrauterine growth retardation (IUGR) Total number of 150 cases were studied out of which 100 placenta were from IUGR group (study group) and the remaining 50 placenta from healthy full term pregnancies(Control group). The incidence of IUGR in our study was 11.6%. The commonest maternal cause for IUGR was anaemia 43%, followed by 18 % cases of preeclampsia and in 37% cases cause was Idiopathic. Maternal characters such as age, parity, and height were studied in relation to foetal outcome. An increase in the birth weight and placental weight was found with an increase in maternal age, height as well as parity. The mean placental weight in IUGR group was 484 grams while in control group was 520 grams. The average surface area in placentae in study group was 200.96 sq.cms. While in control group was 254 sqcms.

Teratogenicity of Monosodium Glutamate on The Pregnant Rats and Their Fetuses

Background: 2% to 3% of all living newborns showed at least one recognizable congenital malformation. Monosodium glutamate (MSG) is widely used as flavor enhancer. But, it induces embryonic and fetal toxicity in rats during the gestational periods. Aim of the work: this study aimed to detect the effects of MSG on placenta and fetal developmental stages at 15th and 19th days of gestation. Material and Methods: fifty mature pregnant Albino rats (Weight 200 ± 20 g) were categorized into two groups according to the time of dissection at 15thor 19th days of gestation. From each group, half of the pregnant mothers (G15 and G19)were daily administrated MSG ( 7 g/10mL/kg b. w. by oral)from the 9th to 14th days of gestation). The control groups (C15 and C 19) were received water only. Results: in G15 and G19 groups, the uterine and fetal shape, number of implantation sites, number of living fetuses, body length, fetal and placental weights and the placental co-efficient were negatively changed when compared to the control groups(C15 and C 19). Also, the placental tissue showed congested blood sinuses and large hemorrhagic areas which contained hemolysed blood cells. Some atrophied decidual cells and pyknotic nuclei were observed with highly distorted maternal and fetal placental layers. Conclusions: this study showed that shortterm MSG exposure caused several maternal and fetal changes. Therefore, MSG is considered as embryotoxic agent and the mothers must avoid administration of this substance during the gestation period

Teratogenicity of Monosodium Glutamate on The Pregnant Rats and Their Fetuses

Background: 2% to 3% of all living newborns showed at least one recognizable congenital malformation. Monosodium glutamate (MSG) is widely used as flavor enhancer. But, it induces embryonic and fetal toxicity in rats during the gestational periods. Aim of the work: this study aimed to detect the effects of MSG on placenta and fetal developmental stages at 15th and 19th days of gestation. Material and Methods: fifty mature pregnant Albino rats (Weight 200 ± 20 g) were categorized into two groups according to the time of dissection at 15thor 19th days of gestation. From each group, half of the pregnant mothers (G15 and G19)were daily administrated MSG ( 7 g/10mL/kg b. w. by oral)from the 9th to 14th days of gestation). The control groups (C15 and C 19) were received water only. Results: in G15 and G19 groups, the uterine and fetal shape, number of implantation sites, number of living fetuses, body length, fetal and placental weights and the placental co-efficient were negatively changed when compared to the control groups(C15 and C 19). Also, the placental tissue showed congested blood sinuses and large hemorrhagic areas which contained hemolysed blood cells. Some atrophied decidual cells and pyknotic nuclei were observed with highly distorted maternal and fetal placental layers. Conclusions: this study showed that shortterm MSG exposure caused several maternal and fetal changes. Therefore, MSG is considered as embryotoxic agent and the mothers must avoid administration of this substance during the gestation period

PECULIARITIES OF THE FUNCTIONAL STATE OF THE MOTHER-PLACENTA–FETUS SYSTEM IN PREGNANT WOMEN WITH PLACENTAL DYSFUNCTION

Among the causes that lead to antenatal affliction of the fetus, namely its hypoxia, hypotrophy, ante- and intranatal distress, is placental dysfunction (PD). Perinatal mortality in PDs is 10.3‰ in newborn infants, 49 ‰ – in preterm infants. Perinatal morbidity with PD reaches 70‰, and mortality rate – 20%. Objective. To investigate the functional state of the fetoplacental complex (FPС) in pregnant women with PD. Material and methods. The functional status of the FPC in 104 patients with PD (main group) and in 136 women with uncomplicated pregnancy and delivery (control group) using ultrasound placentalography, Dopplerometry was examined. Research results. The ultrasound characteristics of the placental dysfunction were the following: discrepancy between the degree of maturity of the placenta of the gestation period, true thickening of the placenta, its hypoplasia, reduction of echogenicity of the placenta, oligohydramnios. Dopplerometric signs of disorder of the utero-placental blood flow were high peripheral vascular resistance, both in dominant and in subdominant UA, asymmetry of blood flow in UA. Hemodynamics of fetal-placental circulation against the ground of PD was characterized by a decrease in the final diastolic blood flow velocity, which was manifested by an increase resistance in the peripheral vascular of the fetal part of the placenta, decrease in placental coefficient. The peculiarity of fetal blood flow in pregnant women with PD was the decrease in the mean value of vascular resistance indices in the middle cerebral artery of the fetus and a significant decrease in the cerebral-umbilical index. Conclusions. In pregnant women with placental dysfunction hemodynamic changes in the utero-placental complex are associated with decrease in the intensity of placental-fetal blood flow and in 16.3% of cases by centralization of the fetal circulation. Timely Dopplerometry is important both in the diagnosis of the compensatory capabilities of the FPK, and during determination of reasonable suggested obstetrical tactics.

Morphological study of placental changes in anemia with its clinical significant

Background: The placenta acts like a sieve, moving oxygen and nutrients from the mother’s body to baby and taking carbon dioxide and waste materials from the baby into mother’s body for elimination. The placenta also plays an important role in hormone production and releases hormones into both the maternal and fetal circulations to affect pregnancy, metabolism, fetal growth, and parturition. Earlier in developing countries women often become anemic during pregnancy because the demand of iron and vitamins will increase. Fetuses are at risk of preterm deliveries, low birth weight due to impairment of oxygen delivery to placenta and fetus. Objectives: To study the morphological changes in placenta in patients with anemia. And also to correlate between the degree of anemia with maternal and fetal complications. Material and Methods: This study was conducted in the Department of Anatomy Government Medical College, Surat. The placentas were collected from labor room and gynecology operation theater. Total 130 cases were studied. Out of 130 cases 100 women having pregnancy with anemia and 30 cases belong to control group pregnant women without anemia. Results: The weight of newborn baby in the present study is found to vary between 900 and 3400 g in the anemic group, where as it is between 2000 and 3500 g in the control group. Thus variation in the fetal weight is much more in the anemic group. Mean placenta weight is 500.30 g in mild anemic groups, 454.73 g group for moderate anemic group, and 405 g for severe anemic group. Majority of placenta in mild, moderate, and severe anemic groups are either round or oval in shape. There is no significant difference in the mean thickness of placenta in the control group and anemic group. The number of cotyledons in the present study is found to vary between 15 and 35 in the anemic group and it is between 17 and 29 in the control group. Surface area of placenta in the present study is found to vary between 133.10 cm2 in the anemic groups, where as it is between 176.32 cm2 in the control group. Mean placental coefficient is 0.203 for the anemic group and 0.0185 for control groups. The common site of insertion of umbilical cord in both the groups is eccentric. Conclusions: It was concluded from the study that the weight of newborn baby is significantly low in anemia and it further decreased according to severity of anemia .Thickness of placenta is not much affected by anemia. Hence, it cannot be used as a reliable criterion for identification of anemia. Thus placenta acts as an effective index, by examination of which we can predicate the status of the fetus in neonatal life.

La placenta de la altura. I Características macroscópicas y morfometría

Los autores han estudiado peso de recién nacidos y placentas de embarazos de Puno, Perú, a una altitud de 3.850 m .; se han estudiado 46 embarazos normales de diferentes hospitales desde 46 grupo control normaI que Lima a 150 m. Los pesos de los recién nacidos fueron similares en ambos lugares, sin embargo, el peso de la placenta y el volumen fueron mayores en Puno, por lo que el coeficiente de la placenta fue mayor en altura. El análisis macroscópico en términos de parénquima y tejido no parénquima no fue diferente en ambos grupos, pero el análisis microscópico mostró capilaridad más rica con vellosidades disminuido en Puno. No se apreciaron diferencias en la proporción de ephithelium trofoblástica. El área total de la superficie de las vellosidades y capilar corial fueron significativamente mayor en altura. Los autores postulan estos cambios morfológicos favorecen el intercambio placentario metabólica en el ambiente hipóxico de gran altura.

Morphometric differentiation between placenta in PIH and normal pregnancy

Background: Placenta is like a diary of gestational life. It is the vital organ for developing fetus, and it is also the most accessible organ of human body. Pregnancy complications such as hypertension, diabetes, and anemia are reflected in a significant way. Placental examination is helpful to plan a safe pregnancy and a healthy baby outcome at its end. Objective: To study morphometric differences of placenta in normal pregnancy and pregnancy-induced hypertension (PIH). Materials and Methods: A total of 100 placentas (50 from normal pregnancy and 50 from PIH group) were collected. Parameters such as weight, volume, thickness, diameter, and area were noted and their means were calculated. These parameters were divided into different ranges. From the weight of the baby and that of the placenta, fetoplacental weight ratio and placental coefficient were calculated. Results: The mean placental weight, area, volume, diameter, and thickness were lower in the PIH group. Weight, volume, area, diameter, and thickness in control group range from 420 to 560 g, 380 to 550 cc, 204.4 to 346 cm2, 17 to 21 cm, 1.7 to 2.3 cm, respectively, and those in PIH group range from 200 to 510 g, 190 to 500 cc, 132.7 to 247.3 cm2, 13 to 18 cm, and 1.2 to 2 cm, respectively. Conclusion: The range of morphometric parameters is comparatively lower in PIH group than in control group. The mean birth weight and fetoplacental weight ratio is higher in control group. The placental coefficient was significantly higher in PIH group.

Study of Placental Insufficiencies in IUGR Babies in Term Pregnancies

<p><strong>Introduction:</strong> In intrauterine growth restricted babies, at term, the placenta might hold the key to the etiology. This present study is aimed at comparison of data of gross and pathological study of placentae from normal weight (control) and IUGR groups and attempted to establish a relationship between placenta pathology and intrauterine growth retardation in term pregnancy.</p><p><strong> Aims and Objectives:</strong> 1. To study placental factors associated with IUGR. 2. To study prevalence of placental factors in details. Material and Methods: A study of 100 patients, with more 37 and less 42 weeks of gestation wasconducted for 2yrs in a tertiary care hospital. A thorough general examination&Systemic examination which included per abdominal examination including uterine height, abdominal girth, symphysio fundal height, estimated fetal weight, abdominal grips, fetal heart auscultation, and per vaginal examination. Routine and specific investigations will be sent for clinical correlation. Placenta obtained after delivery was send for macroscopic and microscopic examination to pathologist. The reports obtained will be used to study placental causes in IUGR and placenta in detail.</p><p><strong>Result:</strong> Average placental weight of term pregnancy is 400 gms and placental coefficient is 0.18. decidual surface area is 254 cm2 and its thickness is 2.72cm. Retroplacental haemorrhage is closely associated with PIH. Microscopic infarction is found with high frequency (p<0.005). Placenta of IUGR fetus, gross pathological changes like severe infarction with or without retroplacental haematoma can obviously be noted but they are not found to be statistically significant. Placental coefficient is increased in cases of anemia. Syncytial knot formation in excess and thickening of basement membrane is well correlated.</p>

Study of Placental Insufficiencies in IUGR Babies in Term Pregnancies

Introduction: In intrauterine growth restricted babies, at term, the placenta might hold the key to the etiology. This present study is aimed at comparison of data of gross and pathological study of placentae from normal weight (control) and IUGR groups and attempted to establish a relationship between placenta pathology and intrauterine growth retardation in term pregnancy. Aims and Objectives: 1. To study placental factors associated with IUGR. 2. To study prevalence of placental factors in details. Material and Methods: A study of 100 patients, with more 37 and less 42 weeks of gestation wasconducted for 2yrs in a tertiary care hospital. A thorough general examinationaSystemic examination which included per abdominal examination including uterine height, abdominal girth, symphysio fundal height, estimated fetal weight, abdominal grips, fetal heart auscultation, and per vaginal examination. Routine and specific investigations will be sent for clinical correlation. Placenta obtained after delivery was send for macroscopic and microscopic examination to pathologist. The reports obtained will be used to study placental causes in IUGR and placenta in detail. Result: Average placental weight of term pregnancy is 400 gms and placental coefficient is 0.18. decidual surface area is 254 cm2 and its thickness is 2.72cm. Retroplacental haemorrhage is closely associated with PIH. Microscopic infarction is found with high frequency (p<0.005). Placenta of IUGR fetus, gross pathological changes like severe infarction with or without retroplacental haematoma can obviously be noted but they are not found to be statistically significant. Placental coefficient is increased in cases of anemia. Syncytial knot formation in excess and thickening of basement membrane is well correlated.

English

Abstract Introduction Placenta is the maternal–foetal contact zone. The placentas of ‘idiopathic’ intrauterine growth retardation babies may hold the key to the aetiology of growth restriction. It was noted by most workers that in cases of intrauterine growth retardation placentas, there were some abnormal positions of insertion of umbilical cords, placental weight and volume was significantly lower than the controls and they also had smaller diameters. The greater placental coefficient in intrauterine growth retardation indicates that though both placentas and babies in intrauterine growth retardation had less weight, placental sizes were not relatively less. This article aims to review literature to identify any morphological and structural peculiarities of placenta that might contribute to development of idiopathic intrauterine growth retardation. Discussion Light microscopy suggested that syncytiotrophoblastic lining was more degenerated and a number of syncytial knots increased in intrauterine growth retardation placentas than that of the control placentas. X cells were present in both the cases, though more in intrauterine growth retardation. Intravillous and perivillous fibrin depositions were markedly increased in intrauterine growth retardation; also there were more hypovascular/avascular villi and large areas of infarction. Conclusion Review of the literature to establish any relationship between placental histomorphometric changes and intrauterine growth retardation suggests that intrauterine growth retardation pregnancies are associated with reductions in villous tree elaboration, particularly affecting the volume and surface area of terminal and intermediate villi, thereby restricting surface area over which foetomaternal exchange may occur. Thus, placental oxygen transfer might be reduced, thereby restricting foetal growth and development.

Gross morphological changes of placentas associated with intrauterine growth restriction of fetuses: A case control study

The present study aimed to throw light to any gross morphological changes of placenta that might contribute to the development of idiopathic IUGR. Gross examination of placentas from full-term uncomplicated pregnancies delivering singleton live IUGR babies, and live normal-weight babies (controls) were performed; then the results were compared. Fifty full-term freshly delivered placentas were collected both from normal deliveries and C.S. Twenty-eight (28) placentas were associated with IUGR and twenty-two (22) were from controls. The positions of insertion of the umbilical cords, placental weights, volumes and diameters were noted. These gross examinations revealed that the control placentas were bigger in diameters, had usual positions of insertion of umbilical cords, mean placental weight was 416.77 gm and mean placental volume was 343.86 ml. In cases of IUGR placentas, there were some abnormal positions of insertion of umbilical cords in 11% placentas (marginal in 7.14% and velamentous in 3.57%), and placental weight and volume was significantly lower ( p value < 0.001). The placentas associated with IUGR were smaller in diameters than those of control group of placentas. The mean placental co-efficient of IUGR group in the present study was 0.156 (range 0.11–0.22) and that of the control group was 0.138 (range 0.12–0.18). The greater placental co-efficient in IUGR indicates that although both placentas and babies in IUGR had less weight, placental sizes were not relatively less. In fact, these placentas were functional, and even tried to compensate the abnormal morphology. Therefore, though IUGR fetuses were more frequently associated with morphologically abnormal placentas, it could not be conclusively decided whether this abnormal gross morphology actually contributed to the intrauterine growth restriction.

Novel determination of filtration coefficient of ovine placenta and intramembranous pathway

We recently reported that distilled water injected into the amniotic compartment is rapidly absorbed by the fetal blood, which perfuses the fetal membranes and the fetal surface of the placenta, i.e., by the "intramembranous pathway." In the present study, we infused warmed distilled water at 2 ml.min-1.kg estimated fetal wt-1 into the amniotic compartment for 6-8 h in 12 chronically catheterized sheep. A steady state was achieved in amniotic fluid, fetal blood, and maternal blood osmolalities in 5.1 +/- 0.3 (SE) h. During the steady state, all of the infused water must pass to the ewe. Because the amount of water directly crossing the fetal membranes into the maternal circulation was not significantly different from zero (3.3 +/- 5.8% of total), we assumed all water crossed the placenta. The placental filtration coefficient was then calculated during the steady state as the infusion rate divided by the changes in the transplacental osmotic gradient and averaged 0.0260 +/- 0.0055 ml.min-1.mmHg-1.kg fetal wt-1. Attempts to correct this value for placental reflection coefficients less than 1 were unsatisfactory; thus the uncorrected value appears to provide the best estimate of the placental filtration coefficient. Similar calculations yielded a value of 0.00137 +/- 0.00025 ml.min-1.mmHg-1.kg-1 for the filtration coefficient of the intramembranous pathway. Thus this method provides a relatively simple new technique for estimating the filtration coefficient of the ovine placenta and intramembranous pathway under steady-state conditions.

Model study of placental water transfer and causes of fetal water disease in sheep

The purpose of the computer simulation was to use experimentally measured parameters of placental water transfer to compute conceptual water acquisition during the last third of ovine pregnancy and to evaluate the possible role of each of these parameters in the pathophysiology of polyhydramnios. Total conceptual water at birth was almost insensitive to the value of the placental filtration coefficient. It was more sensitive to fetal and maternal placental blood flows, the concentrations of actively transported or metabolically produced solutes in fetal plasma (bicarbonate, fructose, alpha-amino acids, urea, lactate), and the hydrostatic pressure difference across the placental barrier. It was quite sensitive to the NaCl reflection coefficient and permeability. We conclude that the actively transported or produced solutes in fetal plasma constitute a primary driving force. The opposing diffusion gradient of NaCl, and to a much lesser extent that of glucose, are essential to restrain the process. The causes of polyhydramnios in this species are, in order of probability, an increase in the placental diffusion permeability of NaCl, a decrease in the placental reflection coefficient for NaCl, or an increase in the concentration of an osmotically effective solute in fetal plasma, by active transport or metabolic production.

Correlations of sialomucins and IgA in the maternal serum of primiparous and multiparous subjects at delivery.

Attention is drawn to correlations between placental coefficients and maternal serum levels of IgA at delivery in primiparae and multiparae. These correlations associate maternal serum IgA with gestational performance and appear to discriminate between groups which differ in that respect. Similar correlations exist between the placental coefficient and maternal serum seromucoid, with group discrimination preserved in primiparae, but not multiparae. Direct correlations between serum seromucoid and IgA in maternal serum can be attributed to their mutual dependence on the size and state of the feto-maternal interface, and may provide a means of detecting placental insufficiency in multigravidae.