Published: 2018-03-27

Morphological changes in placenta in cases of oligohydramnios

Amita Gupta, Sabha Musharaf, Gagan Singh, Aakriti Gupta


Background: There are gross and microscopic changes in placenta and umbilical cord in complicated pregnancies. The objective of this study was to study pathological (gross and microscopic) changes in placenta, membrane and umbilical cord in cases with oligohydramnios and to study relationship between changes in placenta, membranes and umbilical cord with severity of oligohydramnios.

Methods: A total of 50 patients were selected and their placentas were collected after delivery and sent to pathology department in 10 % formalin for histopathological examination. Patients were divided into three groups and the results were compared. Statistical calculations were performed using the SPSS 16.0. In order to detect differences between subjects students t-test was used for continuous variables, while, for categorical variables, the X2 test was used. A p-value of less than 0.05 was considered statistically significant.

Results: Atotal of 50 patients were studied for a period of one year and following observations were made, discoid shape placenta in 45 (90.0%), oval in 5 (10.0%), central attachment of umbilical cord in 16 cases (32.0%), eccentric in 33 (66.0%), marginal in 1 (2.0%) case following variables were compared and p value detected, placental maximum diameter (p <0.0001),placental minimum diameters (p = 0.041), mean of cord length (p <0.0001) placental weight (p = 0.273), placental thickness (p = 0.253), acute chorioamnionitis (p <0.0001), chronic chorioamnionitis (p<0.0001), focal squamous metaplasia (p <0.0001), bacterial colonies in subamnion (p <0.0001), meconium staining (p <0.0001), amnion nodosum (p < 0.0001), intra amniotic haemorrhage (p = 0.090), membranous deciduitis with chorioamnionitis (p = 0.081), focal haematoma (p = 0.010), acute inflammatory infiltrate in Wharton’s jelly (p = 0.012), single umbilical artery (p =0.010), intervillous fibrin deposition (p <0.0001), calcification (p<0.0001), chorangiosis (p <0.0001), syncytial knots (p <0.0001), avascular villi (p = 0.011), villous edema (p = 0.090) and infarct (p = 0.090).

Conclusions: There are alterations in placental morphology associated with oligohydramnios hence placenta should be examined, which may be useful in predicting perinatal morbidity and mortality.


Placenta, Oligohydromnios, Umbilical cord

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Pijnenberg, Bland R, Robertson JM, Brossens WB. Uteroplacental arterial changes related to interstitial trophoblast migration in early human pregnancy. Placenta. 1983;4:387-414.

Yetter JF. Examination of placenta. Am Family Phy. 1998;57(5):1045-54.

Borton C. Placenta and placental problems. Patient Plus. 2006;20:159.

Salafia C, Vintziloes AM. Why all placentae should be examined by pathologist. Am J Obstet Gynaecol. 1999;163(4):1282-93.

Kulkarni ML, Matadu SP, Ashok C, Pradeep N, Avinash T, Kulkarni AM. Absence of Wharton’s jelly around the umbilical arteries. Indian J Paediatr. 2007;74(8):787-89.

Leung AK, Robson WL. Single umbilical artery, report of 159 cases. Am J Child Dis. 1989;143(1):108-11.

Sudha R, Sivakumar V, Jebakani F. Study of shape of placenta and its relation to placental weight in normal and complicated - pregnancy. Nat J Basic Med Sci. 2012;2(4):307-11.

Sepulveda W. Velamentous insertion of umbilical cord: a first trimester sonographic screening study. J Ultrasound Med. 2006;25(8):963-8.

Ziadie M, Kowalski PJ. Placental gross/microscopic abnormalities, non-neoplastic Amnion nodosum. 2011. Available at

Devi H, Uma N. Prospective study of correlation between perinatal outcome and histopathology of placenta in cases of oligohydramnios. J Evidence Based Med Healthcare. 2015;2(5):493-504.

Saleemudin A, Tantbirojn P, Kathleen S. Obstetric and perinatal complication in placentas with fetal thrombotic vasculopathy. Paediatr Dev Pathol. 2010;13(6):459-64.

Hefetz SA. The umbilical cord obstetrically important lesions. Clin Obstet Gynaecol. 1996;39:87.

Suzuki S. Clinical significance of pregnancies with circumvallate placenta. J Obstet Gynaecol Res. 2008;34(1):51-4.

Manning AF, Platt LD, Sipos L. Antepartum fetal evaluation: development of fetal biophysical profile. Am J Obstet Gynecol. 1980;136(6):787-95.

Phelan JP, Smith CV, Small M. Amniotic fluid volume assessment with the four- quadrant technique at 36-42 weeks gestation. J Reprod Med. 1987;32:540-2.

Stoll C, Alembik Y, Roth MP, Dott B. Study of 224 cases of oligohydramnios and congenital malformations in a series of 225,669 consecutive births. Community Genet. 1998;1(2):71-7.

Spinillo A, Cesari S, Bariselli S, Tzialla C, Gardella B, Silini EM. Placental lesions associated with oligohydramnios in fetal growth restricted pregnancies. Placenta. 2015;36(5):538-44.

Hamdany MZ. To study effects of oligohydramnios on histological structure of full term placenta. Tikrit Med J. 2008;14(2):156-69.

Nath J, Jain M, Najam R. A clinical study on oligohydramnios in the third trimester of pregnancy with special emphasis on the perinatal outcome. J Evol Med Dent Sci. 2013;2(39):7386-91.

Adeniran AJ, Stanek J. Amnion nodosum revisited: clinicopathologic and placental correlations. Arch Pathol Lab Med. 2007;131(12):1829-33.

Deborah I, Gersell, Frederick TK. Diseases of placenta. Blaustein’s pathology of the female genital tract, 6th edition. Springer; 2011;19:1000-1069.

Zhang L, Yu YH, Hu MH. Association between ultrasonographic signs of placental premature aging and pregnancy outcome. Acad J First Med College PLA. 2005;25(3):318-20.

Redline RW, Pappin A. Fetal thrombotic vasculopathy: the clinical significance of extensive avascular villi. Hum Pathol. 1995;26(1):80-5.