Histomorphological analysis of placental changes of pre-eclampsia patients in a tertiary care hospital of Puducherry, India
Keywords:Histopathological changes, Placental changes, Pre-eclampsia, Toxemia
Background: Placenta is a dynamic tissue synthesized physiologically to serve as a nutrient source for developing fetus it is exposed to several changes in reaction to many toxemic conditions associated with pregnancies. Studies had proved that placental changes observed on histomorphology is directly proportional to reaction to hemodynamic compensatory mechanisms, thereby aiding the obstetricians to manage the sequelae of complications. Objective of this study was to study the placental histomorphology in pregnancies associated with pre-eclampsia and to quantitate the observed placental changes.
Methods: The study comprised on 101 placental specimens obtained from department of obstetrics and gynecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry. Toxemia of pregnancies were divided into mild, severe preeclampsia and eclampsia based on blood pressure. The 101 cases were divided as 4 groups: Group 1 (control group); Group 2 (mild preeclampsia); Group 3 (severe preeclampsia); Group 4 (eclampsia).
Results: Among the 101 cases, 38 placentas were from uncomplicated full-term deliveries which constitutes the control group. The rest 63 placenta were from toxemia of pregnancies which constitutes the study group.
Conclusions: The incidence of toxemic pregnancies and pre-eclamptic cases are on higher margin than assumed. Histomorphology examination of placenta plays a vital role in assessing etiopathogenesis and mechanism of toxemic pregnancies. This aids the obstetrician to further manage subsequent sequelae and fix the complication to significant proportion.
Benirschke K, Kaufmann P. Pathology of the human placenta. 2nd ed. New York: Springer Verlag; 2010.
Udainia A, Jain ML. Morphological study of placenta in pregnancy induced hypertension with its clinical relevance. J Anat Soc India. 2001;50(1):24-7.
Fernando Arias. In: Practical guide to high-risk pregnancy and delivery, Mosby, Harcourt Asia Private Ltd., 2nd Edition; 2009:184-185.
Pritchard JA, MacDonald PC. In William’s Obstetrics, Appleton Century- Croft, New York; 2017:665-668.
Madazali, Lennon M. Effect of hypoxia on trophoblast in organ culture. Am J Obstet Gynaecol. 2010;107:1058.
Laviana, Scott A. Quantitative structural studies on human placentas associated with pre-eclampsia, essential hypertension and intrauterine growth retardation. Brit J Obstet Gynaec. 2005;92:714.
Memon E, Fox H. Pathology of the placenta. London: WB Saunders; 2016:477-481.
Verma E, Kalra R. Prenatal brain damage and placental infarction-an autopsy study. Dev Med Child Neurol. 2015;37:555-62.
Ashworth JR, Warren AY, Baker PN, Johnson IR. Loss of endothelium dependent relaxation in myometrial resistance arteries in pre-eclampsia. Brit J Obstet Gynaeco. 1997;104:1152-8.
Perrrin EVDK, Sander CM. Introduction: How to examine placenta and why. In: Perrin EVDK, ed. Pathology of placenta, 5th ed New York. Churchil Livingstone Inc.; 1984:57-88.
Fox H. General pathology of placenta. Obstetrics and gynaecological pathology ed. Fox H. New York: Churchill Livingstone; 1995:1477-1508.
Nobis P, Das U. Placental morphology in hypertensive pregnancy. J Obstet Gynecol. 1990;40:166-9.
Sayeed M, Chakrawarti RN, Devi PK. A comparative study of placental villous changes in normal and abnormal pregnancies. J Obstet Gynaecol India. 2016;46:217-21.
Kalra VB, Aggarwal A, Sareen PM, Kalra R. Histopathological changes in placenta in toxaemia of pregnancy. J Obstet Gynaecol India. 2005;35:86-90.
Bhatia A, Sharma SD, Jalnawalla SF, Sagreiya K. A comparative study of placental and fetal outcome. Indian J Pathol Microbiol. 2011;24:277-83.
Mehrotra VG, Mukherjee K, Pande M, Gurtu P, Mukherjee M. The histological study of placentae in normal and abnormal pregnancy. J Obstet Gynaecol India. 2012;22:248-53.