Histological evaluation of placenta in hypertensive pregnancies

Abstract

Background: Maternal and fetal status are reflected in placenta. Toxemia of pregnancy exerts great impact on placenta and thereby fetal and maternal outcomes. Placenta reflects changes of toxemia and these changes are seen morphology as well as histology. Hence study of placenta gives information on the in-utero fetal condition.Methods: A total of 1000 placenta, 500 each from hypertensive and normotensive groups were included in this study conducted in Anatomy Department of SBKS Medical College and Research Centre, Vadodara. Histological evaluation of the samples taken was done under microscope.Results: Microscopic examination of the placenta revealed the presence of calcification, infarction, fibrinoid necrosis, villous hyalinization, syncytial knots and cytotrophoblastic cellular proliferation in both control and hypertension groups. In the present study, calcification was seen in 35.8% in the control group, while the same was seen in 53.8% patients in test group. Fibrinoid necrosis was seen in 48.8% patients in control group as against 69% patients in test group. Villous Hyalinization was seen in 7.40% and 21.4% patients in control and test groups respectively. On the other hand, syncytial knots were seen in 38% and 69% patients in control and test groups respectively. In test group, cytotrophoblastic cellular proliferation was seen in 69% patients while in control group, it was seen in 33.2% patients. Infarction was also seen in test (42.4%) and control (12.6%) groups.Conclusions: Hypertensive disorders of pregnancy have significant effect on the histology of placenta and also influences the fetal outcomes.

Comparison of gross morphological and histological features of placenta between hypertensive and normotensive pregnant women attending Muhimbili National Hospital.

“…Prime gravida is one of the etiological factors of hypertensive disorders of pregnancy and this was confirmed in our study since the majority of mothers with hypertensive disorder of pregnancy were prim gravida. This finding is also confirmed by other previous studies (Kambale et al, 2016, Parmar, Shah andAlamchandani, 2019).…”

“…This might be attributed to the vulnerability of mothers with hypertensive disorders of pregnancy to premature delivery which is in some circumstances the pregnant woman should be delivered irrespective of gestation age. This finding is as it was ever observed in other studies done earlier (Parmar, Shah and Alamchandani, 2019).…”

“…Hypertensive group had significantly high blood pressure as compared to normotensive group. Parmar et al, 2019 has reported significantly high blood pressure in the hypertensive group as compared to normotensive just as it was observed in our study (Parmar, Shah and Alamchandani, 2019) The current study revealed that preterm deliveries were significantly high in the hypertensive group as compared to normotensive group. This might be attributed to the vulnerability of mothers with hypertensive disorders of pregnancy to premature delivery which is in some circumstances the pregnant woman should be delivered irrespective of gestation age.…”

“…Previous histological studies of the placentas have revealed the presence of calcifications, infection, fibrinoid necrosis, syntial knots, villous hyalinization in both groups however these findings were significantly predominant in the hypertensive group (Parmar, Shah and Alamchandani, 2019) (Salmani et al, 2014) (Nag and Vk, 2013) (Sankar et al, 2013) (Chhatwal, Chaudhary and Chauhan, 2018). These studies have been done among Caucasians and have revealed some different findings in some aspects.…”

Histomorphometric Variations of the Placenta in Normal and Hypertensive Pregnancies

“…Ranjan et al, Pramar et al and Chhatwal et al in their studies also observed and reported the findings that are consistent with our study. 11,21,22 Limited funds and time duration were one of the major constraints of the present study. The current study focused on histomorphometric changes in the placenta, while the status of the newborn babies in terms of APGAR score should also be evaluated in association with microscopic studies of the placenta.…”