Morphological, Morphometric, and Histological Evaluation of the Placenta in Cases of Intrauterine Fetal Death (original) (raw)
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IOSR Journals , 2019
Introduction: Placenta is one of the most vital organs which give first-hand information related to outcome of pregnancy to the obstetricians. It helps in the exchange of gases, metabolic products between the mother and the fetus, and removal of wastes from fetal blood into the maternal circulation. Placental examination has been proved to be of clinical value in cases of Intrauterine Growth Retardation (IUGR) and Intra Uterine Fetal Death (IUFD). Aims and Objectives:The aim and objective of the present study is to examine the morphological changes in placentae of normal and in the cases of intrauterinefetal death and intrauterine growth retardation, which in turn will improve the quality of placental diagnosis. Material and Methods:Clinicomorphological study of placental lesions in cases of intrauterine growth retardation and intrauterine death with a sample size of 50 placentae. In the present study, 40 placentae were diagnosed cases of intrauterine growth retardation. Ten placentae from cases of full term normal delivery were taken as control. Gross and histomorphological analysis of the placentae was carried out and correlated with the pregnancy outcome in relation to various etiological factors. Results: Amongst 50 placentae; 10 were normal and 40 placentae were collected from IUGR among them 20 placentae were of PIH, 3 were of anaemia, 3 were of polyhydramnios, 3 were of oligohydramnios, 3 were due to heart disease & 8 were due to idiopathic reasons. Among these, one case of severe anaemia leads to Intrauterine Fetal Death. Majority of IUGR cases were of age group 21yrs-25yrs (40%), and the common etiological factor was PIH (Pregnancy Induced Hypertension).Gross placental lesions i.e calcification, infarcts and haematoma were more commonly seen in the IUGR group.Histopathological evaluation shows variable results. Conclusion: Placental evaluation plays a vital role in deriving the pregnancy outcome of etiological factors affecting to a variable extent. The severity of placental abnormalities expressed as cumulative number of placental lesions like infarcts, decreased villous vascularity, and fibrin deposition are significant risk factors for IUGR and have adverse perinatal outcome.
Introduction: Placenta is the vital organ which maintains the pregnancy and promotes the normal fetal development. It anchors the fetus to the uterine wall and allows the uptake of nutrients, elimination of waste, gas exchange via the mother's blood supply. In our study, we included 82 normal full term placentae and the placentae of 3 PIH, 2 GDM, 2 Anemia mothers. Objective: In our study, we included 82 normal full term placentae and the placentae of 3 PIH, 2 GDM, 2 Anemia mothers. Our main aim is to study the morphology and morphometry of these placentae and analyze how these parameters will help in assessing the fetal health. Materials and Methods: 89 Human placentae were collected from the department of Obstetrics and Gynaecology. The parameters studied are-shape, diameter, thickness, weight, maternal surface number of cotyledons, fetal surface vascular pattern, type of umbilical cord insertion, diameter of umbilical cord, number of umbilical vessels. Results: The predominant shape is round. Mean diameter is 17.22±2.47. The mean thickness in the center is 2.75±0.60 and at the periphery is 1.41±0.54. The average weight of the placenta is 438.76±100.30. Mean no. of cotyledons = 16.04±3.57. magistral type of vascular pattern on fetal surface was seen frequently. Eccentric and central type of umbilical cord insertion is seen in most of the placentae. The mean diameter of the umbilical cord is 1.79±0.85. All the Placentae in our study showed two arteries and one vein. Conclusion: Variations in the morphology and morphometry of the placenta are usually associated with the fetal growth retardation, big babies, childhood hypertension, and various other pathological conditions. Hope our study adds knowledge to the placental parameters and help the Obstetricians, Embryologists, Radiologists, other clinicians and surgeons to understand the patho-physiological mechanisms of Placenta and design the treatment plans for a better maternal and fetal outcome.
Texila International Journal of Public Health, 2024
This study investigates the relationship between placental morphometrics and fetal growth outcomes in normal and intrauterine growth restriction (IUGR) pregnancies. We compared various placental parameters between control and IUGR groups to elucidate the structural differences associated with compromised fetal development. Our findings reveal significant disparities in placental morphology between the two groups. IUGR placentae exhibited markedly reduced weights (350-450g vs. 550-600g in controls), smaller maternal and fetal surface areas, and fewer cotyledons. Fetal weights in IUGR cases were substantially lower (1500-2440g vs. 2400-3500g in controls). Umbilical cords in IUGR pregnancies were generally shorter and slightly thinner, with less optimal insertion sites. These results underscore the critical role of placental structure in fetal growth. The observed reductions in placental size and complexity in IUGR cases likely contribute to diminished nutrient and oxygen transfer, directly affecting fetal development. This study enhances our understanding of the placental factors influencing IUGR and may inform future research on early detection and potential interventions for improved pregnancy outcomes.
A clinicopathological study of the IUGR placenta and its implication in the therapeutic intervention
Background: Ischemia and placental pathology are the two main basic etiopathogenesis behind intra uterine growth retardation (IUGR). Various histomorphological changes are observed in IUGR placenta. distribution, gravidity, socio economic statu placenta. To correlate the data with the neonatal outcome in terms of fetal weight and apgar score. To suggest treatment modalities based on this. Settings and born with birth weight less than 10th percentile of normal weight for age and sex were taken up for the study. Appropriate sections were taken and morphology ananlysed. Age of the mother, gravidity, econo factors were retrieved from the records. Baby's weight and the Apgar score were retrieved from the records. 80% of the mother was in the age group 21 class and 45% of them had no specific etiology. 66% of the placenta had macroscopic abnormality and 60% of the had microscopic abnormality. 51 babies were <5 positive correlation between reduced placental weight and placental diameter with the fetal weight. When the number of lesions in the placenta is increased, apgar score decreased and infant mortality increased[p<0. 001]. Compulsory examination ofall the IUGR placenta
Placenta, 2008
Different classification systems for the cause of intra-uterine fetal death (IUFD) are used internationally. About two thirds of these deaths are reported as unexplained and placental causes are often not addressed. Differences between systems could have consequences for the validity of vital statistics, for targeting preventive strategies and for counselling parents on recurrence risks. Our objective was to compare use of the Tulip classification with other currently used classification systems for causes of IUFD. We selected the extended Wigglesworth classification, modified Aberdeen and the classifications by Hey, Hovatta, de Galan-Roosen and Morrison. We also selected the ReCoDe system for relevant conditions, comparable to contributing factors in the Tulip classification. Panel classification for 485 IUFD cases in the different systems was performed by assessors after individual investigation of structured patient information. Distribution of cases into cause of death groups for the different systems varied, most of all for the placental and unknown groups. Systems with a high percentage of cases with an unknown cause of death and death groups consisting of clinical manifestations only are not discriminatory. Our largest cause of death group was placental pathology and classification systems without placental cause of death groups or minimal subdivision of this group are not useful in modern perinatal audit as loss of information occurs. The most frequent contributing factor was growth restriction. This illustrates the vital role of the placenta in determination of optimal fetal development. In the Tulip classification, mother, fetus and placenta are addressed together. The system has a clear defined subclassification of the placenta group, a low percentage of unknown causes and is easily applied by a multidisciplinary team. A useful classification aids future research into placental causes of IUFD.
International Journal Of Medical Science And Clinical Invention, 2017
Introduction: Intrauterine growth restriction (IUGR) is a condition in which fetus fails to achieve its inherent growth potential. It is the second most common cause of perinatal mortality and morbidity following prematurity. Objectives: Objectives of this study were to see the perinatal outcome and histopathological changes in placenta in IUGR pregnancies. Material & Methods: 100 cases of IUGR were taken up for study along with 50 controls. Ultrasonography was done to evaluate the uteroplacental insufficiency. Placental weight and morphology and histopathology of placenta was done. Results: Prevalence of IUGR was more in younger age group 49%, primigravida 58%, low socio economic status 96% and rural background 77%. History of IUGR in previous pregnancy was 30%. Abnormal color Doppler was found in 47%. Placental weight was less in IUGR and histopathology of placenta showed fibrinoid necrosis in 48% and syncytial knots 44%. Neonatal mortality in the study came out to be 12%. Conclus...
Histopathological Examination of Placenta in Cases of Reproductive Failure
2018
The placenta signifies the "second" or "embryonic" period of pregnancy (after the implantation period) and describes the establishment of a fully functional placenta. The placenta is an apposition of fetal and parental tissue for the purposes of physiological exchange. The placenta is a unique organ with dual blood circulation, functioning throughout foetal development. Placental trophoblasts express and produce coagulation components, participating not only in haemostasis but also in placental vascular development and differentiation 1 . The earlier insight into this organ comes from drawing from illustrators such as Andreas Vesalius (1514-1564). The designation “placenta” was introduced by Gabriele de Falloppio (1523-1562). Others, however believe that this designation, placenta, stemmed from Realdus Columbus in 1559.
Histological Study of Human Placenta in Normal and Anemic Cases
Background: Placenta forms a functional unit between the mother and the fetus and any pathological event that concerns the mother or the fetus will influence the normal function of the placenta. Anemia is commonest hematological disorder that occurs in pregnancy and the commonest cause of anemia during pregnancy is iron deficiency which may be due to nutritional deficiency or increased demand of oxygen in pregnancy. Anemia leading to hypoxia cause changes in structure of placenta. It also exerts profound changes on the maternal circulatory system and has serious effects both on mother and fetus 7 and it is responsible for 20-40% of maternal deaths directly or indirectly. Objective: To analyze the spectrum of histopathological changes in placenta in normal and anemic cases. Material and Methods: A total of 90 placentae were collected soon after deliveries from normal and caesarean sections of which, 45 placentae were from mothers with anemia and 45 placentae were from normal term mothers who formed the control group. Placental tissue was taken for histopathological processing viz: Fixation, Dehydration, Clearing, Embedding and Sectioning and staining was done after that Immunostaining for paraffin sections was done. Results: The area of synctical knot formation, cytotrophoblastic cellular proliferation, fibrinoid necrosis was found higher among the cases as compared to controls which is statistically significant. Hyalinised area was the most common finding among cases while Stromal fibrosis was least finding. Conclusion: Anaemia in pregnancy alters the placental morphology and adequate treatment of anaemia may therefore be critical to normal placental function.