Low Birth Weight Live Births: An Insight Into Placental Pathology (original) (raw)
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Placental pathology in low birth weight babies a prospective observational study
IP Innovative Publication Pvt. Ltd., 2018
Introduction: Low birth weight (LBW) babies are more common in developing countries like India. The placenta is an organ which connects fetus to mother during intrauterine life. Any change in the mother reflects on placenta and thus on the fetus. Materials and Methods: In this study placenta from LBW were evaluated. We included 50 fresh placentae. Gross examination including weight, shape, thickness, feto-placental ratio was calculated. Later, histo-morphological study of all placentae was done. The extent of placental lesions which can influence the birth weight of the baby or adverse fetal outcome were correlated. Results: Out of 50 placentae studied, there was significant reduction in placental weight and dimension. Irregular shape of placenta was seen in 13 cases and most of the plscenta (27 cases) showed paracentral insertion of umbilical cord. On gross, infarction [56%], subchorionic fibrin [64%], intervillous fibrin [52%] were noted. On microscopy, cytotophoblast hyperplasia [52%], stomal fibrosis [48%], fibrinoid necrosis [100%], synnctial knots [32-68%], hypovascular villi [44%] were noted. Conclusion: All major gross and microscopic changes in the low birth weight placentas pointed towards reduced blood flow to the placenta resulting in chronic placental insufficiency. The severity of placental abnormalities expressed as cumulative number of placental lesions is a significant risk factor for LBW babies. Morphological examination of the placenta conducted in the present study proved to be a useful adjunct to the clinical examination in finding the pathogenetic mechanisms during pregnancy resulting in LBW babies and can be helpful in the planning and management of future pregnancies. Keywords: Placental examination, Low birth weight babies, Pregnancy, Feto-placental ratio.
Paripex Indian Journal Of Research, 2021
BACKGROUND: The foetus, placenta and mother constitute triad of contributors to pregnancy outcome. Thus, any insult in the growth of the placenta affects the fetal development and outcome. Anaemia in pregnancy is also very common, but severe anaemia in pregnancy may have adverse effects on pregnancy, delivery and neonatal infants. Maternal anaemia is an independent risk factor for pre-term delivery and low birth weight. The placental examination will help in understanding of the specific etiologies of adverse outcome which will lead to specific treatment and preventive measures for those with risk for recurrence in subsequent pregnancies. Study of the OBJECTIVES: histomorphology of placenta in cases of anaemia and control group, Findings that help to explain adverse pregnancy outcome, Findings predictive of possible recurrence that could guide care in subsequent pregnancies. MATERIALS AND METHODS: Evaluation of 50 placentas of patients with anaemia and 50 of healthy control received at tertiary care hospital over a period of 4 months. In present study mean weight of the newborn baby born to anaemic group RESULT: was significantly lower than the control group. Percentage of asphyxia and death of the newborn baby as well as percentage of shock and death in pregnant women were also more in anaemic cases. In gross features of placenta; irregular shape of the placenta and marginal insertion of umbilical cord, calcification and paranchymal fibrosis were more observed in anaemia cases. In Histopathological examination percentage of Syncytial knots, Fibrinoid necrosis, Placental infarct, Calcification, Fibrosis, Villous hypovascularity, Cytotrophoblastic proliferation and basement membrane thickening were more significant in anaemia cases as compared to control group. Present CONCLUSION: study supports the view that there is a very strong relationship between the placental histomorphology in anaemia with adverse fetal and maternal outcome.
Morphological Changes of Placenta Associated with Maternal Anaemia
Placenta is the mirror of fetomaternal status. The effect of anemia in pregnancy can be diverse and detrimental to the mother and the fetus. This prompted us to carry out the present study, which aimed to observe and compare the morphological features of placenta at term in anemic and non-anemic mothers of North Bengal and to find out the clinical relevance of such structural changes. Total 30 placentas were collected from each group of selected patients after delivery at labor room. Examination of placenta was conducted according to proforma. A general survey of umbilical cord, membranes, fetal surface, and maternal surface was carried out. The diameters were measured, area was estimated, and shape was noted. Placenta and fetus was weighed in the same scale. The volume was estimated by water displacement method. In anemic mothers, mean baby birth weight was found to be significantly less than that of control group. The mean placental weight in test group was significantly increased in comparison to controls. The mean placental volume and mean placental area in case of test group were significantly increased. Occurrence of morphological features, like subchorionic fibrosis; retroplacental clot, gross calcification, or placental infarction etc were found to be significantly higher in anemic mothers in comparison to non-anemic group. In the present study, it was proved that placenta has considerable functional reserve capacity. It tends to limit the ill-effects of tissue injury and of unfavorable maternal milieu like anemia. Our findings were in accordance with the previous studies in this field.
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.
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.
Gross Morphological Changes of Placenta Associated with Maternal Anemia
2020
INTRODUCTION: Placenta is a feto-maternal organ composed of maternal part, decidua basalis, and a fetal part, chorion frondosum. The intra-uterine survival of the fetus is dependent on this vital organ. AIM: The main aim of this study was to compare the macro architectural changes of placenta associated with maternal anemia in Dessie Referral Hospital, Northeast Ethiopia. METHODS: A comparative cross-sectional study design was conducted from May 1-June 16, 2018 at Dessie Referral Hospital. A total of 96 placentas (48 anemic and 48 non-anemic) was collected after delivery at the labor room. EPI data version 4.2.0 was used to enter the data and analyzed by SPSS version 24. One way ANOVA and independent sample ttest was used to compare the mean differences of the groups. RESULTS: In pregnancies with maternal anemia, the mean placental weight was 544±98 g and in nonanemic mother’s it was 502±93 g (p=0.03). The mean birth weight in anemic group was 2502±360 g and in non-anemic group 3035...
Placental changes associated with maternal anaemia
European journal of anatomy, 2014
SUMMARY The present study aimed to assess the morphological and histological changes of placentas associated with maternal anaemia (mothers with Hb level <11 g/dl). The study was conducted in Bankura Sammilani Medical College, West Bengal, India for a period of six months. Placentas collected from cases of maternal anaemia (Hb < 11 g/dl) were forty (40) and those collected from control mothers were thirty (30). All the deliveries were at full term (37-42 weeks) and in the antenatal periods were without any complications or diseases. Macroscopic and microscopic analyses of the placentas were done and these findings were compared. Statistical analysis was performed by using t-test for comparing the mean values of fetal weights, placental weights, placental indices and placental volumes of the maternal anaemia group with those of control group. It was observed that the mean fetal weight of pregnancy with anaemia group was less than those of the control group. The mean placental w...
2016
Placentae from 50 pregnant women were collected from Albatool Obstetrics and Gynecology Teaching Hospital in Mosul-Iraq. Thirty of them belonged to anaemic pregnant women associated with intrauterine growth restriction (IUGR), while the other 20 belonged to uncomplicated pregnancy (as a control group). The parameters studied were mean gestational age, birth weight of babies, mean placental weight, diameter, surface area, and mean placental volume. The main findings in the placentae from anaemic women were compared to the control group. Results reveal that there is a significant decrease in mean birth weight, mean placental weight, diameter, surface area and mean volume of the placentae in anaemia of pregnancy group associated with IUGR as compared with control group. Alterations in various parameters may be due to compensatory phenomena to fulfill the demand of O2 to fetus, subsequently affecting the growing fetus. Appropriate precautions if taken during pregnancy, complications due...