Morphology, Morphometry And Histopathological Changes Of Placenta Among Hypertensive And Normotensive Pregnant Mothers - A Comparative Study

Abstract

Introduction: The vital organ that is essential for fetal development is placenta, its integrity is essential for a healthy pregnancy. Among the various causes of maternal and perinatal morbidity & mortality, hypertensive disorders of pregnancy (HDP) affects 5-10% of pregnancies worldwide. These disorders are associated with abnormal placentation, leading to reduced uteroplacental perfusion and subsequent fetal complications.

Materials and Methods: A total of sixty placentas was collected from 30 normotensive and 30 hypertensive pregnant mothers of age 18-35 years at MGMCRI, Puducherry. Patients with gestational diabetes, chronic renal disorders, or fetal anomalies were excluded. Morphological features (shape, umbilical cord insertion), morphometric parameters (weight, thickness, diameter, number of cotyledons), and histopathological changes (infarcted villi, fibrinoid necrosis, syncytial knots, etc.) of the placenta was examined and statistically analysed.

Results: A significant difference between the two groups was observed. Placentas from hypertensive mothers were more likely to be irregular in shape with eccentric or marginal umbilical cord insertions (p<0.001). Morphometrically, placentas from the hypertensive group had significantly lower weight (360±75g vs. 485±60g), diameter, thickness, and number of cotyledons compared to the normotensive group (p<0.001). Histopathological examination of placentas from hypertensive mothers showed a higher incidence of infarcted villi, fibrinoid necrosis, and syncytial knots.

Conclusion: A significant association of maternal hypertension and morphology, morphometry, and histopathology of the placenta was determined. It includes reduced placental size and compromised vascular structure, reflecting impaired placental function, contributing adverse perinatal outcomes. Examination of the placenta is a valuable tool for understanding the pathophysiology of HDP and its consequences for the foetus.