ABSTRACT
Fetal growth retardation is most commonly caused by placental letdown to meet the increasing demand for oxygen and nutrients of the developing fetus. Intrauterine growth restriction [IUGR] is common happening in Pakistani setup especially in rural areas. Current literature suggests that placental causes are more common than the maternal causes in intrauterine growth restriction. Macroscopic and microscopic examination of placenta can help us to identify the patho-physiology of placental involvement. This is reasonable especially in those cases of intrauterine growth retardation which are not perplexed by maternal causes. To identify macroscopic and microscopic features of placenta in pregnancy complicated with IUGR. Descriptive study. This study was conducted at Sheikh Zayed Medical College/Hospital, Rahim Yar Khan in collaboration with Department of Pathology Quaid-e-Azam Medical College, Bahawalpur and Anatomy Department, Nishtar Medical College, Multan. Study duration was two years from July, 2010 to June, 2012. One hundred and fifty placentae, 85 from cases of intrauterine growth retardation and 65 from normal [control] were enrolled for the study. Fetal and placental weights and placental diameter and thickness were measured. Tissue for histological examination was obtained from: i] Umbilical cord ii] membranes and iii] three placental zones. The tissues were processed and stained with Haematoxlyin, Eosin and Mallory's Trichrome. The prepared tissues were studied microscopically for villous and intervillous lesions utilizing various criteria. Macroscopically there was significant decrease in placental weight, fetal weight, and placental diameter and thickness. Microscopic findings were increased fibrinoid necrosis [46.7%], increased perivillous fibrinoid deposition [16.7%], increased syncytial knots [60%] and increased placental infarction [1.8%]. These findings document comparatively higher frequency of fibrinoid necrosis and perivillous fibrinoid deposition. This draws ours attention to the predominant role of placental causes in cases of idiopathic intrauterine growth retardation