ABSTRACT
Background: Hypertensive disorders complicate 5-10% of all pregnancies and form a dangerous triad with haemorrhage and infection that contribute greatly to maternal morbidity and mortality. The fetus is dependent on placenta for growth and development. Many disorders of pregnancy like hypertension are accompanied by gross pathological changes in placenta. Aim: The aim of the study was to assess the gross morphology of placentae of women with pregnancy induced hypertension and to compare them with normal pregnancies. Material and methods: An observational comparative study was carried out in the Department of Anatomy, S. M. S. Medical College, Jaipur, Rajasthan. Total 80 placentae, 40 from pregnancy induced hypertensive pregnancies and 40 from normal pregnancies were studied for the morphology and compared. Gross morphological features of placentae like weight, shape, insertion of umbilical cord, number of cotyledons, diameter, surface area and central thickness in both groups were recorded and analyzed using ‘Chi square’ and ‘Z’ test of significance. Results: The mean placental weight, numbers of cotyledons, diameter, surface area and central thickness were significantly less (p<0.05) in placentae from pregnancy induced hypertensive women. They also showed increased incidence of marginal insertion of umbilical cord (p<0.01), while the shape of placentae did not show significant variation (p>0.05). Conclusion: The placentae from hypertensive pregnant women showed significant morphological changes as compared to controls which may alter the perinatal outcome.
ABSTRACT
Background: The fetus, placenta and mother constitute a triad of contributors to pregnancy outcome. When pregnancy is complicated by a medical problem like, diabetes mellitus which affects maternal health, architecture and functions of the placenta may even jeopardize the fetal normalcy. The placenta being the bridge between maternal and fetal activities, considered as a window through which maternal dysfunctions and their impacts on fetal well being can be understood. Aim: The aim was to study gross morphology of placentae of women with gestational diabetes mellitus and to compare the results with normal pregnancies. Methods: It was an observational study. After due approval from institutional ethics committee, 40 placentae from pregnant women clinically diagnosed with gestational diabetes mellitus and 40 placentae from uncomplicated normal pregnant womenwere collected from labour room and operation theatre of department of obstetrics and gynaecology of government medical college hospital in Jaipur (Rajasthan). Confirmed gestational diabetic caseswere selected purposively while controls were taken sequentially. Grossmorphological features of each placentawere recorded. The statisticalmethods usedwere unpaired ‘t’ test and chi square test. Results: The results showed that weight, diameter, surface area, central thickness and number of cotyledons of placentae from diabetic mothers were significantly more than placentae from normal uncomplicated pregnancies, while no significant differences were observed in shape and site of umbilical cord insertion. Conclusion: The gross morphology of placentae with gestational diabetes mellitus significantly differs from normal pregnancies which may be associated with alteration in physiological functioning of placenta and ultimately fetal outcome.