ABSTRACT
Background and Objective: Placental pathology has been implicated in the pathogenesis of preterm neonatal morbidity.However, the role of placental infection in the occurrence of neurological, lung, and infection morbidity among prematurely borninfant remains controversial. Furthermore, there is disagreement regarding the association between sepsis in preterm neonateand in utero exposure to placental infection.Objective: The present study was undertaken to investigate the association of placental pathology with the preterm and termdelivery.Materials and Methods: Design: This was a hospital-based observation study. The study included 100 placentas including60 preterm placenta and 40 term placenta from singleton live birth delivered at Rajarajeshwari Medical College and Hospitalfrom November 2018 to November 2019.Results: As placental weight is one of the key indicators of fetal intrauterine status, among term placenta 26% weighedbetween 501 and 750 g and 14% weighed between 251 and 500 g. In the late preterm placenta, 6% were within 501–750 gand 38%were within 251–500 g. Among the early preterm placentas, 2% were found to be within 100–250 g and 14% werefound to be within 251–500 g. Histopathological findings among term placenta in which 23% of the placentas were found to bewith normal morphology, having two arteries and one vein embedded in myxoid matrix and unremarkable, maternal surfacesshow mature vascularized villi and fetal parenchyma also shows mature villi and 5% showed features of chorioamnionitis,8% of the placentas revealed occasional focal areas of calcification on the maternal as well fetal surfaces, 15% showedinfarction, and 3% showed hemorrhagic changes. Histopathology findings among preterm placenta in which 14% normalmorphology, 21% of chorioamnionitis, 10% shows focal and extensive areas of infarction with increased syncytial knots, 4%had hemorrhagic and perivasculitis changes with focal hyalinized villi, and 5% had villitis with mixed inflammatory infiltratein the chorionic villi. Histopathology study among term and preterm comparison, it shows chorioamnionitis with Chi-square19.604 with confidence interval of 35.66–77.04% with P < 0.0001, calcification with P = 0.466, placental infarction withconfidence interval of 41.51–92.47% with P = 0.0002, placental hemorrhage with confidence interval of −31.33%–52.31%with P = 0.613, and villitis with confidence interval of 38.55–100% with P = 0.002. Relative risk with respect to histopathologyamong term and preterm placenta relative risk is 2.3 which means that preterm group has 2.3 times more risk of abnormalplacental histopathology than term group.Conclusion: Among histopathological study between term and preterm placenta, preterm placentas were most commonlyassociated with abnormal histopathological findings, among abnormal histopathological finding chorioamnionitis is the mostcommon.
ABSTRACT
Background: Respiratory distress syndrome occurs primarily in premature infants. The increased risk of RDS is associated with lower gestational age. The length of gestation is the primary factor that influences the risk of RDS the risk for development of RDS increases with maternal diabetes, multiple births, cesarean delivery, precipitous delivery, asphyxia, cold stress, and a maternal history of previously affected infants. Antenatal corticosteroids (ACS) significantly reduced neonatal morbidity and mortality when administered to women with imminent preterm delivery Antenatal steroids accelerate development of type 1 and type 2 pneumocytes, leading to structural and biochemical changes that improve both lung mechanics (maximal lung volume, compliance) and gas exchange. Induction of type 2 pneumocytes increases surfactant production by inducing production of surfactant proteins and enzymes necessary for phospholipid synthesis. Alveolisation occurs rapidly as a result of the antenatal corticosteroids Antenatal corticosteroid is usually administered for fetal lung maturity and can be expected to induce negative maternal and fetal side-effects hence this study was conducted to know the beneficial effect of single dose antenatal corticosteroids verses double doses antenatal corticosteroids. The Objective of the present study was to observe the effect of single dose and double dose antenatal corticosteroids on respiratory distress syndrome in preterm babies born to less than 37 weeks of gestation admitted under department of pediatrics at Raja Rajeswari medical college Hospital, Kambipura, Bangalore.Methods: There were 55 babies born to mothers who received single dose of antenatal corticosteroids and delivered at 12hrs before receiving 2nd dose antenatal corticosteroids and 55 babies born to mothers who received double dose of antenatal corticosteroids. Once baby is born, they compared for the requirement of surfactant.Results: Multiple course of steroids significantly reduced Respiratory distress syndrome.Conclusions: It was concluded that there was significant reduction in RDS in babies whose mother received complete course of antenatal corticosteroids.