ABSTRACT
Introduction: Placenta “the vital organ” for maintaining healthy pregnancy is unique in its development, being derived from both mother and fetus. Thus hypertensive disorder affecting mother has a deleterious impact on placenta which may lead to poor fetal outcome. Aim: A cross-sectional descriptive study was undertaken to analyze and assess the morphological changes in hypertensive placentae and to clinically correlate it with fetal and maternal parameters. Materials and Methods: 50 placentae were freshly collected from pregnancy induced hypertension (PIH) cases (study group) and 50 from normal pregnancy (control group). Study group was divided into three categories depending upon severity of the disease. Observations and Results: 70% in study group were primigravida and were from rural area.46% were in age group of 15 – 20yrs.50% under low socio-economic status and 60% were without any regular antenatal checkup. Preterm, IUGR, still birth and neonatal death accounted to 10%, 12%, 18% and 10% respectively in study group. The average diameter, thickness, volume and number of cotyledons in study group were 15.91±2.11cm, 2.39±.54cm, 297.64±67.90ml and 10.02±4.13respectively. Mean placental weight was 376.41±17.198gm (mild PIH), 330.72±2.90gm (severe PIH), 329.73±3.19gm (eclampsia) and mean birth weight was 2680.29±198.46gm (mild PIH), 2212.06±36.41gm (severe PIH) and 2073.60±9.47gm (eclampsia) respectively in study group. Various pathological changes like retro placental hematoma, infarction and calcification had been noticed. Conclusion: Placental morphometric parameters were significantly reduced (<.001) in study group as compared to control group. Decreased placental weight was associated with reduced birth weight and feto-placental ratio with increase in severity of hypertension significantly (<.001). A significant increase (<.05) in incidence of preterm, IUGR, still birth and neonatal death were found in study group. Assessment of morphological changes and its clinical relevance can be correlated with transactional study so as to provide the safe confinement and reducing the fetal morbidity and mortality.
ABSTRACT
The aim of the study is to determine birth weights, placental weights and feto-placental ratio in consecutive, live singleton term births and study their relationship with some maternal and fetal factors. Method: Fifty placentae were obtained from the labour room of the department of obstetrics and gynecology , Civil hospital, Sola , Ahmedabad between September to December 2010. Each placentae was weighed and the feto-placental ratio and insertion percentage was calculated. Maternal data, including name, age, hospital number, date of last menstrual period, parity, duration of pregnancy, hematological findings and the gestational age were recorded and correlated with birth weight and placental weight. Result: There was 52% of female and 48 % of male babies. The mean birth weight of female babies was 2.58 Kg and that of male babies was 2.69 Kg . The mean placental weight of female babies was 472.70 gms and that of male babies was 513.75 gms. The mean feto-placental ratio of female and male babies was 5.46 and 5.28 respectively. The mean placental weight was found lower with mother’s age < 20 years , increase number of parity and Hb less than 8 gm %. The mean placental weight was found slightly higher in mother’s with blood group A +ve and AB +ve. The site of insertion of umbilical cord was central in 40 %, medial in 38 %, lateral in 14 % and marginal in 8 %. The birth weight of babies was directly proportional to their placental weight. Conclusion: With extra precautions for the factors reducing placental weight and or birth weight one can reduce further risk to mother and foetus.