A Morphometric Correlational Study Of Placenta And Umbilical Cord With Fetus

Background: The placenta is a dynamic organ to maintain the fetal homeostasis by performing a wide range ofphysiological functions. It undergoes various changes in terms of shape, size, surface area and structure duringpregnancy to support growth of the fetus. The efficiency in transfer of nutrients and oxygen through the placentais the primary determinant of birth weight.Detailed study of placenta gives a wide scope of knowledge on fetalgrowth. This study has attempted to find the correlation between umbilical cord length with birthweight and fetallength along with the correlation between other placental parameters and fetal parameters.Materials and methods: The placentas required for this study were collected from the labor room. After thoroughinspection of the placenta, shape and presence of any anomalies were noted and then the size of the placenta,which includes weight, thickness and diameter were measured. The length of the umbilical cord was measuredwith a tape calibrated in centimeters from cut end to placental end and also from cut end to fetal end. Summationof these two values gave the total length of the umbilical cord. The fetal parameters like birth weight wasmeasured by using a digital weighing machine, while the crown-heel length was measured with the help of aninfantometer.Results: 35% of placentas are round shape and 65% are of oval shape. Mean ± SD of placenta weight is 458±49.5gm,umbilical cord length is 56.2 ± 3.2cm, birth weight is 2.4 ± 0.4kg and crown-heel length is 45.8 ± 4.2cm.Conclusion: A significant relation was found between placenta size and birth weight. A non-significant relationwas found between umbilical cord length and birth weight along with umbilical cord length and crown heellength.

Morphometry of Human Placenta in Natural Conception and Assisted Reproduction with its Clinical Significance

Introduction:Placenta is a mirror which reflects the antepartum status of fetus in utero. Our present study aimed to analyse the morphometry of placenta in normal and assisted reproduction.Subjects and Methods:30 Placentas of natural conception and 42 placentas of assisted reproduction (18 cases of singleton pregnancies, 12 cases of twin pregnancies) were collected from OG department, Rajah Muthiah Medical College and from private fertility centre in and around Chidambaram immediately after delivery. Morphometric dimensions of placenta like thickness, diameter, area, number of cotyledons were measured placental weight, fetal weight were also measured.Results:Placental weight of natural conception was 489 ± 107.84 grams, 316.78 ± 88.24 grams in assisted reproduction. Thickness of placenta was 2.767 ± 0.68 cm in natural conception, 1.78 ± 0.68 cm in assisted reproduction. Number of cotyledons, fetal weight, feto - placental ratio were also reduced in assisted reproduction.Conclusion:This is the first study to analyse the morphometric dimensions of placenta in natural conception and in assisted reproduction. Overall there was a reduction in all dimensions of placenta in assisted reproduction. This will be useful for pediatricians who handle the newborns of assisted reproduction.

Determinants of feto-placental ratio.

The dimension of delivered placentae mirrors the cumulative growth of the placenta from conception to parturition. Placental weight is the gross summary of fetal growth under the influence of many extrinsic and intrinsic factors. Hence, the present study evaluated the influence of gestation, sex of the newborn, and parity on feto-placental ratio. The study was conducted on 391 placentae of singleton newborn from a teaching hospital of North Karnataka, India. Data was collected from August 2012 to January 2013 by using standard operating procedures. The Mean and standard deviations of placental morphometry, weight and birth weight are 440 ± 100gm and 2700±500 gm respectively. In gestational age 28 to 32 weeks, the feto-placental ratio was 5.61:1; this increased consistently up to 6.19:1 with increasing gestation group 37 weeks and above. Feto-placental ratio increased with increasing groups of gestational age. Feto-placental ratio in <37 weeks of gestation was in favor of primipara (6.0:1) whereas, the similar figures in term babies was more in multipara (6.3:1). The paritywise feto-placental ratio direction changed from preterm to term babies, but the differences were not statistically significant. However, irrespective of gestation, multipara had higher feto-placental ratio (6.2:1) as compared to primipara (6.1:1). However, irrespective of gestation, males had higher feto-placental ratio (6.2:1) as compared to females (6.1:1). Feto-placental ratio is influenced by variates of pregnancy like gestation, sex of the newborn and parity. Hence, variations in any of these factors lead to adverse pregnancy outcome by deviation of feto-placental ratio.

Morphology and Morphometric Study of Human Placenta in Rural Southern India.

Aims: To study the morphology and do the morphometric analysis of placenta and to correlate with the foetal parameters, in order to help in the assessment of the state of well being of foetus. To study the histomorphological features of placenta in various conditions complicating the pregnancy. Study Design: Descriptive type of study. Place and Duration of Study: Department of Pathology and Department of Obstetrics and Gynaecology, Sri Manakula Vinayagar Medical College, Puducherry, between July 2013 and August 2013. Methodology: We included 51 fresh placentae. Gross examination including weight, shape, thickness, feto-placental ratio, placental co-efficient was calculated. Later, histo- morphological study was done. Results: Out of the 51 placentae, 48 were circular in shape and 3 were oval in shape. In the present study the mean (± SD) diameter of the placenta was 14.65 cm and thickness of the placenta was 1.42 cm. The thickness of placenta was reduced (<1.5cm) in all cases of Pregnancy induced hypertension (PIH), Isoimmunisation, twin pregnancy, prematurity and anemia. Placental weight was reduced in all cases of PIH, low birth weight baby, prematurity and Increased placental weight was seen in the gestational diabetes. Fetoplacental ratio was 5.39:1(both sexes considered together) and placental coefficient was 0.19. In PIH, the average foeto-placental ratio was 5.20:1and the average placental coefficient was 0.19. Gestational diabetes showed a foeto-placental ratio of 5.30:1, the placental coefficient being 0.18 with a considerable increase in the birth weight and in the placental weight. Anaemia showed a significant reduction in the placental weight, with a foeto-placental ratio of 5:1 and an increase in the number of ill-defined cotyledons. In prematurity, average foeto-placental ratio was 4.43:1, while Rh isoimmunisation did not show any decrease in the foeto- placental ratio. Conclusion: As anticipated, in case of PIH complicating pregnancies, the morphometric values of the placenta like the diameter, number of cotyledons and the average placental and foetal birth weights were found to be lower than that of the normal, uncomplicated pregnancies. At the same time, all these parameters were increased in cases of diabetes. So morphometric investigation of the placenta will be tremendously useful in the early assessment of placental insufficiency and also the state of foetal well being.