Evaluation of placental blood flow in pregnancy induced hypertension and pre-eclamptic patients [quantitative microscopic study]

ABSTRACT

A prospective controlled study to measure quantitatively placental and fetal blood volume as an area percent in normal pregnancy and in pregnancy complicated by induced hypertension [PIH], preeclampsia [PE] and correlate the findings with fetal outcome. It was conducted on 50 patients attended the labour ward of Bab El Shaaraya Maternity Hospital. They were divided into 2 groups. The control group consisted of 10 singletone full term normal pregnant patients. The study group consisted of 40 singletone, full term pregnant patients and their pregnancy is complicated either by PIH or PE. Twelve of them were pre-eclamptic, 8 patients had severe pre-eclampsia [SPE] and 20 patients had PIH. All patients were in active process of labour, fetal and maternal monitoring was performed. Mode of delivery, fetal weight and Apgar score were reported. Placental weight, diameter, thickness were recorded. Placental paraffin section were made, stained with Hx. and Eosin stain and examined for morphological changes. Then quantitative analysis of maternal and fetal blood as an area percent was done using Leica Quantimet 500+ Image Analysis System. Twenty different microscopic fields of lmm[2] surface area in each section were examined. Results of PIH showed a high significant increase [p < 0.005], while SPE showed highly significant reduction [p<0.001] in maternal blood area percent compared to the control placenta. There was no significant difference between PE maternal blood area percent and the control patients. There was a significant reduction in fetal blood area percent in PE and SPE patients compared to the control group, while no significant difference was noted between PIH patients and the control group. Placental weight of SPE patients was significantly lower than that of the control patients. The PIH and PE patients had non-significant difference in placental weights compared to the control. Newborns of PE and SPE patients showed a significant reduction of weight compared to control group newborns, but those of PIH patients were not significantly different in weight from the control group newborns