Comparative study between histological changes in placenta from pre-eclampsia cases and normal pregnancy with special reference to cytotrophoblastic cell hyperplasia, villous stromal fibrosis and fibrinoid necrosis

Bhawana Sahay, Leena Talukdar, Pallavi Sahay, Debashish Datta, Rangnath Chaubey


Background: Placenta is a vital organ and the most accurate record of the infant’s prenatal experience. Pregnancy complications like hypertension significantly affect the placenta. Thus there is a need for thorough examination of it. Therefore the present study is dedicated to see the histological changes in placenta of pre-eclampsia with special reference to cytotrophoblastic cell hyperplasia, villous stromal fibrosis and fibrinoid necrosis and compared it with that of normal placenta.

Methods: Total 60 placentas were collected (30 from pre-eclampsia and 30 from normal pregnancy). Results were expressed in percentage after counting 100 villi. Data analysis has been done using Graphpad InStat 3 version and data is significant when p – value is <0.05.

Results: Mean no. of cytotrophoblastic cell hyperplasia, villous stromal fibrosis and fibrinoid necrosis in normal placenta are 10.1±5.01, 2.26±1.56 and 2.84±1.4 respectively and those in pre-eclampsia placenta are 36.82±16.15, 28.16± 34.42 and 8.22±1.44 respectively which are highly significant ( p-value <0.001).

Conclusions: There is significant increase in number of cytotrophoblastic cell hyperplasia, villous stromal fibrosis and areas fibrinoid necrosis in placenta from pre-eclampsia cases than that of normal placenta. These changes may be due to vascular insufficiency which is usually occurring in pre-eclampsia.


Cytotrophoblastic cell hyperplasia, Fibrinoid necrosis, Pre-eclampsia, Villous stromal fibrosis

Full Text:



Bewly S, Cooper D, Campbell S. Doppler investigation of uteroplacental blood flow resistance in the second trimester. A screening study for pre-eclampsia and intra-uterine growth retardation. Br J Obst Gynaecol. 1991;98:871-9.

Stock MK, Anderson DF, Phernetton TM, McLaughlin MK, Rankin JH. Vascular response of the maternal placental vasculature. J Dev Physiol. 1980;2:239-46.

Thomson AM, Billewickz, Hytten FE. Placenta in relation to birth weight. J Obstet Gynecol Br CW. 1969;76:865-72.

Kalra VB, Aggarwal A, Sareen PM, Kalra R. Histopathological changes in placenta in toxaemia of pregnancy. J Obstet Gynaecol India. 1985;35:86-90.

Kalousek DK, Langlosis S. The effects of placental and somatic chromosomal mosaicism on foetal growth. In: Ward RHT, Smith SK, Donnai (eds), Early foetal growth and development. RCOG Press. 1994;245-56.

Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:S1-22.

Das B, Dutta D, Chakraborthy S, Nath P. Placental morphology in hypertensive disorders of pregnancy and its correlation with fetal outcome. J Obstet and Gynecol India. 1996;46(1):40-6.

Majumdar S, Dasgupta H, Bhattacharya K, Bhattacharya A. A study of placenta in normal and hypertensive pregnancy. J Anat Soc India. 2005;54(2):1-9.

Ahmed M, Daver RG. Study of placental changes in pregnancy induced hypertension ;Int J Reprod Contracept Obstet Gynecol. 2013;2(4):524-7.

Narasimha A, Vasudeva DS. Spectrum of changes in placenta in toxaemia of pregnancy. Indian Journal of Pathology and Microbiology. 2011;54(1):15-20.

Dhabhai P, Gupta G, Bapna N. Histological Study Of Human Placenta In Normal And Pregnancy Induced Hypertension (PIH) Cases. 2013;2(11):30-5.

Fox H. Effect of hypoxia and trophoblast in organ culture.; Am J Obstet Gynaecol. 1970;107:1058-64.

Genset DR. Estimating the time of death of stillborn foetuses-II. A study of 71 stillborns. B J Obst Gynaecol. 1992;80:585-92.

Fox H. Fibrosis of placental villi. J Pathol Bacteriol. 1968;95:573.

Mathew R, Aikat M, Aikat BK. Morphological study of placenta in abnormal pregnancies. Indian J Pathol Microbiol. 1973;16:15.

Fox H. Fibrinoid necrosis of placental villi. J. Obstet. & Gynaecol. Br. Commonw 1968;75:448-52.

McKay DG, Hertig AT. Adams EC, Richardson MV Obstet Gynecol. 1958;12(1):1-36.

Wigglesworth JS. The gross and microscopic pathology of the prematurely delivered placenta. J Obs Gynaey Brit Commonwealth. 1962;69:934-43.

Hulka JF, Brinton V. Antibody to trophoblast during early postpartum period in toxemic pregnancies. AJOG. 1963;86:130-4.

Fox H: Quoted from” Pathology of the placenta”. Philadelphia, WB Saunders. 1978;95-101.