A light microscopic study of placentae in eclamptic mothers at term

Rudradev Meyur, Anirban Sadhu, Hironmoy Mondal, Santanu Kumar Khanra


Background: Eclampsia is one of the leading causes of maternal and consequent foetal mortality in India. Studies on the histology of eclampsia are relatively uncommon, more so in the eastern region of India. The present study therefore is an attempt to analyse the changes which occur in placentae of eclamptic mothers with the help of light microscope as it is considered to be the epicentre of the disease. These findings are useful to understand the pathology of the killer disease and improve morbidity and mortality.

Methods: 60 cases were selected for the study. 30 were non-eclamptic and 30 were eclamptic. Abnormalities in blood vessels, villi and basement membrane of placentae were searched for after routine H and E staining.

Results: Eclamptic cases recorded with higher incidences of fibrinoid necrosis of villi, cytotrophoblastic proliferation, increased syncytial knots, hypo vascular villi and thickening of basement membrane. Non-eclamptic cases recorded only fibrinoid necrosis. Other features were not observed in the latter cases.

Conclusions: Light microscopic changes observed in eclamptic placentae may contribute to the pathogenesis of the condition and serve as the baseline for further studies.


Eclampsia, Fibrinoid necrosis, Villi

Full Text:



Sibai BM. Diagnosis, prevention, and management of eclampsia. Obstet Gynecol. 2005;105(2):402-10.

Mattar F, Sibai BM. Eclampsia. VIII. Risk factors for maternal morbidity. Am J Obstet Gynecol. 2000;182:307-12.

Obed SA, Wilson JB, Sakay A. Determinants of maternal mortality in eclampsia at Karle Bu teaching Hospital in Accra, Ghana. Ghana Med J. 1999;33:88-9.

Ogunbode O. Clinical aspects of eclampsia at Ibadan, Nigeria. Nigeria Med J. 1997;7:162-6. Campbell DE, editor. Preeclampsia (Last updated on 2009 January 06) Available at (Last cited on 2009 June 18).

Subramaniam, V. Seasonal variation in the incidence of preeclampsia and eclampsia in tropical climatic conditions. BMC Women's Health. 2007;7:1-18.

Akhlaq M, Nagi AH, Yousaf AW. Placental morphology in pre-eclampsia and eclampsia and the likely role of NK cell. Indian J Pathol Microbiol. 2012;55:17-21.

Nobis PN, Hajong A. Eclampsia in India Through the Decades. J Obstet Gynecol India. 2016;66(S1):S172-6.

WHO Reduction of maternal mortality. A joint WHO/UNEPA/ UNICEF/World Bank Statement, Geneva, 1999. Available at

Vanawalla NY, Ghamande S, Ingle KM. A five year Analysis of Eclampsia. J Obstet Gynecol India. 1989;39:513-5.

Suman G, Somegowda S. Maternal and perinatal outcome in Eclampsia in a District Hospital. J ObstetGynecol India. 2007;57:324.

Sing K, Medhi R, Bhattacharjee AK, et al. Book of Abstract, 53rd AICOG, Guwahati 2010;17.

Chandriole N, Singh S, Dhillon BS. Eclampsia, care hood and management practices at tertiary hospital in India (ICMR), New Delhi. Book of Abstract AICOG, Guwahati; 2010;33.

Pal A, Bhattacharjee R, Bannerjee C. Maternal mortality over a decade in a referral medical college hospital, West Bengal. Indian J Perinatol Reprod Biol. 2001;04:10-3.

Singh S, Gugapriya TS. Microanatomical analysis of hypertensive placentae- a retrospective case control study. Nat Jour Clinical Anatomy. 2013;2(1):5-10.

Jones CJP, Fox H. An ultrastructural and ultra-histochemical study of human placenta in maternal preeclamsia. Placenta. 1980;1:61-76.

Narasimha A, Vasudeva DS. Spectrum of changes in placenta in toxaemia of pregnancy. Ind J Pathol Microbiol. 2011;54(1):15-20.

Navbir P, Alka N, Antima G. Histological changes in placentae in pregnancies complicated by pre-eclampsia and eclampsia and corelation with foetal outcome. Int J Pharm Bio Sci. 2012;3(2):551-60.

Wigglesworth JS, The Langhans layer in late pregnancy. A histological study of normal and abnormal cases. J Obstet Gynaec Brit C’Wealth. 1962;69:355.

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

Dhabhai P, Gupta G, Bapna N. Histological study of human placenta in normal and pregnancy induced hypertension (PIH) cases. Int J Pharmaceut Sci Invention. 2013;2(1):30-5.

Burstein R, Frankel S, Soule SD, Blumenthal HT. Aging of the placenta: Autoimmune theory of senescence. Am J Obstet Gynaecol. 1973;116:271.

Teasdale F. Gestational changes in functional structure of the human placenta in relation to foetal growth. Am J Obst. 1980;137:560-2.

Udainia A, Bhagwat SS, Mehta CD. Relation between placental surface area, infarction and foetal distress in pregnancy induced hypertension with its clinical relevance. J Anat Soc Ind. 2004;53;1:27-30.

Zacutti A, Borruto F, Bottacci G, Giannoni ML, Manzin A, Pallini M, et al. Umbilical blood flow and placental pathology. Clin Exp Obst Gynaecol. 1992;19:63-9.

Fox H. The significance of villous syncytial knots in the human placenta. J Obstet Gynaec Brit C’ Wealth. 1965;72:347.

Mallik GB, Mirchandani JJ, Chitra S. Placenta in intrauterine growth retardation. J Obstet Gynaecol India. 1979;29:805-10.

Mirchandani JJ, Mallik GB, Chitra S. Correlation of foetal outcome with some pathological changes of placenta. J Obstet Gynaecol India. 1979;29:1131-9.

Mirchandani JJ, Mallik GB, Chitra S. Villous fibrinoid necrosis and basement membrane thickening in toxaemia of pregnancy and in intrauterine growth retardation. J Obstet Gynaecol India. 1979;29:407-11.

Benirschke K, Kaufmann P. Pathology of the human placenta. 2nd ed. New York: Springer Verlag; 1990.

Bhatia A, Sharma SD, Jalnawalla SF, A comparative study of placental pathology and fetal outcome. Indian J Pathol Microbiol. 1981; 24:277.

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

Masodkar AR, Kalamkar LR, Patki PS. Histopathology of placenta and its correlation with foetal outcome. J Obstet Gynaecol India. 1985; 35:294.

Mehrotra VG, Mukherjee K, Pande M, Gurtu M. The histological study of placenta in normal and abnormal pregnancy. J Obstet Gynaecol India. 1972;22:248.

Sodhi S, Mohan H, Jaiswal TS, Mohan PS, Rathee S. Placental pathology in pre-eclampsia eclampsia syndrome. Indian J Pathol Microbiol. 1990;33:11-6.

Salgado SS, Salgado MKR. Structural changes in pre-eclamptic and eclamptic placentas-an ultrastructural study. J Coll Physicians Surg Pak. 2011;2(8)482-6.

Burstein R, Berns AW, Hirata Y, Blumenthal HT. A comparative histo and immunopathological study of the placenta in diabetes mellitus and in erythroblastosis fetalis. Am J Obstet Gynaecol. 1963;86:66-72.

Fox H, Basement membrane changes in the villi of human placenta. J Obstet Gynaecol Brit Crquote Wealth. 1968;75:302.