DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20184047

A study of placental morphology and correlation with colour doppler ultrasonography, maternal and neonatal outcome in high risk pregnancies

Kartheek Botta Venkata Satya, Bhagyalakshmi Atla, Uma Prasad, Uma Namballa, Sreevalli Prabhakula

Abstract


Background: The placenta has multifaceted roles in foetal development and survival. Determination of placental abnormalities is very much essential in preventing intrauterine and perinatal morbidity and mortality. The aim of present endeavor was to study the placental histology and correlate with colour flow doppler ultrasonography, maternal and neonatal outcome.

Methods: A prospective comparative study was conducted in 50 antenatal women of >28 weeks gestation. Out of these, 25 cases of high risk pregnancies which included pregnancy induced hypertension, preeclampsia, intrauterine growth retardation (IUGR) and anaemia of chronic disease. Other 25 normal antenatal cases were taken as controls. All the women were subjected to colour doppler ultrasonography and study of placental histology done and results were correlated to maternal and neonatal outcome.

Results: The Doppler flow was abnormal in 44% of high risk groups. Abnormal histological changes were seen in all the high risk cases (100%). The mean diameter of the placenta (20.69 cms) and the mean birth weight in high risk group (2.34kgs) were comparatively less than that of control group. Abnormal histological changes were maximally found in high risk groups of abnormal Doppler in comparison to control group. Perinatal mortality (2.22%), Apgar score (90.9%), IUGR (4.44%) are higher in cases with abnormal histology of placenta compared to normal cases.

Conclusions: Placental abnormalities correlate well with the factors causing high risk pregnancies and the subsequent maternal and foetal outcomes. Placental examinations may help in better understanding of the mechanisms of placental dysfunctions that may contribute to more effective therapeutic strategies in the future.


Keywords


Colour doppler ultrasonography, High risk pregnancy, Maternal and foetal outcome, Placenta

Full Text:

PDF

References


Gagnon R. Placental insufficiency and its consequences. Eur J Obstetr Gynecol Reprod Biol. 2003 Sep 22;110:99-107.

Ahmed M, Daver RG. Study of placental changes in pregnancy induced hypertension. Int J Reprod Contracept Obstetr Gynecol. 2016 Dec 13;2(4):524-7.

Goswami P, Lata H, Memon S, Khaskhelli LB. Excessive placental calcification observed in PIH patients and its relation to fetal outcome. JLUMHS. 2012 Sep 1;11(03):143-8.

Udainia A, Jain ML. Morphological study of placenta in pregnancy induced hypertension with its clinical relevance. J Anat Soc India. 2001;50(1):24-7.

Fox H. The morphological basis of placental insufficiency. J Obstetr Gynaecol India. 1975;25:441-50.

Kishwara S, Ara S, Rayhan KA, Begum M. Morphological changes of placenta in preeclampsia. Bangladesh J Anat. 2009 Jan;7(1):49-54.

Teasdale F. Histomorphometry of the human placenta in pre-eclampsia associated with severe intrauterine growth retardation. Placenta. 1987 Mar 1;8(2):119-28.

Cibils LA. The placenta and newborn infant in hypertensive conditions. Am J Obstetr Gynecol. 1974 Jan 15;118(2):256-70.

Seyam YS, Al‐Mahmeid MS, Al‐Tamimi HK. Umbilical artery Doppler flow velocimetry in intrauterine growth restriction and its relation to perinatal outcome. Int J Gynecol Obstetr. 2002 May 1;77(2):131-7.

Gupta D Jain P, Parashar R, Kural M. A study of placenta and its blood vessels in high risk pregnancies by Colour Doppler USG and its correlation with maternal and neonatal outcome. Int J Scientific Engineering Res.2014;5(1):417-21

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.

Mardi K, Sharma J. Histopathological evaluation of placentas in IUGR pregnancies. Indian J Pathol Microbiol. 2003 Oct;46(4):551-4.

Madazli R, Somunkiran A, Calay Z, Ilvan S, Aksu MF. Histomorphology of the placenta and the placental bed of growth restricted foetuses and correlation with the Doppler velocimetries of the uterine and umbilical arteries. Placenta. 2003 May 1;24(5):510-6.