Morphometric, Histological Variations in the Placenta of Normotensive and Pregnancy Induced Hypertensive Mothers

Authors

  • Falak naz Khyber Medical College,Peshawar
  • Shazia Khyber Medical College
  • Zainab Rehman Khyber Medical College
  • Fatma Afridi Khyber Medical College
  • Shahsawar Afridi Ayub Medical College
  • Sarah Rehman Fauji foundation Hospital

DOI:

https://doi.org/10.35845/abms.2024.1.303

Keywords:

Pregnancy induced hypertension, Normotensive, cotyledons, placenta, Apgar score, fetal health

Abstract

Objective  

To study the macroscopic and microscopic alterations in placenta of pre-eclamptic mother using combination of morphometric and histological analysis. 

Methods

This was a retrospective cohort study carried out among pregnant women. The duration of this study was 6 months in a clinical setting of Khyber Teaching Hospital and Anatomy Department of Khyber Medical College Peshawar from the duration of Jan 2021 to 31 Dec 2021.  A total of 50 freshly delivered normal normotensive (control group) and 50 pregnancy-induced hypertensives (PIH) mothers (test group) of age limit 18-40 years were examined both grossly and histologically for placenta. Data was collected and analyzed by SPSS version 21.

Result

On gross examination, the morphometric parameters were significantly decreased in test group. Histological study showed the fibrinoid necrosis. Endothelial proliferation and calcification in the present study. The numbers of cotyledons were the same in the control (normotensive) and test (hypertensive) groups.

Conclusion

The study provided valuable insights into the histological and morphometric differences in the placenta of the test and control group. The observed placental variations in the test group were seen as significantly different from the control and it may influence fetal health and the pathophysiology of this condition in pregnant women. It will be more valuable if there are further studies on molecular and genetics having direct implications on these changes and further clinical management among PIH mothers.

References

Kaufman MR and Brown TL. AMPK and placental progenitor cells. AMP-activated Protein Kinase. 2016: 73-9.

Melbourne A, Aughwane R, Sokolska M, et al. Separating fetal and maternal placenta circulations using multiparametric MRI. Magnetic resonance in medicine. 2019; 81: 350-61.

Keche HA and Kazi S. Correlation of histology of placenta with fetal outcome in pregnancy induced hypertension. National Journal of Clinical Anatomy. 2018; 7: 24-31.

Nanci A. Ten Cate's Oral Histology-e-book: development, structure, and function. Elsevier Health Sciences, 2017

Dahlstrom JE, Subramaniam A and Faye-Petersen OM. Maternal Vascular Malperfusion and Associated Maternal Diseases. Benirschke's Pathology of the Human Placenta. 2022: 507-54.

Ghani N and Yadav K. Comparative Study on Macroscopic Morphology of Human Placenta in Preterm, Term & Post Term Pregnancy. International Multispecialty Journal of Health. 2018; 4: 109-14.

Starikov R, Inman K, Chen K, et al. Comparison of placental findings in type 1 and type 2 diabetic pregnancies. Placenta. 2014; 35: 1001-6.

Staud F and Karahoda R. Trophoblast: The central unit of fetal growth, protection and programming. The international journal of biochemistry & cell biology. 2018; 105: 35-40.

Vayssière C, Sentilhes L, Ego A, et al. Fetal growth restriction and intra-uterine growth restriction: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. European journal of obstetrics & gynecology and reproductive biology. 2015; 193: 10-8.

Rajan B. Patterns of Antenatal Medication Use, its Determinants, and Outcomes in Pregnancy Among Women Admitted in the Obstetrics Wards of a Tertiary Care Hospital: A Cross Sectional Study. Rajiv Gandhi University of Health Sciences (India), 2019.

Lo JO, Mission JF and Caughey AB. Hypertensive disease of pregnancy and maternal mortality. Current Opinion in Obstetrics and Gynecology. 2013; 25: 124-32.

Toshimitsu M, Nagamatsu T, Nagasaka T, et al. Increased risk of pregnancy-induced hypertension and operative delivery after conception induced by in vitro fertilization/intracytoplasmic sperm injection in women aged 40 years and older. Fertility and Sterility. 2014; 102: 1065-70. e1.

Fakharunissa WM, Naqvi R, Jabbar S, Zaidi SA and Fatima ST. Pregnancy induced hypertension among pregnant women delivering in a tertiary Care Centre. Pakistan Journal of Medical & Health Sciences. 2022; 16: 709-.

Sun C, Groom KM, Oyston C, Chamley LW, Clark AR and James JL. The placenta in fetal growth restriction: what is going wrong? Placenta. 2020; 96: 10-8.

Ilekis JV, Tsilou E, Fisher S, et al. Placental origins of adverse pregnancy outcomes: potential molecular targets: an Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. American journal of obstetrics and gynecology. 2016; 215: S1-S46.

Asif HM, Sultana S, Akhtar N, Rehman JU and Rehman RU. Prevalence, risk factors and disease knowledge of breast cancer in Pakistan. Asian Pacific journal of cancer prevention. 2014; 15: 4411-6.

Gibbs I, Leavey K, Benton SJ, Grynspan D, Bainbridge SA and Cox BJ. Placental transcriptional and histologic subtypes of normotensive fetal growth restriction are comparable to preeclampsia. American Journal of Obstetrics and Gynecology. 2019; 220: 110. e1-. e21.

Rohini P, Siddharth T, Fathima A and Dhiren P. Human Placentae in Pregnancy-induced Hypertension-A Histologic and Morphometric Analysis. Int J Anat Appl Physiol. 2018; 4: 95-8.

Talpur RA, Siddiqui S, Khowaja S, Noor N, Baloch MS and Qazi MM. Histomorphometric Variations of the Placenta in Normal and Hypertensive Pregnancies. Journal of Islamabad Medical & Dental College. 2020; 9: 242-8.

Salmani D, Purushothaman S, Somashekara SC, et al. Study of structural changes in placenta in pregnancy-induced hypertension. Journal of natural science, biology, and medicine. 2014; 5: 352.

Nigam JS, Misra V, Singh P, Singh P, Chauhan S and Thakur B. Histopathological study of placentae in low birth weight babies in India. Annals of Medical and Health Sciences Research. 2014; 4: 79-83.

Kinshella M-LW, Omar S, Scherbinsky K, et al. Maternal dietary patterns and pregnancy hypertension in low-and middle-income countries: a systematic review and meta-analysis. Advances in Nutrition. 2021; 12: 2387-400.

Karmakar M, Kumar S, Chattopadhyay S, Kar S, Vaid L and Sen S. A study on the morphology and the morphometry of the human placenta and its clinical significance in rural population in Eastern India. Asian Pacific Journal of Health Science. 2018; 5: 202-9.

Elamin AA, Ahmed MNM, El Elhaj A, et al. Vicissitudes in the placental cotyledon number in a singleton pregnancy with gestational diabetes. International Journal of Applied and Basic Medical Research. 2022; 12: 24.

Kartha S, Poothiode U and Jayalakshmy P. Placental pathology in pregnancy induced hypertension. Journal of Evolution of Medical and Dental Sciences. 2014; 3: 9272-9.

Matthews KC, Fox NS and Rebarber A. The association between placental histopathology, fetal growth restriction, and preeclampsia in twin pregnancies. American Journal of Perinatology. 2019; 38: 784-90.

Staff AC, Fjeldstad HE, Fosheim IK, et al. Failure of physiological transformation and spiral artery atherosis: their roles in preeclampsia. American journal of obstetrics and gynecology. 2022; 226: S895-S906.

Moran MC, Mulcahy C, Zombori G, Ryan J, Downey P and McAuliffe FM. Placental volume, vasculature and calcification in pregnancies complicated by pre-eclampsia and intra-uterine growth restriction. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2015; 195: 12-7.

Edzie EKM, Dzefi-Tettey K, Brakohiapa EK, et al. Assessment of the clinical presentations and ultrasonographic features of uterine fibroids in adult Africans: A retrospective study. Oman Medical Journal. 2023; 38: e459.

Downloads

Published

2024-06-21

How to Cite

1.
Naz F, Iftikhar S, Rehman Z, Afridi F, Afridi S, Rehman S. Morphometric, Histological Variations in the Placenta of Normotensive and Pregnancy Induced Hypertensive Mothers. Adv Basic Med Sci [Internet]. 2024Jun.21 [cited 2024Dec.7];8(1):17-22. Available from: https://abms.kmu.edu.pk/index.php/abms/article/view/303