Introduction: Thyroid disorders are common in the reproductive age group of women and these can cause significant perinatal outcomes.Though the effect of abnormal thyroid hormones on the foetus and its development is established, their effect on the placenta and its contribution towards the effect is not elaborately studied. Aim: To compare the microscopic features of euthyroid placentae with those of mothers with thyroid dysfunction. Materials and Methods: This is prospective observational study wherein placentae received from October 1 ,2017 to March 31, 2019 in the Department of pathology, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India, were collected, processed and analysed. A total of 539 cases were received for histopathological examination during this period, of these 64 cases had abnormal antenatal thyroid profile. These were compared grossly and microscopically with the control group of 64 euthyroid cases. Results: The total sample of the study comprised of case group(n=64) and control group(n=64), mean age: mean age of the women 26.91±4.1 years. The case group samples included 3 hyperthyroid cases and 61 hypothyroid cases.In the control group, 3 (2.3%) foetuses were dead as compared to 6 (4.7%) foetuses in hypothyroid group and 3 (2.3% of total, 100% of hyperthyroid group) foetuses in hyperthyroid group (p< 0.001). Abnormal shape of the placenta was seen in 1 (0.8%) case in normal group as compared to 3 (2.3%) in hypothyroid group and 1 (0.8%) case in hyperthyroid group (p=0.018). However, there weren’t any significant microscopic changes. Conclusions: Maternal thyroid disorders result in abnormal shape of placenta and hence resulting in foeto-maternal insufficiency and subsequent foetal growth restriction and adverse foetal outcome.
Defective placentation results in a host of pregnancy complications like fetal loss, preeclampsia, and fetal growth restriction and abruptio placentae. There have been recent major advances in obstetric ultrasound such as high-resolution antenatal structural imaging, determination of maternal and fetal blood ow parameters and 3D and 4D ultrasound, which have revolutionised the obstetric care by antenatal diagnosis of placental pathology and its effect on the fetuses. The aim of this study is to correlate placental pathology ndings to antenatal Doppler and ultrasonogram and fetal outcome. : All placental specimens received in the department of Pathology, Karnataka Institute of MedicalMETHODS sciences, Hubballi from October 2017 to March 2019 were collected after taking an informed consent. All the casesINCLUSION CRITERIA: with antenatal Doppler and ultrasonogram details, irrespective of the gestational age and fetal outcome. UnbookedEXCLUSION CRITERIA: cases and cases without clinical history and image ndings. 115 cases Gross examination was done and sections were takenSAMPLE SIZE: from parenchyma, umbilical cord and the membranes according to Amsterdam guidelines for microscopic examination. The resultant microscopic ndings were correlated with antenatal Doppler and ultrasonogram. 115 of the 539 cases included in this study had Doppler data,RESULTS: among them, 19 cases showed abnormal Doppler. Placentae with abnormal Doppler ndings showed increased syncytial knots, poor vasculo- syncytial membrane, villous crowding and infarct (p<0.05) and were associated with increased fetal death and growth restriction. CONCLUSION: Placental study correlated with the Doppler ndings and was instrumental in reaching a specic diagnosis in inconclusive cases.
Introduction: Placenta is poetically described as a diary which bears the events of intrauterine life; hence examining them, especially in perinatal death can provide valuable information regarding the cause of death and sometimes gives an idea about recurrence of such events. Aim: To describe the various placental lesions in perinatal death and compare them with equal number of normal placentae. Materials and Methods: This prospective, comparative, crosssectional study was conducted in tertiary care centre, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India. All placentae, irrespective of the gestational age, received in the Department of Pathology, from October 1st 2017 to March 31st 2019 were collected after taking an informed consent. A total of 539 cases were received in this time frame, of which 121 (22.45%) were dead and included in the study and were compared with 121 normal placentae (alive), without any maternal co-morbidities. The placentae were grossed and assessed according to Amsterdam guidelines. The significance of the difference observed was established by Chi-square test using Statistical Package for Social Sciences software (SPSS) version 21.0. Results: Of these 121 cases, 89 (73.5%) cases had placental changes, whereas 32 (26.5%) cases were devoid of placental changes. Placental infarct and increased syncytial knots were seen contributing maximum to foetal death in 31 (25.6%) cases followed by chorioamnionitis. Rare cases like Twin Reversed Arterial Perfusion (TRAP) syndrome, Persistent Right Umbilical Vein (PRUV), maternal floor infarct were also reported. Conclusion: Despite many antenatal imaging advances, placental examination still remains valuable in diagnosing cause of death and growth restriction in the foetus especially recurrent causes, favouring clinical intervention in those cases.
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