Histopathological study of placentae in low birth weight babies in India

Abstract

Background:The antenatal health-care given to pregnant women has great influence on the rates of perinatal death and morbidity. Amongst the different causes of perinatal mortality, low birth weight (LBW) is the single most significant factor therefore placenta from all the LBW babies (LBWB) should be examined routinely to find out the likely cause.Aims:The aims of this study were to assess the pathological changes in the placenta in association with LBWB.Materials and Methods:This is a Case control study performed at Medical College Allahabad,(MLN) India. In this study, 90 placentae were included. 30 placentae from full-term vaginally delivered babies, weighing more than 2500 g were included as the control group. 60 placentae belonged to babies whose birth weight was less than 2500 g (LBW). Weight of the baby was taken within the 1st h of birth and Apgar score was noted. Gross and microscopic examination of placentae was done. Statistical correlation of was carried out between them by using SPSS 18 version. Chi-square test with or without yate's correction was used as and when required. P < 0.05 was taken as critical level of significance.Results:Placenta was circum-marginal in both groups. Attachment of cord was mainly central in the control group 90% (27/30), whereas eccentric attachment was prominent in patient group 66.67% (40/60). The difference was statistically significant (P < 0.001). Calcification and sub-chorionic fibrin deposition was seen in significantly higher numbers of placentae from patients than controls (P < 0.01) infarction and meconium staining were seen in placentae from patients only. Histologically placental ischemia, infarction and calcification were seen in significantly higher number of patients (P < 0.001, P < 0.001 and < 0.01 respectively). Fibrinoid necrosis, stromal fibrosis, placental dysmaturity and obstructive vasculopathy were seen in placentae from patients only.Conclusion:Placental pathology among LBW infants was high in comparison to control group. The findings suggest that chronic ischemia and associated secondary changes probably lead to improper perfusion and LBWB.

Comparison of Placental Histopathology in IUG Rand Normal Term Infants: A Cross-Sectional Study

“…In this study we have tried to study the significant placental pathology in IUGR cases.Mean Placental weight of IUGR cases was 380 gm (less than 25 th percentile) as compared to the 510 gm (>50 th percentile) in control group. Similar finding was seen in other studies 8,9 .Few studies suggested circumvallate placenta, circummarginate, velamentous insertion of the cord and placenta previa as possible causes of IUGR 1,10,11 . In this study almost all the placenta had marginal insertion of membranes.…”

“…This could be due to the small sample size combined with only three cases of PIH in our study. Therefore, it is recommended such pathological findings be examined in a larger sample size in future studiesIntervillousfibrinoid deposition of more than 10% was more common in the study group as was seen in previous studies 9,13,15,16 . Maternal thrombophilias, both inherited and acquired have been seen to be associated with increased fibrinoid deposition in intervillous space.…”

Placental pathology in low birth weight babies a prospective observational study

“…10 Intra uterine growth retardation can be due to maternal, fetal, placental and unknown causes, but the basic pathophysiology is due to either reduced availability of nutrients in mother or its reduced transfer by the placenta to the fetus and may also be due to reduced utilization by the fetus. 9 LBW more frequently show multiple type of lesion in their placenta. Evidence suggests that fetal growth retardation occurs due to more than single lesion in uteroplacenta or villous.…”

“…Fibrinoid necrosis, stromal fibrosis, placental dysmaturity and obstructive vasculapathy were seen in placentae from patients only. 9 [Fig. 3,4].…”

“…It undergoes different changes in weight, volume, structure, shape and function continuously throughout the gestation to support the prenatal life. 9 The careful examination of placenta can reveal many facts that may either directly or indirectly explain the past event that potentially determine the outcome of pregnancy. 3 There are various factors to be studied in villious abnormalities of placenta like cytotrophoblast proliferation, intervillous fibrin deposition, infarction, syncytial knots, stromal fibrosis, fibrinoid necrosis.…”