Histopathological Study of Villous Hypervascularity and Chorangiosis at Different Maternal Hemoglobin Levels

Abstract

Introduction: Placenta has a remarkable reserve capacity to survive in the harmful environment, but some of the damaging factors, especially maternal anemia may have negating effects on placenta which might compromise the fetal well-being. Decreased hemoglobin level in pregnancy is associated with villous hypervascularity and chorangiosis, which can be assessed for diagnostic purposes because it has been considered as a result of placental hypoxia caused by maternal anemia. The objective of this study is to assess the morphological pattern of villous hypervascularity and chorangiosis at different maternal hemoglobin levels. Material and methods:This descriptive study was carried out over a period of 2 years in a tertiary care hospital. Nonprobability convenience sampling was done. Placentas were obtained from 100 full-term pregnant women having different hemoglobin levels. After processing and staining, the slides were examined under light microscope and number of blood vessels were calculated in 10 villi in 10 non-infarcted areas in 3 random fields per each slide under 10X objective. Results:At normal hemoglobin level, all the chorionic villi showed normal number of blood vessels, while at 10.0-10.9 gm/dl, 50% (12 out of 24 cases), at 7-9.9 gm/dl, 36.4% (12 out of 33 cases) and at < 7 gm/dl, 72.2% (13 out of 18 cases) placental specimens showed hypervascularity. Chorangiosis was not seen at hemoglobin level ≥ 10.0 gm/dl while 18.1% (6 out of 33 cases) having hemoglobin level 7-9.9 gm/dl and 27.8% specimens having hemoglobin level ≤ 7.0 gm/dl (5 out of 18 cases) showed chorangiosis Conclusion:In current study number of capillaries per chorionic villi were found to be significantly more at decreasing concentration of hemoglobin, displaying adaptive alterations

Histopathology of Placentae in Pre-Eclampsia: A Review

“…The study revealed that HV is prominent with increased incidence of anaemia. 33 36,37 A twin study piloted by Jaiman et al, observed that there was defective villous maturation due to hypoxia. 38 Morgan et al, in their study observed in terminal villi there was significant hyper maturity.…”