Study of structural changes in placenta in pregnancy-induced hypertension

Salmani, Deepalaxmi; Purushothaman, Suja; Somashekara, Saligrama Chikkannasetty; Ekambaram, Gnanagurudasan; Sumangaladevi, Kampli; Harikishan, Recapu; Venkateshwarareddy, Muthinpala

doi:10.4103/0976-9668.136182

Cited by 67 publications

(72 citation statements)

References 6 publications

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“…8 The values corelate with the earlier study by Majumdar et al 36 Salmani D et al observed that the weight of the placenta was less in preeclampsia and eclampsia when compared with normal placenta. 8 The mean neonatal birth weight was more in normal pregnancy (3.14 kg). It was less in preeclamptic and eclamptic cases (<2.5 kg).…”

Section: Discussionsupporting

confidence: 84%

“…6 Maternal vasospasm leads to fetal hypoxia and accordingly it may lead to fetal distress and fetal death. 7,8 FGR and PE are defined as placentally-related complications in a large proportion of cases, as they are often characterized by defective placental development (e.g. inadequate remodelling of maternal spiral arteries and altered uteroplacental blood perfusion).…”

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confidence: 99%

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Placental damages from ultrasonic changes to histopathological findings in maturing placenta in pregnancy complicated with hypertension: an observational clinical study

Dutta

Sahu

Chatterjee

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONWorldwide, 10 % of all pregnancies are complicated by hypertension, with pre-eclampsia and eclampsia being the major causes of maternal and prenatal morbidity and mortality.1 It is also estimated that pregnancy induced hypertension (PIH), one of the hypertensive disorders of pregnancy, affects about 5-8% of all pregnant women ABSTRACT Background: The development of mild hypertension or preeclampsia at or near term is associated with minimal maternal and neonatal morbidities. Obstetric ultrasound provides a cornerstone to other modalities used for assessing hypertensive disorders of pregnancy. Placental architecture is modified in PE and eclampsia. This study was designed to detect the placental changes in hypertensive disorders of pregnancy and correlation with ultrasonic and histopathological changes. Methods: The study group comprised of 42 patients with pregnancy complicated with hypertension with period of gestation above 20 weeks and B.P. more than 140/90 mm of Hg measured on two occasions 6 hours or more apart. The control group consists of 42 normotensive patients matched with age and parity. One ultrasonic examination was performed between 28 weeks and 34 weeks and another after 34 weeks till term. Apart from routine parameters i.e. BPD, AC, FL, Amniotic fluid index, EBW and gestational age routine placental grading were performed according to the classification proposed by Grannum and associates. To evaluate perinatal outcome following measurement were studied birth weight immediately after delivery, mode of delivery, perinatal morbidity and mortality, APGAR score, presence of fetal distress. Results: In 97.62% cases (41 out of 42) of control group showed Grade-II changes as opposed to 57.14% of cases (24 out of 42) in study group before 34 weeks. All 21 cases in study group showing Grade 'III' changes before 34 weeks had infarction, calcification, increased syncytial knots, fibrinoid necrosis from 95.23 to 100% of these cases showed all these changes. Only 2 cases (9.52%) showed perivascular hemorrhage having Grade 'III' before 34 weeks. Conclusions: Accelerated maturation of placenta in pregnancy complicated with hypertension are more common in the hypertensive group. Increased histopathological degenerative changes e.g. calcification, fibrinoid necrosis etc., are more marked even before 34 weeks of gestation in hypertensive group.

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Section: Discussionsupporting

confidence: 84%

mentioning

confidence: 99%

Placental damages from ultrasonic changes to histopathological findings in maturing placenta in pregnancy complicated with hypertension: an observational clinical study

Dutta

Sahu

Chatterjee

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…12.14 Preeclampsia not only affects placental weight but also its dimensions. 12,14,15,16 The reduction in number of cotyledons, placental weight, diameter, and surface area in the present study is consistent with some of the previous studies (Table 3). 13,17,18 The explanation to negative effect of preeclampsia to placental development can been seen in microscopic and ultramicroscopic structural study of placenta.…”

Section: Discussionsupporting

confidence: 82%

A Morphometric Comparative Study of Placenta in Normal and Preeclampsia Pregnancies Delivering at 36 to 38 Weeks of Gestation and Its Impact on Birth Weight

Girish¹,

Nandagopal²,

Padmini³

et al. 2015

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BACKGROUND: Placenta is a remarkable organ which functions as a vital organ for the developing fetus. Evaluation of placenta conveys the intrauterine environment of the fetus. Examination placenta in many diseases, including preeclampsia, and its comparison to placenta in normal pregnancies reveals placental pathology as a cause of fetal growth disorders. OBJECTIVE OF THE STUDY: To correlate effect of preeclampsia on placental development and subsequently its effect on fetal growth. MATERIALS AND METHODS: Across-sectional study was conducted in a tertiary care center. The placentas from pregnancy delivered between 36 to 38 weeks were included in the study. Morphometric measurements of 100 placentas from pregnancies that had preeclampsia were compared with 100 placentas from pregnancies that were normotensive. The placental morphometry was correlated with fetal birth weight. OBSERVATIONS AND RESULTS: Study showed that the placental development was significantly affected with relation to shape in preeclampsia group. 97% were discoid in normotensive group whereas in preeclampsia group it was 88%. Attachment of cord were more eccentric in preeclampsia than normotensive group (26% vs.

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“…9 Furthermore, it has been shown that placental weight and size are reduced in women with hypertensive disorders of pregnancy and this is associated with unfavorable effects on fetal growth. 10 Given the increased risk of placental insufficiency in this population and the association between GWG and birth weight, 2 one may postulate that disproportionate GWG may be necessary in this group to overcome placental insufficiency and achieve an ideal birth weight. In contrast, we found that in our population, weight gain below IOM recommendations was associated with a decreased risk of superimposed preeclampsia without an associated increased risk of SGA.…”

Section: Discussionmentioning

confidence: 99%

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2017

AJP Rep

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Chronic hypertension (HTN) complicates approximately 3% of pregnancies in the United States 1 and increases the risk of poor maternal and neonatal outcomes, including superimposed preeclampsia, placental abruption, cesarean delivery, stroke, renal or cardiac failure, miscarriage, stillbirth, growth restriction, prematurity, and neonatal death.The Institute of Medicine (IOM) has developed guidelines for gestational weight gain (GWG) to target an ideal birth weight. 2 However, these guidelines were developed in a healthy population, and no specific guidelines were created for special populations such as women with chronic (HTN). Because women with chronic HTN are at increased risk of AbstractObjective To assess the impact of gestational weight gain (GWG) outside the Institute of Medicine (IOM) recommendations on perinatal outcomes in pregnancies complicated by chronic hypertension (HTN). Methods The study consisted of a retrospective cohort of all singletons with HTN from 2000 to 2014. Maternal outcomes examined were superimposed preeclampsia and cesarean delivery. Neonatal outcomes were small for gestational age (SGA), large for gestational age (LGA), and preterm birth (PTB). Groups were compared using analysis of variance and chi-squared test for trend. Backward stepwise logistic regression was adjusted for confounding factors. Results Of 702 subjects, 106 (15.1%) gained within, 176 (25.0%) gained less, and 420 (59.8%) gained more weight than the IOM recommendations. After adjusting for confounders, GWG above IOM recommendations remained associated with LGA (adjusted odds ratio [AOR]: 2.53, confidence interval [CI] 95%:1.29-4.95). Weight gain less than recommended was associated with a decreased risk of superimposed preeclampsia (AOR: 0.49, CI 95%: 0.26-0.93) without increasing the risk of SGA (AOR: 1.03, CI 95%: 0.57-1.86). Conclusion Women with pregnancies complicated by chronic HTN should be counseled regarding the association of LGA with excessive GWG. Additionally, they should be counseled that weight gain below recommendations may be associated with a decreased risk of superimposed preeclampsia; however, this association deserves further investigation.

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Study of structural changes in placenta in pregnancy-induced hypertension

Cited by 67 publications

References 6 publications

Placental damages from ultrasonic changes to histopathological findings in maturing placenta in pregnancy complicated with hypertension: an observational clinical study

Placental damages from ultrasonic changes to histopathological findings in maturing placenta in pregnancy complicated with hypertension: an observational clinical study

A Morphometric Comparative Study of Placenta in Normal and Preeclampsia Pregnancies Delivering at 36 to 38 Weeks of Gestation and Its Impact on Birth Weight

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