A PROSPECTIVE STUDY ON HISTOPATHOLOGICAL CHANGES IN PLACENTAS OF HIGH-RISK PREGNANCY AT A TERTIARY CARE HOSPITAL
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Abstract
: Placenta serves as a mirror of intrauterine maternal and fetal environment, and its histopathological examination provides valuable insight into adverse pregnancy outcomes and also aids in understanding underlying pathophysiological processes. Objective: To evaluate the spectrum of gross and microscopic histopathological changes in placentas of high‑risk pregnancies. Method: A prospective observational study for a period of 6 months was conducted on 50 placentas obtained from high‑risk pregnancies at a tertiary care hospital. Gross morphological parameters, including placental weight, thickness, and diameter, were recorded. Histopathological findings like syncytial knots, villous fibrosis, villous hyalinization, fibrinoid necrosis, infarcts, calcification, chorioamnionitis, intervillous hemorrhage, cytotrophoblastic proliferation, and perivillous fibrin deposition were studied. Results: The most common high‑risk groups encountered were gestational hypertension (26%), severe anemia (20%), and gestational diabetes mellitus (14%). Mean maternal age was highest in GDM pregnancies (30.4 ± 3.4 years). Overall mean gestational age was 36.5 ± 1.7 weeks in high risk pregnancies.
Placentas in GDM showed the highest mean placental weight (564 g), diameter (18.2 cm), and thickness (3.8 cm), while preterm placentas had the lowest values (mean weight 217 g). Syncytial knot formation was most marked in GDM (64.2 ± 15.3/100 villi) and GHTN (62.3 ± 10.4/100 villi). Calcifications were most frequent in IUGR (3.5 ± 0.9/10 LPF), followed by hypertensive and anemic cases. Villous stromal fibrosis, fibrinoid necrosis, and intervillous hemorrhage were significantly associated with hypertension and IUGR. Chorioamnionitis was observed predominantly in GDM and preterm cases.
Conclusion: Placentas from high‑risk pregnancies show a distinct spectrum of histopathological changes, varying with the underlying maternal condition. Thus placental examination serve as a valuable adjunct in explaining adverse maternal and perinatal outcomes and guiding future obstetric care.
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Dr.N.Bhavana
Assistant Professor, Dept. of Pathology, Sri Venkateswara Institute of Medical Science, Tirupati
Dr.C.Sushma
Associate Professor, Dept. of Pathology, S.V.Medical College, Tirupati
Dr.Md.Khader Faheem
Associate Professor, Dept. of Pathology, Govt. Medical College, Kadapa
Dr.C.A.Vishali
Assistant Professor, Dept. of Pathology, Anna Gowri Medical College & Hospital, Puttur
Dr.G.Indrani
Professor & Head, Dept. of Pathology, S.V.Medical College, Tirupati