The New Indian Journal of OBGYN. 12(1):141-146

A comparative study of placental histomorphological changes in a normal pregnancy and an intrauterine growth restriction pregnancy

Deepika Agrawal, Sunita Agrawal, Arun K Dora

ABSTRACT

Objectives: The wellbeing of a fetus depends a lot on the proper functioning of the placenta. The placental pathology can be seen at a gross and microscopic level. Intrauterine growth restriction and other pathological conditions can be the result of these changes in the placenta. The aim is to study and compare the gross and histopathological changes in the placenta of normal and intrauterine growth restriction pregnancies. Methods: It is a prospective observational study conducted in a tertiary hospital. The study was conducted on 71 pregnant women with IUGR fetus and 129 normal fetuses attending a tertiary hospital OPD and labour room between 2016 and 2018. Mother, placenta, fetus and newborn data were recorded before and after delivery. After checking the inclusion and exclusion criteria, pregnancies with IUGR were taken as cases and normal pregnancies as controls. All the data were collected and tabulated and then analyzed with appropriate statistical tools “MedCalc”. Results: There are statistically significant differences found in gross and histological changes in the placenta of IUGR and the control group. Among gross features, in FGR group, mean weight of the placenta was 363.52 grams, calcification was found in 33.80% cases and infarction in 26.76% of cases and in control group, mean weight of the placenta was 547.16 grams ( P value < 0.0001), calcification was found in 15.50% cases ( P value-0.0049) and infarction 8.53% cases ( P value - 0.0012). Among histopathological features, in FGR group, perivillus fibrin deposit (PFVD) was found in 38.03% of cases, syncytial knot found in 30.99% of cases and fibrinoid necrosis found in 29.58% cases. In control group, PFVD was found in 20.16% of cases (P value - 0.0101), syncytial knot was found in 14.73% of cases (P value - 0.0110) and fibrinoid necrosis found in 9.30% cases (P value - 0.0005). Conclusions: The abnormal gross pathological and histopathological changes like calcifications, infarction, perivillus fibrin deposit, fibrinoid necrosis and syncytial knot are seen in a statistically significant higher percentage in pregnancies with intrauterine growth restriction.