Publication:

A study of placental morphology and correlation with colour doppler ultrasonography, maternal and neonatal outcome in high risk pregnancies

Background The placenta has multifaceted roles in foetal development and survival. Determination of placental abnormalities is very much essential in preventing intrauterine and perinatal morbidity and mortality. The aim of present endeavor was to study the placental histology and correlate with colour flow doppler ultrasonography, maternal and neonatal outcome.

Methods A prospective comparative study was conducted in 50 antenatal women of >28 weeks gestation. Out of these, 25 cases of high risk pregnancies which included pregnancy induced hypertension, preeclampsia, intrauterine growth retardation (IUGR) and anaemia of chronic disease. Other 25 normal antenatal cases were taken as controls. All the women were subjected to colour doppler ultrasonography and study of placental histology done and results were correlated to maternal and neonatal outcome.

Results The Doppler flow was abnormal in 44% of high risk groups. Abnormal histological changes were seen in all the high risk cases (100%). The mean diameter of the placenta (20.69 cms) and the mean birth weight in high risk group (2.34kgs) were comparatively less than that of control group. Abnormal histological changes were maximally found in high risk groups of abnormal Doppler in comparison to control group. Perinatal mortality (2.22%), Apgar score (90.9%), IUGR (4.44%) are higher in cases with abnormal histology of placenta compared to normal cases.

Conclusions Placental abnormalities correlate well with the factors causing high risk pregnancies and the subsequent maternal and foetal outcomes. Placental examinations may help in better understanding of the mechanisms of placental dysfunctions that may contribute to more effective therapeutic strategies in the future.