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ORIGINAL ARTICLE
Year : 2012  |  Volume : 39  |  Issue : 1  |  Page : 17-18

Hypertensive disorders affecting the morphometry of placenta


Department of Anatomy, USM-KLE IMP, Belgaum, Karnataka, India

Date of Web Publication21-May-2012

Correspondence Address:
Sharmishtha Ghodke
Department of Anatomy, USM-KLE IMP, Belgaum, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-5009.96464

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  Abstract 

The placenta reflects the changes due to maternal hypertension, as it is a mirror of the maternal and fetal status. The study of a hundred placentae was conducted, to find out the morbid changes in the placentae of hypertensive mothers, in comparison to those of mothers with normal pregnancies. In gross appearance the placentae of mothers with PIH (Pregnancy-Induced Hypertension) were smaller and irregular. Surface area and volume showed reduction in the placentae of PIH mothers. Thus, the severity of hypertension adversely affects both fetal and placental outcome.

Keywords: Hypertension, placenta, surface area, weight of fetus, weight of placenta


How to cite this article:
Ghodke S, Dharwadkar S. Hypertensive disorders affecting the morphometry of placenta. J Sci Soc 2012;39:17-8

How to cite this URL:
Ghodke S, Dharwadkar S. Hypertensive disorders affecting the morphometry of placenta. J Sci Soc [serial online] 2012 [cited 2018 Aug 16];39:17-8. Available from: http://www.jscisociety.com/text.asp?2012/39/1/17/96464


  Introduction Top


Nowadays, stress and strain, increased maternal age, change in the lifestyle of Indian women, and the number of pregnancy-induced hypertension (PIH) cases are on the increase. As an anatomist it is very essential to know the macroscopic changes in the placentae of hypertensive women in relation to the normal ones. From the last century most of the studies on the placenta have been done mainly by obstetricians and gynecologists. Very little study is contributed by an anatomist. Being a crucial organ in pregnancy, the placenta attracted the attention of many workers for its study, in relation to its weight and surface area. Till 1996, nobody had taken efforts to measure the exact surface area of the placenta of pregnancy-induced hypertension mothers. Toxemia of pregnancy is the leading cause of maternal mortality and is an important factor in fetal loss. The incidence is high in backward countries with malnutrition, hypoproteinemia, and poor obstetric facilities.

The present study is undertaken to compare the morphometric changes in the placentae of normal and PIH mothers. The study showed a regression equation with regard to (1) Weight of Placenta, (2) Volume of Placenta, (3) Exact surface area of placentae.

Aim

To study the adverse effects of maternal hypertensive disorders on the morphometry of the placenta and its subsequent influence on the neonatal outcome.


  Materials and Methods Top


Weighing machine for placenta (2 kg), weighing machine for baby (10 kg), small bucket full of water, Tray, Measuring Jar, Scalpel with surgical blade, Graph paper.

A total of 100 placentae were studied. Fifty were from normotensive and 50 from hypertensive mothers (B.P > 140 / 90 mm / Hg). Measurements included weight, surface area, and volume of the placentae [Figure 1]. Most of the placentae were from the primipara. The placenta with cord and membrane was collected immediately after delivery. In all cases the amnion and chorion were trimmed from the placenta. The umbilical cord was cut at a distance of 5 cm from the site of insertion. The placentae were washed thoroughly mopped with the help of blotting paper and weighed. The volume of the placenta was calculated by using the Archimedes principle. Baby weight was recorded in each case. Next the surface area of the maternal surface of placenta was calculated by taking its imprint on graph paper. Volume of the placenta was calculated by using Archimedes principle.
Figure 1: Maternal surface area, weight, and volume of the placentae.

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  Observation and Results Top


Macroscopic findings of placenta [Table 1].
Table 1: Macroscopic findings of placenta

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  Discussion Top


Hypertensive disorders have a definite adverse influence on the morphometry of the placenta. The placenta provides valuable information on the fetal outcome. The pregnancy-induced hypertensive syndrome exerts its deleterious effects on the placenta. The present study was undertaken to analyze and assess the morphometric variations of the placenta like the weight surface area and volume. The hypertensive disorder of pregnancy is a disease of primigravida as reported by Teasdale. [1] Salvatore [2] reported preterm deliveries in 50.71% of the hypertensive cases. We found less incidence of premature and low birth weight babies. Our study cases were monitored in a health camp and in a regular Outpatient Department (OPD). Browne Veall (1953) [3] and Garg, Rath, and Sharma (1996) [4] studied the placental surface in pregnancy-induced hypertension cases. Das [5] and Mujumdar [6] reported that hypertensive placentae tend to be smaller than the normotensive ones. Nazmeen [7] also reported the weight and volume of the placenta to be less in pregnancy-induced hypertension cases. Chakarvorty [8] studied the fetal and placental weight changes in normal and pre-eclampsia cases, and supported the same. Compared to Mujumdar, [6] in our study, the placental mean weight and volume recorded was less because of the regional effects and due to a greater number of primipara in our study. Janthanaphan [9] and Virupaxi [10] noted reduced placental weight and in its ratio to birth weight in normal pregnancy.


  Conclusion Top


We have come to a conclusion that maternal hypertensive disorders have a definite adverse influence on the morphometry of placenta. It is also seen that the placenta has a great potential to provide valuable information in the case of an adverse fetal outcome. In these days of increasing medicolegal cases, this will help many doctors to achieve the goal of a good fetomaternal outcome.

The method used for calculating volume is very easy and economical. Volume measurement can be easily performed by Dai's in PHC, which will be helpful to detect reduced placental volume and in turn reduced fetal weight. By regular monitoring and supervision in pregnancy-induced hypertensive cases, Good fetal weight and increased incidence of normal delivery is recorded.

 
  References Top

1.Teasdale F. Histomorphometry of the human placenta in maternal preeclampsia. Am J Obstet Gynecol 1985;152:25-41.  Back to cited text no. 1
[PUBMED]    
2.Salvatore C. The placenta in acute toxaemia. Am J Gynaecol 1968;102:347-9.  Back to cited text no. 2
    
3.Browne JC, Veall N. The maternal blood flow in normotensive and hypertensive women. J Obstet Gynecol Br Emp 1953;60:141-7.  Back to cited text no. 3
    
4.Garg K, Rath G, Sharma S. Association of birth weight placental weight and the site of umbilical cord insertion in hypertensive mothers. J Anat soc India 1996;44:4.  Back to cited text no. 4
    
5.Das B, Dutta D, Chakraborty S, Nath P. Placental morphology in hypertensive disorders of pregnancy and its Co-relation with fetal outcome. J Obstet Gynecol India 1996;46:40-6.  Back to cited text no. 5
    
6.Mujumdar S, Dasgupta H, Bhattacharya K, Bhattacharya AA. study of placenta in normal and hypertensive pregnancies. J Anat Soc India 2005;54:34-8.  Back to cited text no. 6
    
7.Nazmeen N, Silotry M, Seth N. Morphologocal study of placenta of normal and pregnancy induced hypertension patients. J Anat Soc India 2006;55:72-121.  Back to cited text no. 7
    
8.Chakravorty AP. Fetal and placental weight changes in normal pregnancy and pre- eclampsia. J obstet Gynaecol Br commonw 1967;74:247-53.  Back to cited text no. 8
[PUBMED]    
9.Janthanaphan M, Kor-Anantakul O, Geater A. Placental weight and its ratio to birth weight in normal pregnancy at Songkhlangarind Hospital. J Med Assoc Thai 2006;89:L130-7.  Back to cited text no. 9
    
10.Virupaxi RD, Potturi BR, Hulkkeri VB. Study of morphology of placenta and its relation with low birth weight babies and prevalence of birth defects in 950 live births in civil Hospital of Belgaum city. J Anat Soc India 2003;52:82-115.  Back to cited text no. 10
    


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    Tables

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Abstract
Introduction
Materials and Me...
Observation and ...
Discussion
Conclusion
References
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