A CASE CONTROL RESEARCH ON THE EFFECTS OF CHEWABLE AND NON-SMOKED CHEWABLE TOBACCO ON PLACENTAL MORPHOLOGY OF THE TOBACCO USERS

Objective: The study is focused on assessment and relationship of morphological changes happening in the placentae of mothers who used to chew tobacco and placentae of non-tobacco users. Methodology: This case-control study was carried out at Mayo Hospital, Lahore (Obstetrics, Gynecology and Anatomy Department) during the timeframe one year starting from June, 2016 to June, 2017. A total of sixty subjects were selected and divided into two groups. Group ‘A' comprised of placentae of 30 non-smoked tobacco users whereas Group ‘B' consisted of 30 placentae of tobacco users. The features considered during the evaluation were shape, site of attachment of umbilical cord, weight, and central and peripheral thickness of placentae of both groups. Results: The average value for weight of placenta for Group A was (444.56 + 112) gm and for Group B was 437.8 + 61.94. The mean diameters of the placentae were: (17.50 + 1.8) cm (tobacco users); (17.94 + 1.2) cm (non-tobacco user). The cotyledons difference in the numbers was highly significant (p < 0.001). The cotyledons readings were (16.33 + 2.39) and (13.81 + 1.36) for Group ‘A' and ‘B' respectively. The central thickness of placentae was recorded as (1.94 + 0.59) cm in Group A and (2.49 + 0.47) cm in Group B. The average outer thickness of the placentae in both groups was almost the same; Group ‘A' (1.75 + 0.41) cm and Group ‘B' (1.74 + 0.44) cm. Conclusion: Placental morphology is highly affected by the non-smoked use of tobacco and in turn has the potential of adverse affects on the outcome of the pregnancy. Smokers' placentae are even more complex as compared to non-smoked chewed form of tobacco users. Keywords: Placenta, Non-Smoked tobacco, Tobacco and Morphology.