Placental pathology in low birth weight babies a prospective observational study

Introduction: Low birth weight (LBW) babies are more common in developing countries like India. The placenta is an organ which connects fetus to mother during intrauterine life. Any change in the mother reflects on placenta and thus on the fetus. Materials and Methods: In this study placenta from LBW were evaluated. We included 50 fresh placentae. Gross examination including weight, shape, thickness, feto-placental ratio was calculated. Later, histo-morphological study of all placentae was done. The extent of placental lesions which can influence the birth weight of the baby or adverse fetal outcome were correlated. Results: Out of 50 placentae studied, there was significant reduction in placental weight and dimension. Irregular shape of placenta was seen in 13 cases and most of the plscenta (27 cases) showed paracentral insertion of umbilical cord. On gross, infarction [56%], subchorionic fibrin [64%], intervillous fibrin [52%] were noted. On microscopy, cytotophoblast hyperplasia [52%], stomal fibrosis [48%], fibrinoid necrosis [100%], synnctial knots [32-68%], hypovascular villi [44%] were noted. Conclusion: All major gross and microscopic changes in the low birth weight placentas pointed towards reduced blood flow to the placenta resulting in chronic placental insufficiency. The severity of placental abnormalities expressed as cumulative number of placental lesions is a significant risk factor for LBW babies. Morphological examination of the placenta conducted in the present study proved to be a useful adjunct to the clinical examination in finding the pathogenetic mechanisms during pregnancy resulting in LBW babies and can be helpful in the planning and management of future pregnancies.