Morphological study of placenta in normal and hypertensive pregnancies

Background: Hypertensive disorders complicate 5-10% of all pregnancies and form a dangerous triad with haemorrhage and infection that contribute greatly to maternal morbidity and mortality. The fetus is dependent on placenta for growth and development. Many disorders of pregnancy like hypertension are accompanied by gross pathological changes in placenta. Aim: The aim of the study was to assess the gross morphology of placentae of women with pregnancy induced hypertension and to compare them with normal pregnancies. Material and methods: An observational comparative study was carried out in the Department of Anatomy, S. M. S. Medical College, Jaipur, Rajasthan. Total 80 placentae, 40 from pregnancy induced hypertensive pregnancies and 40 from normal pregnancies were studied for the morphology and compared. Gross morphological features of placentae like weight, shape, insertion of umbilical cord, number of cotyledons, diameter, surface area and central thickness in both groups were recorded and analyzed using ‘Chi square’ and ‘Z’ test of significance. Results: The mean placental weight, numbers of cotyledons, diameter, surface area and central thickness were significantly less (p<0.05) in placentae from pregnancy induced hypertensive women. They also showed increased incidence of marginal insertion of umbilical cord (p<0.01), while the shape of placentae did not show significant variation (p>0.05). Conclusion: The placentae from hypertensive pregnant women showed significant morphological changes as compared to controls which may alter the perinatal outcome.