Morphology and Morphometric Study of Human Placenta in Rural Southern India

摘要

Aims: To study the morphology and do the morphometric analysis of placenta and to correlate with the foetal parameters, in order to help in the assessment of the state of well being of foetus. To study the histomorphological features of placenta in various conditions complicating the pregnancy. Study Design: Descriptive type of study. Place and Duration of Study: Department of Pathology and Department of Obstetrics and Gynaecology, Sri Manakula Vinayagar Medical College, Puducherry, between July 2013 and August 2013. Methodology: We included 51 fresh placentae. Gross examination including weight, shape, thickness, feto-placental ratio, placental co-efficient was calculated. Later, histo-morphological study was done. Results: Out of the 51 placentae, 48 were circular in shape and 3 were oval in shape. In the present study the mean (± SD) diameter of the placenta was 14.65 cm and thickness of the placenta was 1.42 cm. The thickness of placenta was reduced (<1.5cm) in all cases of Pregnancy induced hypertension (PIH), Isoimmunisation, twin pregnancy, prematurity and anemia. Placental weight was reduced in all cases of PIH, low birth weight baby, prematurity and Increased placental weight was seen in the gestational diabetes. Feto-placental ratio was 5.39:1(both sexes considered together) and placental coefficient was 0.19. In PIH, the average foeto-placental ratio was 5.20:1and the average placental coefficient was 0.19. Gestational diabetes showed a foeto-placental ratio of 5.30:1, the placental coefficient being 0.18 with a considerable increase in the birth weight and in the placental weight. Anaemia showed a significant reduction in the placental weight, with a foeto-placental ratio of 5:1 and an increase in the number of ill-defined cotyledons. In prematurity, average foeto-placental ratio was 4.43:1, while Rh isoimmunisation did not show any decrease in the foeto- placental ratio. Conclusion: As anticipated, in case of PIH complicating pregnancies, the morphometric values of the placenta like the diameter, number of cotyledons and the average placental and foetal birth weights were found to be lower than that of the normal, uncomplicated pregnancies. At the same time, all these parameters were increased in cases of diabetes. So morphometric investigation of the placenta will be tremendously useful in the early assessment of placental insufficiency and also the state of foetal well being.