“CORRELATION OF MACROSCOPIC AND MICROSCOPIC FEATURES OF PLACENTA WITH MORPHOMETRICAL FEATURES OF FETUS IN HIGH-RISK PREGNANCY- A CROSS SECTIONAL STUDY”

Abstract

Background: In high-risk pregnancies, the structure of the placenta can significantly influence fetal development and pregnancy outcomes. This thesis aims to explore the intricate relationship between the placental attributes, both macroscopic and microscopic and the morphometric features of the fetus in such high-risk conditions.

Objectives:

1. To study the histomorphological features of the placenta in high-risk pregnancies.


2. To correlate the findings with fetal parameters in high-risk pregnancies.


3. To use Histochemical staining (Periodic Acid Schiff) and Immunohistochemistry

(CD34) for demonstrating features in high-risk pregnancies.

Methodology:

The present study involves collection of relevant clinical data from 117 pregnant women with high risk pregnancies and collection of placentas after their expulsion for histopathological examination.

Results:

Among the study population, the majority was from the age group of 21 – 30 years old, followed by < 20 years, 31-35 years and > 35 years. The mean placental weight distribution among the high-risk category was statistically significant (p-value < 0.005). Mean baby weight distribution was statistically significant (p-value < 0.001). Preterm babies had the lowest brith weights, while GDM babies had the highest weights. Syncytial knots >30% occurred in 62 cases, mainly in anemia, PIH, and hypothyroidism. PIH had the lowest fetoplacental ratio, while GDM had the highest. GDM had the lowest fetoplacental coefficient, while PIH patients had the highest. PIH patients had the thinnest placentas, while GDM and RH-negative pregnancy patients had the thickest. Five had increased villous vascularity, with 2 having anemia and 3 with GDM.Twelve had decreased villous vascularity, with 7 having anemia, 3 with PIH, and 2 with RH-negative pregnancy. Preterm births have the highest mean calcification (3.54) and variability (5.01), while PIH and anaemia show moderate levels with high variability. GDM and IUD have the lowest calcification (0.27 and 0.20), highlighting the need for tailored monitoring and intervention.

Conclusion:

The study investigated the link between placental characteristics and fetal development in high-risk pregnancies. These histopathological abnormalities found in placentas of different high-risk categories emphasize early recognition and management of high risk pregnancies which can in turn lead to improvement in perinatal outcome.