Gross Placenta Characteristics in Pre-eclampsia/Eclampsia and Normotensive Pregnancies. A Comparative Study.

Abstract

Background: Preeclampsia/eclampsia is a leading cause of maternal and perinatal mortality; the prevailing theory is that it is a consequence of disordered placentations which are manifested as vascular and villous abnormalities with consequences in the developing foetus. Objective: To evaluate and study gross changes in the placentae of women with preeclampsia/eclampsia and normotensive mothers and correlate with pregnancy outcome and neonatal morbidity and mortality. Methods: This was a comparative(prospective) study of pathologic lesions in the placentae of 146 pregnant women; 73 were normotensive (control group) while the other 73 women were preeclamptic /eclamptic (study group). The placental findings in the two groups were further examined for association with severity of the hypertensive disease and neonatal mortality. Results: The mean placental weight was lower in the study group compared to the control (556.82 grams ± 169.72 vs. 649.93 grams ± 116.38, p<0.001). Placenta weight was significantly lower at gestational ages of 31-36.6weeks. The study group had a significantly higher percentage of abnormalcord insertions than the control group. There was no significant association between gross parameters and disease severity. Gross infarcts were only seen in placentae of study group and the difference was statistically significant. Gross infarcts and membrane colour were significantly associated with perinatal mortality. The study group had 11% neonatal mortality while there were no neonatal deaths in the control group. Conclusion: There were distinct gross pathological changes in the placentae of mothers with preeclampsia/eclampsia several of these pathological changes occurred more in the severe and eclamptic cases. There was also association with perinatal mortality.