An Observational Study of Placental Changes among Term and Preterm Babies Delivered in Tertiary Care Hospital

  • C Y Nagesh Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
  • R Prema Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
  • E Adarsh Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
  • Leenu Rajarajeswari MedicalCollege and Hospital, Bengaluru, Karnataka, India
Keywords: Gestational age, Placental pathology, Preterm infants

Abstract

Background and Objective: Placental pathology has been implicated in the pathogenesis of preterm neonatal morbidity.
However, the role of placental infection in the occurrence of neurological, lung, and infection morbidity among prematurely born
infant remains controversial. Furthermore, there is disagreement regarding the association between sepsis in preterm neonate
and in utero exposure to placental infection.
Objective: The present study was undertaken to investigate the association of placental pathology with the preterm and term
delivery.
Materials and Methods: Design: This was a hospital-based observation study. The study included 100 placentas including
60 preterm placenta and 40 term placenta from singleton live birth delivered at Rajarajeshwari Medical College and Hospital
from November 2018 to November 2019.
Results: As placental weight is one of the key indicators of fetal intrauterine status, among term placenta 26% weighed
between 501 and 750 g and 14% weighed between 251 and 500 g. In the late preterm placenta, 6% were within 501–750 g
and 38%were within 251–500 g. Among the early preterm placentas, 2% were found to be within 100–250 g and 14% were
found to be within 251–500 g. Histopathological findings among term placenta in which 23% of the placentas were found to be
with normal morphology, having two arteries and one vein embedded in myxoid matrix and unremarkable, maternal surfaces
show mature vascularized villi and fetal parenchyma also shows mature villi and 5% showed features of chorioamnionitis,
8% of the placentas revealed occasional focal areas of calcification on the maternal as well fetal surfaces, 15% showed
infarction, and 3% showed hemorrhagic changes. Histopathology findings among preterm placenta in which 14% normal
morphology, 21% of chorioamnionitis, 10% shows focal and extensive areas of infarction with increased syncytial knots, 4%
had hemorrhagic and perivasculitis changes with focal hyalinized villi, and 5% had villitis with mixed inflammatory infiltrate
in the chorionic villi. Histopathology study among term and preterm comparison, it shows chorioamnionitis with Chi-square
19.604 with confidence interval of 35.66–77.04% with P < 0.0001, calcification with P = 0.466, placental infarction with
confidence interval of 41.51–92.47% with P = 0.0002, placental hemorrhage with confidence interval of −31.33%–52.31%
with P = 0.613, and villitis with confidence interval of 38.55–100% with P = 0.002. Relative risk with respect to histopathology
among term and preterm placenta relative risk is 2.3 which means that preterm group has 2.3 times more risk of abnormal
placental histopathology than term group.
Conclusion: Among histopathological study between term and preterm placenta, preterm placentas were most commonly
associated with abnormal histopathological findings, among abnormal histopathological finding chorioamnionitis is the most
common.

Author Biographies

C Y Nagesh, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India

Junior Resident, Department of Paediatrics

R Prema, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India

Professor, Department of Paediatrics

E Adarsh, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India

Professor and Head, Department of Paediatrics,

Leenu, Rajarajeswari MedicalCollege and Hospital, Bengaluru, Karnataka, India

Final Year Under Graduate

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Published
2021-09-29