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

Abstract

Niger Delta Journal of Medical Sciences 37

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 abnormal

cord 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.