Placental histopathology in high-risk pregnancy

Sunil Kumar, Vijaya Sudarshan


Introduction: Placenta is a vital organ for the wellbeing of the fetus. Pregnancies with preganancy induced hypertension (PIH), diabetes, anemia etc. are associated with adverse neonatal outcome. Objective: This study explores the histopathological changes in the placenta of the mothers with conditions known to have an adverse effect on fetal well-being. Methods: The study was conducted at the Department of Obstetrics and Gynecology and Department of Pediatrics, Raipur. In the study, 96 placenta (with their membrane and cords) were included. Among 96 placenta, 72 were cases with maternal risk factors viz. bad obstetric history, maternal anemia, PIH, diabetes, history of handling, advanced age and 24 placenta were controls without significant risk factors and were studied for histopathological changes. Results: Women with a history of fetal-neonatal loss in the past showed more of chorioamnionitis (33%) in their placenta. Placental pathology of 20 anemic women was compared with non-anemic controls. Anemic mothers found to have more of infarction (60%), calcification (30%) and villous fibrosis (100%). Calcification was found in 33% of cases. Syncytial knots (p-0.001) and Cytotrophoblast proliferation (p<0.01) were statistically significant with females with PIH as compared to controls and the incidence of villous fibrosis with diabetic mother was statistically significant (p-0.04). Conclusion: In the present study, it was found that the placenta in anemic mothers showed evidence of uteroplacental ischemia and early senescence. Diabetic mothers showed signs of dysmaturity and increased fibrinoid necrosis with evidence of placental insufficiency responsible for increased morbidity in the newborn of diabetic mothers.

Full Text:



Norwitz ER, Schust DJ, Fisher SJ. Implantation and the survival of early pregnancy. DOI:10.1056/NEJMra000763

Fox H. The histopathology of placental insufficiency. J Clin Pathol Suppl (R Coll Pathol). 1976;10:1-8.

Redline RW, Patterson P. Patterns of placental injury. Correlations with gestational age, placental weight, and clinical diagnoses. Arch Pathol Lab Med. 1994 Jul;118 (7): 698-701.

Nahar L, Nahar K, Hossain MI, et al. Placental changes in pregnancy induced hypertension. Mymensingh Med J. 2013 Oct;22(4):684-93.

Evers IM, Nikkels PG, Sikkema JM, Visser GH. Placental pathology in women with type 1 diabetes and in a control group with normal and large-for-gestational-age infants. Placenta. 2003 Sep-Oct;24(8-9):819-25.

Saha S, Biswas S, Mitra D, Adhikari A, Saha C. Histologic and morphometric study of human placenta in gestational diabetes mellitus. Ital J AnatEmbryol. 2014; 119 (1):1-9.

Rangnekar AG, Darbari R. Placental changes in pregnancy anaemia : A study of one hundred cases: J Obstet Gynaecol India.1993; 43(4): 473-8.

Rusia U, Bhatia A, Kapoor S, et al. Placental morphology & histochemistry in iron deficiency anemia. Indian J Med Res. 1988 May;87:468-74.

Singla PN, Chand S, Khanna S, Agarwal KN. Effect of maternal anaemia on the placenta and the newborn infant. Acta Paediatr Scand. 1978 Sep;67(5):645-8.

Boyd TK, Redline RW. Chronic histiocytic intervillositis: a placental lesion associated with recurrent reproductive loss. Hum Pathol. 2000 Nov;31(11):1389-96.

Guzman ER, Shen-Schwarz S, Benito C, et al. The relationship between placental histology and cervical ultrasonography in women at risk for pregnancy loss and spontaneous preterm birth. Am J Obstet Gynecol. 1999 Oct; 181(4):793-7.

Ghidini A, Salafia CM. Histologic placental lesions in women with recurrent preterm delivery. OI:10.1111/j. 0001-6349.2005.00694.x

Anjali R. Masodkar et al. Histopathology ofplacenta and its correlation worth outcome: Journal of Obstetrics and Gynaecology of India, 1985: 35(2): 294-300.

Fox H. Pathology of the placenta in maternal diabetes mellitus. Obstet Gynecol. 1969 Dec;34(6):792-8.

Anjali Satosar. Histologic correlates of viral and bacterial infection of the placenta associated with severe morbidity and mortality in new born. Human Pathology 2006; 35(5): 536-545. Doi: 10.1016/J. Humpath. 2004. 01.015.

Naeye RL, Friedman EA. Causes of perinatal death associated with gestational hypertension. Am J Ob Gyn. 1979;133(8):8-10. Doi: 10.1016/0002-9378(79)90402-2.

Arias F, Rodriquez L, Rayne SC, Kraus FT. Maternal placental vasculopathy and infection: two distinct subgroups among patients with preterm labor and preterm ruptured membranes. Am J Obstet Gynecol. 1993 Feb;168 (2):585-91.


  • There are currently no refbacks.