Anatomy

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Browsing Anatomy by Subject "Anemia, Placenta, Birth Weight, Morphology"

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    Morphological Changes of Placenta and Birth Weight of Fetus Associated with Maternal Anemia in Dessie Referral Hospital, North East Ethiopia.
    (Addis Ababa Universty, 2018-10) Gebremeskel, Teshome; Mulu, Abay (Assistant Professor of Anatomy)
    Background: – Placenta is a feto maternal organ composed of maternal component, decidua basalis, and a fetal component, chorion frondosum. The intra-uterine existence of the fetus is dependent on this vital organ. Anemia during pregnancy is considered as a cause of pre-placental hypoxia which can give rise to fetal hypoxia and its complications. Objective: – To compare the morphological changes of placenta and birth weight of the fetus associated with maternal anemia in Dessie Referral Hospital from February, 2018-October, 2018. Methods and Materials: – A comparative cross sectional method was conducted from May-June, 2018 at Dessie Referral Hospital. Informed consent was taken from mothers under the study and a total of 96 placentas (48anemic and 48 non anemic) was collected after delivery at labor room. The diameter and thickness was measured, the number of cotyledons was counted and shape of placenta was noted. Placenta and fetus was weighed in the same scale. Tissue for microscopy was taken from 66 placentas (33 anemic and 33 non-anemic). Ocular micrometer was used to measure the width of intervillous space. EPI data version4.2.0 was used to enter the data and the data was analyzed by SPSS version 21.One way ANOVA and independent sample t- test was used to compare the mean differences of the groups. Result: -In pregnancies with maternal anemia, mean placental weight was 544±98g and for non- anemic mother’s it was 502±93g (p=0.03). The mean birth weight in anemic group was 2502±360 g and in non-anemic group 3035±305 g (p<0.001). The mean number of cotyledons, was 13.5±1.8 and 17.6±1.1, (p<0.001) in anemic and non-anemic groups, respectively. There was a significant difference in mean placental diameter of anemic 18±1.5cm and 17±1.5 cm in non-anemic mothers (p<0.001).Placenta was thicker in anemic mothers 22.7±2.4 mm than non-anemic mothers 20±0.6 mm, (p<0.001). A major shape of placenta in this study was circular followed by oval in both groups. However, 4(8.3%) irregular and 2(2.1%) succenturiate lobe was observed in anemic mothers. Based on the result of microscopic morphology, 75.7% of anemic placentas terminal villi vessels were increased in number, compared to 15.1% in non-anemic (p=0.001). Placental calcification was 72.7% in anemic groups compared to 54% in non-anemic groups, however, it was insignificant (p=0.12). Eighty one percent of anemic placentas had diffuse syncytial knots compared to 15.1% in non-anemic groups. Intervillous space was wider in anemic compared to non-anemic groups (p<0.001). Conclusion: - Placenta was bigger in anemic mothers than non-anemic mothers with increased in mean placental weight, thickness and diameter. Maternal anemia was associated with decrease in number of cotyledons and birth weight of fetus. Majority of placental shape in this study was circular followed by oval both in anemic and non- anemic mothers. Vessels of terminal villi in anemic placenta were increased in number compared to non-anemic. Calcification of placenta was more prominent in anemic groups compared to non- anemic even though it was not significant. Intervillous space width was more prominent in anemic groups.