Effects of Preeclampsia and Intrauterine Growth Restriction on Morphology of Placenta and Birth Weight of Fetus in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
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Date
2020-08
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Addis Abeba University
Abstract
Background: The placenta is a unique characteristic of higher mammals that develops in the
uterus during pregnancy. It is connected with the fetus through the umbilical cord. Preeclampsia
(PE) and Intrauterine growth restriction (IUGR) influence the normal function of the placenta
which in turn affects the birth weight of the fetus.
Objective: To comparethe Effects of Preeclampsia and IUGR on Morphology of Placenta and
Birth Weight of Fetus in Tikur Anbessa Specialized Hospital from May 2019 to June 2019.
Method:A comparative cross-sectional study was conducted on 54 pregnant women consisting
of 22 mothers with PE, 10 with IUGR, and 22 without any complication. Maternal, fetal, and
placental data were recorded after delivery. The micro/macroarchitecture of the placenta was
examined by inspection, measuring and microscopically. The data were entered using EPI data
version 4.2.0 and analyzed by SPSS version 21. One way ANOVA was performed to compare
the mean differences of the placenta and the newborn’s weight across the groups. P values less
than 0.05 were assumed as statistically significant.
Results: The findings showed that placental weight was 485.45gm in the normotensive,
422.27gm in the PE, and 328.00gm in IUGR groups (p<0.002). The mean placental diameter was
19.05cm, 17.07cm, and 15.08cm in uncomplicated, PE, and IUGR mothers respectively
(p<0.001). The mean placental thickness was 21.16mm in uncomplicated, 19.42mm in PE, and
17.06mm in IUGR mothers (p<0.001). The mean placental number of cotyledons in the
uncomplicated group was 19.00 whereas it was 17.18 and 15.10 in PE and IUGR participants
respectively (p<0.001). Histological results; placental calcification was observed in 60% of
IUGR and 36.4% of PE, infarction in 40% of IUGR and 36.4% of PE, thrombosis in 30% of
IUGR, cytotrophoblast proliferation in 31.8% PE, syncytial knots in 36.4% of PE, basement
membrane thickening in 30% of IUGR and fibrinoid necrosis in 22.7% of PE groups.
Conclusion: Preeclampsia and IUGR significantly decreased the weight, diameter, thickness,
and the number of cotyledons of the placenta. The weights of the babies also were significantly
smaller in IUGR. Even though it was not statistically significant histological abnormalities of the
placenta was more common among IUGR and PE patients than the uncomplicated pregnancies.
Using the current study as a baseline, investigations should be conducted on the effects of
specific types of preeclampsia on morphology of placenta.
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Keywords
Birth weight, Intrauterine growth restriction, Morphology, Placenta, Preeclampsia