HISTOLOGICAL STUDY OF ABRUPTIO PLACENTAE IN TERM DELIVERY AND ITS IMPACT ON FETAL OUTCOME

Abstract

Objective: To identify the histological morphology of abruptio placentae and comparing it with that of normal placenta of normal pregnancy at term and to compare its impact on fetal outcome.

Study Design: A case control study.

Place and Duration of Study: The study was conducted at Anatomy Department of Federal Medical and Dental College in collaboration with Department of Obstetrics and Gynecology, Pakistan Institute of Medical Sciences (PIMS)/Shaheed Zulfiqar Ali Bhutto Medical University Islamabad over a period of eight months, from Jul 2015 to Feb 2016.

Material and Methods: Forty mothers with abruptio placentae and forty mothers with normal placentae of normal pregnancy were selected from emergency and outpatient department of Gynecology and Obstetrics Department of PIMS affiliated with Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU) Islamabad. Histological morphology was carried out on these placentae. A case control study with purposive sampling technique was done for comparison between two groups. A structured data collection check list was used to collect the required data. SPSS version 20 and MS Excel were used for statistical analysis. Students T test and Chi- Square tests were applied accordingly to compare the results of two groups, with p-value<0.05 being considered to be statistically significant.

Results: We included eight placentae with forty abruption cases and forty normal placentae. Among these frequent age was 26 to 30 years (50%). The mean fibrinoid necrosis was 11.4 ± 2.2 as compared to controlled group 6.1 ± 1.2. The mean syncytial knots of abruption placentae were 49.6 ± 10.2 as compared to normal placentae 30.7 ± 5.6. While the mean area of calcification was 6.3 ± 3.7 in patients compared to 1.1 ± 1.6 in the controls. Abruption placentae had great impact on fetal weight reduction from 3.1 ± 0.6 to 2.2 ± 0.7 and Apgar Score as well.

Conclusion: The histomorphological changes in abruptio placentae were statistically significant as compared to control group and lead to poor fetal outcome.