Morphological Changes in Placenta Associated with Maternal Hypertension at PMCH, Patna

Abstract

Background: Hypertensive disorders of pregnancy are important contributors to maternal and perinatal morbidity and mortality worldwide. Maternal hypertension leads to uteroplacental insufficiency resulting in significant gross placental alterations that adversely affect fetal growth and pregnancy outcome.
Objective: To evaluate gross morphological changes in placenta associated with maternal hypertension and correlate these findings with fetal outcome.
Materials and Methods: A hospital-based cross-sectional observational study was conducted in the Department of Anatomy in collaboration with the Department of Obstetrics and Gynecology at PMCH, Patna. A total of 100 placentae obtained from hypertensive pregnancies were examined. Gross morphological parameters including placental weight, diameter, thickness, placental infarction, calcification, retroplacental hematoma, and cord insertion abnormalities were evaluated. Statistical analysis was performed using SPSS version 25. Quantitative variables were expressed as mean ± standard deviation. Chi-square test and Student’s t-test were applied, and p-value <0.05 was considered statistically significant.
Results: The majority of mothers belonged to the age group of 21–30 years (62%). Reduced placental weight was observed in 56% cases, placental infarction in 48%, calcification in 42%, retroplacental hematoma in 18%, and abnormal cord insertion in 12% cases. Mean placental weight progressively decreased with increasing severity of hypertension and was lowest in eclampsia cases (398 ± 42 g; p <0.001). Placental infarction showed significant association with low birth weight (p = 0.002).
Conclusion: Maternal hypertension produces significant gross placental morphological alterations that reflect uteroplacental insufficiency and are associated with adverse fetal outcomes. Careful gross placental examination may provide important prognostic information regarding fetal wellbeing.