Relationship between Maternal Diseases and Placental Morphology among Parturient’s in Port Harcourt, River State: A Multi-Centre Study.
Main Article Content
Keywords
Maternal Medical Diseases, Parturient , Placental Morphology, Port Harcourt, Relationship.
Abstract
Background: Maternal diseases that complicate pregnancies such as Pregnancy induced hypertension (PIH) or Gestational Diabetes Mellitus (GDM) etc are markedly impressed on the placenta microscopically and macroscopically resulting in in defective placental development and perinatal morbidity and mortality. This study aimed to study the gross anatomy of the placenta and its relationship with maternal medical illnesses.
Methodology: This study was a multi-centre hospital-based prospective cross-sectional study of 250 parturient who had term deliveries in Port Harcourt. The socio-demographic data and the medical history of the parturient were collected using a proforma. The placenta was collected after delivery and examined, and the morphometric features were noted. Data analysis was done with SPSS IBM version 23. Correlation and Regression analysis were employed in investigating the relationship between maternal/neonatal characteristics and placental morphology. Statistical significance was at a p-level of less than 0.05.
Results: The mean age of the women ± SD = 30.44±4.1years and the median parity was para-2. Gestational Hypertension was the most common medical condition among participants. There was a statistically significant association between the maternal medical conditions and the placental shape with a preponderance of the oval shape among the women with hypertensive disorders. There was also, a statistically significant association between maternal medical conditions in pregnancy and other placental measurements such as weight, number of cotyledons, diameter, thickness, and cord insertion.
Conclusion: Maternal medical conditions in pregnancy was found to have significant macroscopic imprints on the placental morphology and these can help in the diagnosis and management of medical illnesses that complicate pregnancies in our environment. More research is needed to establish causation.
References
2. Burton GJ, Fowden AL. The placenta: a multifaceted, transient organ. Phil. Trans. R. Soc. B 2015;370: 20140066. http://dx.doi.org/10.1098/rstb.2014.0066
3. Louise, C. Pre-eclampsia and other disorders of placentation. In: obstetrics by Ten Teachers, 19th edition (Nineteenth edition), 2011;120.
4. Ilekis JV, Tsilou E, Fisher S, Abrahams VM, Soares MJ, Cross JC, et al. Placental Origins of Adverse Pregnancy Outcomes: Potential Molecular Targets- An Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. American Journal of Obstetrics and Gynecology, 2016;215(1): S1-S46. doi: 10.1016/j.ajog.2016.03.001.
5. Roberts J, Cooper DW. Pathogenesis and genetics of pre-eclampsia. The Lancet, 2001;357(9249), 53-56.
6. Benirschke, K. The placenta-how to examine it and what you can learn. Contemporary ob gyn, 1981;17(3), 117
7. Kouvalainen K, Pynnönen AL, Mäkäräinen M, Peltonen T. Weights of placenta, fetal membranes and umbilical cord. Duodecim; laaketieteellinenaikakauskirja, 1971; 87(17): 1210-1214.
8. Majumdar S, Dasgupta H, Bhattacharya K, Bhattacharya A.. A study of placenta in normal and hypertensive pregnancies. Journal of Anatomical Society India, 2005; 54: 1 - 9.
9. Soma H, Yoshida K, Mukaida T, Tabuchi Y. Morphologic changes in the hypertensive placenta. Contributions to Gynecology and Obstetrics, 1982a; 9: 58-75.
10. Arey LB. The presence and arrangement of smooth muscle in the human placenta. Anatomical Record. 1948; 100(4)636-643.
11. Kirkwood BR, Sterne JA. C. Essential Medical Statistics 2nd ed. United Kingdom. Blackwell Science, United Kingdom, 2003; 420 - 421.
12. Afodun AM, Ajao MS, Enaibe BU. Placental Anthropometric Features: Maternal and Neonate Characteristics in North Central Nigeria. Advances in Anatomy, 2015; 790617: 1-6
13. Abaidoo CS, Boateng KA, Warren MA. Morphological Variations of the “Baby's Supply Line” Journal of Science and Technology. 2008; 28(2): 1 - 9.
14. Vandana T, Punita M, Pankaj AK, Amita P, Archana R. Study of Shape of Placenta and Its Relation to Placental Weight in Normal and Diabetic Pregnancies. International Journal of Multidisciplinary Research and Development, 2015; 2(9): 666-669.
15. Soma H, Yoshida K, Mukaida T, Tabuchi Y. Morphologic changes in the hypertensive placenta. Contributions to Gynecology and Obstetrics. 1982a; 9: 58-75.
16. Kajantie E, Thornburg K, Eriksson JG, Osmond L, Barker DJ. In preeclampsia, the placenta grows slowly along its minor axis. International Journal of Developmental Biology. 2009; 54(2-3), 469-473.
17. Punshon T, Li Z, Jackson BP, Parks WT, Romano M, Conway D, et al. Placental metal concentrations in relation to placental growth, efficiency, and birth weight. Environment International, 2019; 126: 533-542.
18. Evers I, Nikkels P, Sikkema J, Visser G. Placental pathology in women with type 1 diabetes and in a control group with normal and large-for-gestational-age infants. Placenta, 2003; 24(8-9): 819-825.
19. Afadhali DR, Kelvin MK. The Effect of Placental Weight And Cotyledon Count To The Fetal Birth Outcome At A Regional Referral Hospital In Tanzania International Journal of Anatomy and Research, 2017; 5(4.2): 4538-4542.
20. Clifton VL, Giles WB, Smith R, Bisits AT, Hempenstall PA, Kessell CG. Alterations of placental vascular function in asthmatic pregnancies. American Journal of Respiratory and Critical Care Medicine. 2001; 164(4): 546-553.
21. Udainia A, Jain ML. Morphological Study of Placenta in Pregnancy Induced Hypertension With its Clinical Relevance. J Anat. Soc. India. 2001; 50(1): 24-27
22. Majumdar S, Dasgupta H, A Study of Placenta in Normal and Hypertensive Pregnancies. J Anat Socie India. 2005; 54(2): 1 – 9.
23. Kulandaivelu AR, Srinivasamurthy BC, Murugan A, Mutharasu A. Morphology and morphometric study of human placenta in rural southern India. British Journal of Medicine and Medical Research. 2014; 4(15): 2995.
24. Saha S, Biswas S, Mitra D, Adhikari A, Saha C. Histologic and morphometric study of human placenta in gestational diabetes mellitus. Italian Journal of Anatomy and Embryology. 2014; 119(1): 1-9.
25. Kambale T, Iqbal B, Ramraje S, Swaimul K, Salve S. Placental morphology and fetal implications in pregnancies complicated by pregnancy-induced hypertension. Medical Journal of Dr. DY Patil University. 2016; 9(3): 341.
26. Desoye G, Hauguel-de Mouzon S. (2007). The human placenta in gestational diabetes mellitus: the insulin and cytokine network. Diabetes care. 2007; 30(2): S120-S126.
27. Clapp JF, Schmidt S, Paranjape A, Lopez B. (2004). Maternal insulin-like growth factor-I levels (IGF-I) reflect placental mass and neonatal fat mass. American Journal of Obstetrics and Gyn 2004; 190(3):730-736. an Journal of Obstetrics and Gynecology, 190(3), 730-736.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.
Oluwagbemiga Adewale, Ultimate Specialist Hospital, Port Harcourt, Rivers State, Nigeria.
Consultant, Department of Obstetrics and Gynaecology