Placental changes in eclampsia and fetal outcome.

Mymensingh Med J 16(2):191-6 (2007) PMID 17703158

Eclampsia-a common pregnancy induced disorder that poses a great threat to the fetus secondary to the placental changes. Since placenta is mostly vascular organ, the present comparative study was designed to examine microscopic vascular changes as well as to observe their impact on the macroscopic dimensions of the placenta and on the fetus in eclamptic and normal pregnant women. The study was carried out in the department of Anatomy, Bangabandu Sheik Mujib Medical University (BSMMU) during the period of October 2000 to August 2001. Forty human placentas were collected just after Caesarian section at 37 to 40 weeks of gestation: 20 from mothers with eclampsia and 20 from non-diabetic, non-eclamptic, normotensive control mothers. Compared to the Control group the value regarding weight, volume, diameter and thickness were significantly smaller values in the Eclampsia group (p0.001). Microscopically there was a general tendency of increased intimal thickness due to atherosclerotic type of changes in eclampsia in 1st, 2nd and last branching sites of chorionic arteries. Statistical significance difference was observed more in case of the 1st and 2nd branching site (p0.001). The positive correlation between placental and neonatal weight reached a significant level. Although not all the significant findings support each other. Considering the tendencies of increased intimal thickness and suggestions from other studies, it seems that in the eclamptic placentas, successful compensatory effort against chorionic arterial atherosclerosis fails to protect the fetuses and placentas face more severe forms of atherosclerosis, and consequently gave rise to smaller babies.