Study of Gross and Histological Features of Placenta in Intrauterine Growth Retardation

Abstract

Fetal growth retardation is most commonly caused by failure of the placenta to meet the increasing demands for oxygen and substrate of the developing fetus. Intra uterine growth retardation is common occurrence in Indian setup. Recent literature suggests that placental causes are more common than the maternal causes in intrauterine growth retardation. Gross and histological study of placenta can help us to understand the pathophysiology of placental involvement. This is warranted specially in those cases of intrauterine growth retardation which are not confounded by maternal causes. Fifty five placentae [30 from cases of intrauterine growth retardation and 25 from normal (control)] were utilized for the study. Fetal weights, placental weights and placental dimensions were measured. Tissue for histological examination was obtained from: i) Umbilical cord ii) membranes and iii) three zones in placenta. The tissues were processed and stained with Haematoxlyin and Eosin. Tissues were microscopically studied for villous and intervillous lesions utilizing various criteria. Microscopic findings were: i) increased fibrinoid necrosis (46.7%), increased perivillous fibrinoid deposition (16.7%), increased syncytial knots (60%) and increased placental infarction (1.8%). Macroscopically there was significant decrease in placental weight, fetal weight, diameter and thickness of placenta. The findings of the present study document comparatively higher incidence of fibrinoid necrosis and perivillous fibrinoid deposition. These findings underscore the predominant role of placental causes in cases of idiopathic intrauterine growth retardation.