Study of histological changes of placenta in pregnancy-induced hypertension in poorvanchal region of Uttar Pradesh, India

Introduction: The placenta is a fetomaternal organ. It is a connection of the fetus with the uterine wall of mother. Through the placenta, exchange of gases and nutrient supply takes place. Through the placenta, fetal blood tissue comes in direct contact with the maternal blood without any rejection. It is a special transient organ of pregnancy. In our study, we carried out the microscopic examination of the placenta in pregnancy-induced hypertension, i.e., syncytial knot, cytotrophoblastic cellular proliferation, fibrinoid necrosis, endothelial proliferation, and calcified villous spot. Material and Methods: One hundred and fifty-two placentas of full-term pregnancy were collected from the labor room/operation theater of the Gynecology and Obstetrics Department of the Government Medical College and Superfacility Hospital Azamgarh. Out of one hundred and fifty-two placentas, 76 cases were controls from mothers with no known history of preexisting hypertension and 76 were collected from mothers with pregnancy-induced hypertension. Placentas were kept in 10% formalin for 24 h for fixation. After 24 h, tissues of placentas were passed through a series of the procedures from dehydration and clearing to wax impregnation before being sectioned from automated microtome. Time took for processing was 24 h. Five microns thick tissues sections were cut. Prepared slides were mounted in DPX and covered with the cover slip. Through binocular light, microscope slides were examined at ×10, ×40, and ×100 magnifications. Results: Histology in our study revealed that syncytial knots were present in placentas of all 100% of hypertensive and only 32.89% of normotensive mothers. Cytotrophoblastic proliferation was seen in 98.68% and 19.73% placentas of hypertensive and normotensive mothers, respectively. Fibrinoid necrosis of placenta was found in 88.15% of hypertensive and only 28.94% of normotensive mothers. The 100% placentas of the hypertensive mothers had endothelial proliferation as compared to controls. Calcified villous spots were seen in 84.21% and 31.57% of placentas of hypertensive and normotensive mothers, respectively. Discussion and Conclusion: Pregnancy-induced hypertension adversely affects the health of the fetus through its harmful effects on the placentas. Syncytial knots, cytotrophoblastic cellular proliferation, fibrinoid necrosis, endothelial proliferation, and the calcified villous spots were present more in the placentas of hypertensive mothers in our study in comparison to the study of other authors. In our research, we found that endothelial proliferations were present in all placentas. If proper treatment is given to the mother in the early stage of pregnancy, it may prevent the death of a fetus. Hence, this study helps the clinician for early diagnosis and treatment of pregnancy-induced hypertension.