Histopathological Study of Full-Term Placenta in Selected Normotensive And Pre-eclamptic Women in Bangladesh

N. A. Khan, N. Nahid, M. Chowdhury, M. Z. Hossain, M. S. A. Patwary, M. Kamal, Khandaker Farah Anjuman Ikra
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Abstract

Pre-eclampsia is a disorder of 2nd half of pregnancy, which is characterized by a combination of hypertension, proteinuria and edema, secondary to decreased placental perfusion. Clinical studies suggest that there are histopathological changes in the placenta of pre-eclamptic women, compared to normotensive pregnant women. In developing countries, pre-eclampsia causes an estimated 50,000 maternal deaths per year. Only a small number of studies have however, been conducted in Bangladesh. Objective: To compare the histopathology of placenta in selected pre-eclamptic and normotensive pregnant women. Methods: 220 pregnant women were selected with inclusion and exclusion criteria from 3 different medical colleges and divided into 2 groups – A study group, consisting of 110 pre-eclamptic women and a control group consisting of 110 normotensive pregnant women. Dietary information was collected by 7 days food frequency questionnaire and food score was determined. Anthropometric and biochemical tests were performed. To evaluate the histopathology of placenta, tissue samples were collected from the placenta after delivery, and were prepared for histopathological studies, by haemotoxylin and eosin stain method. The mean number of areas of syncytial knot formation, the mean number of areas of cytotrophoblastic cell proliferation, the mean number of areas of fibrinoid necrosis, and the mean number of areas of hyalinised villi of pre-eclamptic and normal pregnant women were evaluated. Results: The mean number of areas of syncytial knot formation, the mean number of areas of cytotrophoblastic cell proliferation, the mean number of areas of fibrinoid necrosis, and the mean number of areas of hyalinised villi were found to be significantly higher in the study group, compared to the control group. Conclusion: Therefore, mean number of areas of syncytial knot formation, the mean number of areas of cytotrophoblastic cell proliferation, the mean number of areas of fibrinoid necrosis is increased in the placenta of pre-eclamptic women, compared to normotensive pregnant women. J Dhaka Med Coll. 2021; 30(2) : 189-195
孟加拉国正常血压和先兆子痫妇女足月胎盘的组织病理学研究
先兆子痫是发生在妊娠后半期的一种疾病,以高血压、蛋白尿和水肿为特征,继发于胎盘灌注减少。临床研究表明,与血压正常的孕妇相比,子痫前期妇女的胎盘有组织病理学变化。在发展中国家,估计每年有5万名产妇死于先兆子痫。然而,在孟加拉国只进行了少量的研究。目的:比较子痫前期与血压正常孕妇胎盘组织病理学的差异。方法:选取3所不同医学院校符合纳入和排除标准的孕妇220例,分为2组:研究组110例先兆子痫妇女,对照组110例血压正常孕妇。采用7 d食物频率问卷法收集饲粮信息,并进行评分。进行人体测量和生化试验。为评价胎盘组织病理学,取胎盘组织标本,采用血氧素染色法和伊红染色法进行组织病理学研究。评估子痫前期和正常孕妇合胞结形成的平均面积、细胞滋养细胞增殖的平均面积、纤维蛋白样坏死的平均面积和透明绒毛的平均面积。结果:研究组合胞结形成的平均面积、细胞滋养层细胞增殖的平均面积、纤维蛋白样坏死的平均面积和透明绒毛的平均面积均显著高于对照组。结论:与血压正常的孕妇相比,子痫前期妇女胎盘中合胞结形成的平均面积、细胞滋养层细胞增殖的平均面积、纤维蛋白样坏死的平均面积均增加。达卡医学院,2021;30(2): 189-195
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