Dhivya R, Nina V Kate, Lalitha P, Kanjanamala A
Abstract: Preterm birth is multifactorial and has long term health consequences for the child. Placenta plays a central role in preterm birth and the placental pathology was associated with adverse maternal and neonatal outcomes in various studies, which highlights the importance of placental examination in preterm births. Hence, we studied gross and histopathology of preterm (cases) placentas and their association with neonatal outcome. Controls were term deliveries. A total of 300 placentas, 150 preterm and 150 term were examined and the respective neonates were followed for complications till discharge. Results and conclusion:Abnormal placental pathology found in preterm placentas were infarction (22%), calcification(44%), acute (2.7%) and chronic (5.3%) chorioamnionitis, marginal cord insertion (17.3%), thin cord (6%), false knot(1.3%).Fibrinoid necrosis (1.3%) and fleshy cord (4%) were found in term placentas. Outcomes in preterm neonates observed were low Apgar scores (10.7%), NICU admission (32%), respiratory distress syndrome (28.7%), neonatal jaundice (6.7%), intraventricular hemorrhage (2%), seizures (1.3%), retinopathy of prematurity(0.7%) and sepsis (3.3%). 45.5% of infarction in preterm placentas was associated with RDS and 25% of chronic chorioamnionitis was associated with sepsis were statistically significant, (p<0.05). Thin umbilical cords were significantly associated with IUGR and oligohydramnios.
Keywords: Preterm birth, Placental pathology, Neonatal outcome, Association