PLACENTAL HISTOPATHOLOGY ACCORDING TO AMSTERDAM CRITERIA AND CORRELATION WITH MATERNAL AND NEONATAL OUTCOMES: A CASECONTROL STUDY

Aims And Objective: To assess the placental histopathology (as per the Amsterdam consensus criteria) with fetal placental Doppler and maternal & fetal outcomes in subjects with pre-eclampsia with severe features versus normotensive controls. Methods: A case control study was conducted over a period of 1 year at Medical college, Baroda which evaluated 40 women who were divided into 20 cases (PE with severe features) and 20 controls (normotensives) after matching chronological age, gestational age and parity. Parametric tests such as independent t-test and sensitivity, specificity and Odds ratio were calculated. Results: Placentae of subjects with PE with severe features were significantly small and having less weight than the normotensive controls. Mean thickness of UC in case group was 0.70±0.23cm and mean thickness in control group was 0.96±0.10cm with p value <0.0001. No significant difference was seen in Feto-placental ratio. Infarction was present in 65% of cases and 5% of controls. Decidual vasculopathy was seen in 90% of cases and was not at all seen in controls. Increased syncytial knots were seen in 100% of cases and 65% of controls with p value of 0.0040. Vascular sclerosis and stromal fibrosis were seen more in cases than in controls with p value 0.0196 and <0.0001 respectively. Conclusion: The Amsterdam classification was useful in delineating histopathological findings such as syncytial knots, infraction, decidual vasculopathy & villous stromal vascular karyorrhexis which were found to correlate with abnormal Doppler velocimetry and adverse maternal and neonatal outcomes. However, it was found to be tedious and time consuming.