EVALUATION OF PLACENTAL PATHOLOGIES IN HYPERTENSIVE VS. NORMOTENSIVE PREGNANCIES

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and fetal morbidity and mortality worldwide. These conditions are closely linked to placental abnormalities that may compromise fetal development and contribute to adverse pregnancy outcomes. Objective: To compare the occurrence and types of placental abnormalities in hypertensive versus normotensive pregnant women at the time of delivery. Methods: This cross-sectional study was conducted over eight months in a tertiary care hospital in Lahore, Pakistan. A total of 200 pregnant women were enrolled, including 100 with hypertensive disorders and 100 normotensive controls. Placentas were collected immediately after delivery for gross and histopathological examination. Parameters such as placental weight, infarctions, hematomas, calcifications, and microscopic lesions including syncytial knots, villous infarctions, and vascular malperfusion were evaluated. Data were analyzed using SPSS version 26. Independent t-tests and chi-square tests were used for statistical comparisons, with p-values <0.05 considered significant. Results: Hypertensive pregnancies exhibited significantly more placental abnormalities compared to normotensive ones. Mean placental weight was lower in the hypertensive group (437.5g vs. 496.2g). Rates of infarctions (42% vs. 15%), hematomas (19% vs. 6%), and calcifications (51% vs. 28%) were notably higher. Histologically, increased syncytial knots (67% vs. 23%), villous infarctions (54% vs. 16%), and maternal vascular malperfusion (63% vs. 19%) were significantly more prevalent in hypertensive pregnancies. Conclusion: Hypertensive disorders are associated with significant structural and vascular changes in the placenta, which may underlie poor perinatal outcomes. Placental evaluation in such pregnancies is essential for understanding disease impact and guiding clinical management.