Quantitative Correlation between Abruptio Placentae and Normal Termed Placental Morphology

Abstract Placental abruption is an obstetric complication where the placental lining has separated from uterus, clinically presenting as vaginal bleeding in the latter half of pregnancy. In spite of its high incidence, there is lack of study on the anatomical basis of abruption. The present study was aimed at the quantitative analysis of the gross and histological features of the abruptio placenta and term human placenta. Forty five placentae comprising 30 from abruptio and 15 from normal patients were collected as study and control groups respectively. The placentae were fixed with 10% formalin. Gross morphological variables (placental weight, thickness, density) and histological features (cytotrophoblastic proliferation, syncytial knots, vasculosyncytial membrane, fibrinoid necrosis, basement membrane thickness, stromal fibrosis and infarction) were recorded and compared for both the groups. All statistical data were analyzed by using student’s t-test. Gross morphological variables showed no statistically significant relationship. For each histological parameter 200 villi were counted in each section of the two quadrants. We found statistically significant increase in cytotrophoblastic cell proliferation, syncytial knots, fibrinoid necrosis, basement membrane thickness, stromal fibrosis and infarction in abruption cases than in term placentae. Vasculosyncytial membrane was significantly reduced in abruption cases than in term placentae. All these histological findings correlate well with the uteroplacental ischemia in abruptio placentae.