Comparative Study of Microscopic Changes in Human Placenta of Pre-eclamptic and Eclamptic Patients of Eastern Uttar Pradesh

Introduction: Pregnancy-induced hypertension (PIH) is a major cause of maternal and perinatal morbidity worldwide and is known to significantly alter placental structure and function.These alterations impair uteroplacental perfusion and contribute to adverse outcomes such as intrauterine growth restriction, preterm birth, and stillbirth.Understanding the microscopic changes in the placenta associated with pre-eclampsia (PE) and eclampsia is essential for better insight into disease progression.Aim and objectives: To evaluate and compare the microscopic changes in placentas from normotensive pregnancies and those complicated by PIH (PE and eclampsia).Methodology: This comparative study was conducted in the Anatomy Department and Obstetrics and Gynecology Department at BRD Medical College, Gorakhpur.A total of 100 placentas were examined: 50 normal, 26 pre-eclamptic, and 24 eclamptic.All samples were collected immediately after delivery, fixed in 10% neutral buffered formalin, processed routinely, and stained with hematoxylin and eosin.Histopathological parameters were graded using standard scoring criteria and analyzed statistically using the Chi-square test.Results: All six histological parameters showed statistically significant associations and demonstrated progressively worsening lesions from normal to PE and eclampsia.Fibrin deposition increased from 0% in normal cases to 58% severe in eclampsia; fibrinoid necrosis from 0 to 96%; syncytial knots from 22 to 46% severe; cytotrophoblastic proliferation from 6 to 42% severe; endothelial proliferation from 0 to 71% severe; and calcification from 48 to 69%.Conclusion: Pregnancy-induced hypertension is strongly linked with progressive and characteristic placental histopathological alterations.The severity of microscopic changes increased from normal to PE and was most pronounced in eclampsia, reflecting worsening placental hypoxia and vascular injury.These findings highlight the value of placental evaluation in understanding disease severity and predicting fetal outcomes.