Placental changes and perinatal outcomes among women with preeclampsia/eclampsia and normotensive women: A comparative study

Abstract

Objective: The study objective was to evaluate placental changes and the perinatal outcomes among women with preeclampsia/eclampsia and compare to normotensive pregnant women. Materials and Methods: This was a comparative (prospective) study, participants were 146 pregnant women; 73 preeclamptic/eclamptic (study group) and 73 normotensive (control group) at 28–40-week gestation selected by purposive sampling. The primary outcome measure was the placenta characteristics, while the secondary outcome was the perinatal outcomes. Statistical analysis was done using SPSS version 23.0, and statistical significance was set at P ≤ 0.05. Results: The mean placental weight for study group was significantly lower than controls (556.82 g ± 169.72 vs. 649.93 g ± 116.38; P ≤ 0.001); 12 (16%) placentae in the study group had gross placental infarction compared to none (0%) among controls. Study group placentae showed 11 types of microscopic placental changes compared to four among controls. Decidual vasculopathy (P = 0.049), incomplete vascular modeling (P = 0.019), accelerated villi maturity (P = 0.049), acute chorioamnionitis (P = 0.048), and microcalcifications (P = 0.040) were significantly associated with low APGAR scores in the study group. The 1st and 5th min APGAR scores were lower in the study group (P ≤ 0.001, 49.3% vs. 8.2%) and (P = 0.002, 11% vs. 0%), respectively, while all the eight perinatal mortality recorded were in the study group. Conclusion: Preeclampsia/eclampsia is associated with abnormal gross and microscopic placental changes which predisposes to increased adverse perinatal outcome. Antenatal surveillance for preeclampsia/eclampsia should prioritize Doppler studies to characterize the placenta and appropriately plan the delivery.