R.K. Diwan

Morphological and morphometric evaluation of placenta in hypothyroid mothers

Introduction: Pregnancy has a significant impact on thyroid gland and its function. Hypothyroidism, usually evident as subclinical hypothyroidism, occurs in approximately 2.5% of otherwise normal pregnancies, and is associated with various morphological, histological, and histochemical changes in the placenta. It is, therefore, obvious that hypothyroidism is associated with gross placental abnormalities that compromise placental function and hence fetal growth. Material and Methods: This prospective, observational study was conducted over a period of 1 year from August 2013 to July 2014 in a tertiary care teaching hospital in the state capital of Uttar Pradesh of India. Two groups were formed. Group A (euthyroid) included placenta of uncomplicated pregnancy with full-term delivery to serve as controls for comparison. Group B (hypothyroid) included placenta of patients with hypothyroidism (thyroid stimulating hormone level: ≥3.0 IU/L) diagnosed either before or during pregnancy. Each placenta was observed for shape, diameter, and number of cotyledons. Two groups were compared for these variables. Statistical analysis was performed using Statistical Package for Social Sciences version 15.0 statistical analysis software. The values were represented in number (%) and mean ± standard deviation. P value was calculated for each variable, and P value less than 0.05 was considered to be statistically significant. Results: A total of 70 subjects were included. Group A comprised of 20 and Group B of 50 subjects. Circular shape of placenta was more common in group B and the difference was statistically significant (P = 0.037). Mean diameter, cotyledon size, and mean thickness were higher in group B as compared to group A. Statistically, significant differences between the two groups were observed for mean diameter (<0.001), cotyledon size (<0.001), and thickness (<0.05) Conclusion: Placenta of hypothyroid mothers was usually circular in shape. It was found to be less heavy and thinner but larger in diameter with more cotyledons in comparison to normal.