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Morphological study of placental changes in anemia with its clinical significant

Bhavika Panchal, Jigna Parmar, C D Mehta.

Abstract
Background: The placenta acts like a sieve, moving oxygen and nutrients from the mother’s body to baby and taking carbon dioxide and waste materials from the baby into mother’s body for elimination. The placenta also plays an important role in hormone production and releases hormones into both the maternal and fetal circulations to affect pregnancy, metabolism, fetal growth, and parturition. Earlier in developing countries women often become anemic during pregnancy because the demand of iron and vitamins will increase. Fetuses are at risk of preterm deliveries, low birth weight due to impairment of oxygen delivery to placenta and fetus.

Objectives: To study the morphological changes in placenta in patients with anemia. And also to correlate between the degree of anemia with maternal and fetal complications.

Material and Methods: This study was conducted in the Department of Anatomy Government Medical College, Surat. The placentas were collected from labor room and gynecology operation theater. Total 130 cases were studied. Out of 130 cases 100 women having pregnancy with anemia and 30 cases belong to control group pregnant women without anemia.

Results: The weight of newborn baby in the present study is found to vary between 900 and 3400 g in the anemic group, where as it is between 2000 and 3500 g in the control group. Thus variation in the fetal weight is much more in the anemic group. Mean placenta weight is 500.30 g in mild anemic groups, 454.73 g group for moderate anemic group, and 405 g for severe anemic group. Majority of placenta in mild, moderate, and severe anemic groups are either round or oval in shape. There is no significant difference in the mean thickness of placenta in the control group and anemic group. The number of cotyledons in the present study is found to vary between 15 and 35 in the anemic group and it is between 17 and 29 in the control group. Surface area of placenta in the present study is found to vary between 133.10 cm2 in the anemic groups, where as it is between 176.32 cm2 in the control group. Mean placental coefficient is 0.203 for the anemic group and 0.0185 for control groups. The common site of insertion of umbilical cord in both the groups is eccentric.

Conclusions: It was concluded from the study that the weight of newborn baby is significantly low in anemia and it further decreased according to severity of anemia .Thickness of placenta is not much affected by anemia. Hence, it cannot be used as a reliable criterion for identification of anemia. Thus placenta acts as an effective index, by examination of which we can predicate the status of the fetus in neonatal life.

Key words: Placenta, morphology, anemia


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