Review began 06/07/2024
Review ended 06/10/2024
Published 06/21/2024
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Paiker et al. This is an open access article
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Morphological, Morphometric, and Histological
Evaluation of the Placenta in Cases of
Intrauterine Fetal Death
Mah Paiker , Kamil Khan , Dewanshi Mishra , Stuti Tandon , Abeer Khan , Asma Nigar ,
Syed Fiza Mustaqueem , Mahboobul Haque
1. Anatomy, Integral Institute of Medical Sciences and Research, Integral University, Lucknow, IND 2. Obstetrics,
Integral Institute of Medical Sciences and Research, Integral University, Lucknow, IND 3. Pathology, Integral Institute
of Medical Sciences and Research, Integral University, Lucknow, IND 4. Anatomy, All India Institute of Medical
Sciences, Patna, Patna, IND
Corresponding author: Dewanshi Mishra, dewanshimishra.dm@gmail.com
Abstract
Background
The human placenta is a remarkable organ that develops during pregnancy and is crucial in supporting fetal
growth and development. The placenta supplies oxygen and nutrients to the fetus and removes waste
products from the fetal bloodstream. It also produces hormones that support pregnancy, such as human
chorionic gonadotropin, progesterone, and estrogen. Placental insufficiency occurs when the placenta
cannot deliver adequate nutrients and oxygen to the fetus. This can result in intrauterine fetal death (IUFD),
stillbirth, intrauterine growth restriction, low birth weight, and premature birth. It can also be associated
with developmental delays or long-term health issues for the baby. This study aimed to assess the
morphologic, morphometric, and histologic changes in the placenta associated with IUFD and compare it
with the placenta of live births.
Methodology
This study was conducted at the Department of Anatomy in collaboration with the Department of Obstetrics
and Gynaecology, Integral Institute of Medical Sciences and Research and King George’s Medical University
Lucknow, where 60 placentas were studied. Placentas were further categorized into the following two
groups: Group A, the study group in which placentas from IUFD were taken (n = 30), and Group B, the control
group where placentas from live births were taken (n = 30). Morphological and morphometric features of
both groups were recorded and compared. Histological features of placentas from IUFD (Group A) were
examined after hematoxylin and eosin staining.
Results
A total of 60 placentas were observed (Group A and Group B). In Group A (IUFD) and Group B (control
group), most pregnancies were multigravidas. Round-shaped placentas were the most common type in both
groups (Group A = 46.67%, Group B = 66.67%). The average thickness of placentas from Group A (IUFD) cases
was significantly reduced (mean thickness = 1.17 ± 0.07 cm) compared to controls in Group B (mean
thickness = 2.04 ± 0.93 cm). The p-value obtained was significant at 0.0001. There was a notable reduction in
the average placental diameter in Group A (mean diameter = 241.73 ± 65.54 cm) compared to Group B (mean
diameter = 263.72 ± 162.67 cm). The p-value obtained was not significant at 0.49. On histopathological
examination of the placentas of Group A (IUFD), perivillous fibrin deposition and high-grade calcification
were seen in a significantly high number of placentas (70% and 60%, respectively).
Conclusions
The knowledge of the placenta’s morphologic, morphometric, and histologic changes can be utilized to
establish the cause of fetal death. In instances of fetal growth limitation and fetal demise that are clinically
inexplicable, they can also explain the causes.
Categories: Pathology, Anatomy, Obstetrics/Gynecology
Keywords: intrauterine fetal death, placenta, histology, morphology, morphometry
Introduction
The placenta is an intricate and vital organ during pregnancy, coordinating a wide range of functions
throughout this period. Alongside the fetus, the placenta undergoes significant transformation and growth
from its early development to the end of pregnancy [1]. Although the placenta is present only during
gestation, its impact extends beyond this period. The fetus perceives the placenta as a reflection of the
external environment, and the signals it receives through this organ can have significant consequences for
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Open Access Original
Article DOI: 10.7759/cureus.62871
How to cite this article
Paiker M, Khan K, Mishra D, et al. (June 21, 2024) Morphological, Morphometric, and Histological Evaluation of the Placenta in Cases of
Intrauterine Fetal Death. Cureus 16(6): e62871. DOI 10.7759/cureus.62871