Original Research Article DOI: 10.18231/2394-6792.2018.0075 Indian Journal of Pathology and Oncology, July-September, 2018;5(3):385-390 385 A study on histopathological changes in placenta in pre-eclampsia/eclampsia: A case-control study in tertiary care centre, western India CR Gore 1 , Aditi Pandey 2,* , Abhinav Shetty 3 , Ruby Rao 4 , Sourabh Paranjape 5 1 Professor, 2,3,4,5 Resident Dept. of Pathology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India * Corresponding Author: Email: draditipandey@gmail.com Received: 12 th January, 2018 Accepted: 10 th March, 2018 Abstract Introduction: In pregnancy induced hypertension (PIH), pathological changes in the placenta occurs which may result in reduced blood flow across placenta. The present study has been undertaken to assess the morphology & histology of placenta from mothers with PIH and to correlate their findings with those of normal pregnancies. Materials and Methods: The present study was a case-control study conducted during July 2015 to September 2017. Placenta of cases of singleton normal pregnancies & those complicated by pre-eclampsia/ eclampsia and of known gestational period were included. The placentae were divided into two groups; Group 1: Pregnancy with hypertension (cases) and Group 2: Normal pregnancy (control). Detailed macroscopic and microscopic examinations were conducted on the placentae. Results: The mean weight of placenta (474 ± 58 grams) was higher among control group in comparison to PIH group (420 ± 61 grams). This difference was statistically significant. (p 0.001) The mean fetoplacental weight ratio (6.14 ± 0.503) was higher among PIH group in comparison to control group (6.03 ± 0.409). This difference was statistically insignificant. (p ˂0.05). Th ere was significant association between presence of gross infarction, calcification, Hyalinised area /10 lpf, medial coat proliferation/ 10 lpf, intervillous hemorrhage, decreased villous vascularity and PIH. Conclusion: It is concluded that there was statistically significant difference between mean birth weight of the babies and mean placental weight in control group and PIH group. It also revealed striking villous lesions like increased syncytial knots, cytotrophoblastic cell proliferation, villous stromal fibrosis and fibrinoid necrosis in placenta from preeclampsia cases. Keywords: Placenta, Histopathological Changes, Pre-eclampsia, Eclampsia. Introduction Hypertensive disorders complicating pregnancy are common. It forms one of the deadly triad, along with haemorrhage &infection, which contribute greatly to maternal &foetal morbidity & mortality. 1 In pregnancy induced hypertension (PIH), pathological changes in the placenta such as infarction, calcifications, diffuse placental thrombosis, inflammatory placental vasculopathy and abnormal trophoblastic proliferation occur. It results in reduced blood flow across placenta and uteroplacental insufficiency. 2 Naeye and Friedman (1979) calculated that 70% of excess foetal deaths in women with hypertension are due to placental infarcts. It has been recorded that the maternal utero-placental blood flow is decreased in PIH due to maternal vasospasm. It causes indirect constriction of foetal stem arteries. Babies of such mothers are mostly small for date. 3 Histological findings like cytotrophoblastic cellular proliferation, syncytial knot formation, fibrin plaque formation etc. have been observed in greater amount in hypertensive placentae. 4,5 Gross pathological changes are commonly seen in placentae of severe preeclampsia. The characteristic placental changes of preeclampsia would be predicted to be those associated with placental ischemia. In consistence with this prediction, the placenta in preeclampsia is small. The gross placental changes with severe preeclampsia and foetal growth retardation are quite similar. 6,7 In view of this, the study of placenta should provide insight into the pathophysiology of pre- eclampsia. The present study has been undertaken to assess the morphology & histology of placenta from mothers with pre-eclampsia/eclampsia and to correlate their findings with those of normal pregnancies. Materials and Methods The present study was a case-control study conducted in the Department of Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune in close association with the Department of Obstetrics and Gynecology at our hospital during July 2015 to September 2017. Placentae of cases of singleton normal pregnancies & those complicated by pre-eclampsia/ eclampsia were included in the study. The placentae of pregnancies complicated by other medical disorders like diabetes mellitus etc., multiple pregnancies and preterm pregnancies were excluded. The placenta received from the Department of Obstetrics and Gynecology was divided into two groups. Group 1: Pregnancy with Hypertension (cases): Placenta of patients (with B.P. > 140/90 mmHg after 28