MORPHOMETRICAL ANALYSIS OF INTERVILLOUS SPACE AND VILLOUS MEMBRANE THICKNESS IN MATERNAL ANAEMIA

Authors

  • Nazma Kiran
  • Alia Zubair
  • Henna Khalid
  • Ambreen Zafar

Abstract

Background: Anaemia in pregnancy is linked with an increased risk of preterm delivery, low birth weight, perinatal and maternal mortality and it is related with variable histo-morphological changes in placenta which show a reflection for the poor foetal outcome. The objective of this study is to assess the micro-morphometery of intervillous space and villous membrane of placenta in anaemic mothers. Methods: This case control study was carried out at Army Medical College, National University of Sciences and Technology Islamabad in collaboration with Department of Obstetrics and Gynaecology, Military Hospital, Rawalpindi, Pakistan, from December 2011 to November 2012. A total of 75 placentas were included, that were divided into study and control group. In control group (n=15) placentas were taken from mothers having normal haemoglobin levels and study group (n=60) included placentas from anaemic mothers having haemoglobin less than 11g/dl. Study group was subdivided into three groups, i.e., mildly (10.0-10.9g/dl), moderately (7.0-9.9g/dl) and severely (<7g/dl) anaemic group. Three representative sections were taken from placenta, i.e., one close to umbilical cord (A), one from periphery (C) and one midway between A and C (B).Ocular micro-meter was used to measure intervillous space and villous membrane thickness. Results: Intervillous space was prominent in study groups (41.26±16.33ìm) as compared to control group (15.98±3.81ìm) (p<0.05). Thickness of villous membrane was significantly less in study group as compared to control group (2.97±0.70) (p<0.05). Conclusion: The present study showed wide intervillous space and thin villous membrane in study group as compared to control group reflecting adaptive changes in response to hypoxiain maternal anaemia.Keywords: Intervillous space, villous membrane, maternal anaemia, Placenta

References

Al-Hilli NM. The effect of maternal anaemia on cord blood haemoglobin & newborn birth weight. Karbala J Med 2009;2:589–93.

Malee M. Anaemia in pregnancy. Obstet Gynecol 2008;112(1):201–7.

Buseri FI, Uko EK, Jeremiah ZA, Usanga EA. Prevalence and risk factors of anaemia among pregnant women in Nigeria. Open Hematol J 2008;2:14–9.

Benoist BD, McLean E, Egli I, Cogswell M, Editors. Worldwide prevalence of anaemia 1993-2005. WHO global database on anaemia. Switzerland Geneva: WHO Press; 2008.

Van den Broek N. Anaemia and micronutrient deficiencies. Br Med Bull 2003;67:149–60.

Li M, Yee D, Magnuson TR, Smithies O, Caron KM. Reduced maternal expression of adrenomedullin disrupts fertility, placentation, and fetal growth in mice. J Clin Invest 2006;116:2653–62.

Verma R, Mishra S, Kaul JM. Cellular changes in the placenta in pregnancies complicated with diabetes. Int J Morphol 2010;28:259–64.

Chowdhury AM, Anwar S, Begum M, Eva KN, Shahnaz, F. Effects of insulin treated established diabetes mellitus (EDM) on the volume of placental parenchyma and weight of the neonate. Bangladesh J Anat 2009;7(1):45–8.

Mongia SM, Jain SK, Yadav M. Placenta: The Wonder Organ. J Indian Acad Forensic Med 2011;33:140–2.

Ramic S, Zigic Z, Aleckovic M. Stereological analysis of mature human placenta of pregnant of pregnant women of different age. Bosnian J Basic Med Sci 2006;6(2):7–10.

Reshetnikova OS, Burton GJ, Teleshova OV. Placental histomorphometry and morphometric diffusing capacity of the villous membrane in pregnancies complicated by maternal iron-deficiency anaemia. Am J Obstet Gynecol 1995;173:724–7.

Baptiste-Roberts K, Salafia CM, Nicholson WK, Duggan A, Wang NY, Brancati FL. Maternal risk factors for abnormal placental growth: The national collaborative perinatal project. BMC Pregnancy Childbirth 2008; 8:44.

Grewal A. Anaemia and pregnancy: Anaesthetic implications. Indian J Anaesth 2010;54:380–6.

Begum M, Nurunnabi ASM, Ara S, Begum GN. Effect of antenatal anaemia of the mother on the volume of the placenta. Anwer Khan Modern Med Coll J 2011;2(1):22–5.

Saga Z, Minhas LA. Morphometry of villous membrane of placenta at high and low altitudes. J Rawal Med Coll 2008;12(2):52–6.

Begum M, Ara S, Kishwara S, Nurunnabi ASM, Abu Rayhan K. Microscopic changes of the placental componentsin maternal anaemia. Bangladesh J Anat 2010;8:59–63.

Saga Z, Minhas LA, Rana R. Effects of altitude on morphology of human placenta with special reference to terminal villi and syncytial knots. Int J Pathol 2008;6:26–9.

Huang A, Zhang R, Yang Z. Quantitative (stereological) study of placental structures in women with pregnancy iron-deficiency anaemia. Eur J Obstet Gynecol Reprod Biol 2001;97:59–64.

Roberts DJ. Placental Pathology, a Survival Guide. Arch Pathol Lab Med 2008;132:641–51.

Adil SAK. Histopathological study of placenta in severe anaemia during pregnancy [MD thesis]. Karnataka: Rajiv Gandhi University of Health Sciences; 2006.

Downloads

Published

2014-06-01