| Preeclampsia (PE) is a hypertensive disorder of pregnancy associated with significant maternal and fetal
complications. Structural and histomorphometric changes in the placenta, particularly alterations in syncytial knots (SKs)
and vasculosyncytial membranes (VSMs), contribute to placental dysfunction and fetal hypoxia. This study aims to
compare placental morphology and histological changes between normotensive and preeclamptic pregnancies to
understand their impact on fetal outcomes. Methods: A total of 42 placentas were collected at Sri Lakshmi Narayana
Institute of Medical Sciences & Hospital in 2021, with 21 from normotensive pregnancies (control group) and 21 from
preeclamptic pregnancies (PE group). Placental weights, diameters, and thicknesses were measured, and histological
sections were analyzed using hematoxylin and eosin (H&E) staining. 1,500 terminal villi (TVs) were examined for SK
density, VSM thickness, and SK variations. Statistical analysis was performed using SPSS version 10, and a p-value < 0.05
was considered significant. Results: PE placentas exhibited significant increases in SK density and diameter compared to
controls (p < 0.0001). The thickness of VSM in PE placentas was twice as high as in controls, further impairing
fetoplacental circulation. Type 3 SKs, which indicate severe placental dysfunction and fetal hypoxia, were exclusively
found in PE placentas. Placental weight was significantly lower in the PE group (p < 0.0001), and neonatal birth weights
were also reduced (p = 0.001). No significant differences were observed in placental thickness or diameter between groups.
Conclusion: The structural abnormalities observed in PE placentas, particularly increased VSM thickness and SK density,
suggest compromised feto-maternal exchange and placental insufficiency. These alterations may contribute to fetal hypoxia
and low birth weight, supporting the role of placental morphometry as an indirect measure of placental function and
pathology. Understanding these histopathological changes in PE could help improve early detection and management
strategies for high-risk pregnanciesddd |
