A Comparative Gross and Microscopic Study of Placenta in Intrauterine Growth Restriction and Appropriate for Gestational Age

Background: The placenta plays a critical role in fetal development and acts as a mirror reflecting intrauterine conditions. Intrauterine Growth Restriction (IUGR) is a serious obstetric complication often linked to placental insufficiency. Comparative gross and microscopic evaluation of placentas from IUGR and Appropriate for Gestational Age (AGA) infants can provide valuable insights into underlying pathophysiological processes.

Objective: To evaluate and compare the gross and histopathological features of placentas in IUGR and AGA pregnancies, and to identify significant morphologic indicators associated with fetal growth restriction.

Methods: A total of 150 placentas were collected from term deliveries at Obs & Gynae Department, BIRDEM General Hospital, Dhaka, Bangladesh between January and December 2023. The study population was divided into two groups: 75 IUGR and 75 AGA cases. Gross parameters including placental weight, diameter, thickness, and cord insertion were recorded. Microscopic features such as infarction, syncytial knots, fibrinoid necrosis, and villous immaturity were evaluated. Statistical analysis was conducted using SPSS version 25.0.

Results: Significant differences were observed in placental weight, diameter, and thickness between IUGR and AGA groups (p<0.01). Histopathological features such as infarction (40%), fibrinoid necrosis (33.3%), and syncytial knots (26.6%) were markedly more prevalent in IUGR placentas. These features were statistically significant with p-values <0.01.

Conclusion: Placental abnormalities are significantly associated with intrauterine growth restriction. Morphological and histological assessment of the placenta can serve as a predictive tool in evaluating fetal growth and guiding perinatal care.

Keywords: Placenta, Intrauterine Growth Restriction, Histopathology, Gross Morphology, Appropriate For Gestational Age, Perinatal Outcome.