Placental and Umbilical Cord Morphometry in Hypertensive Diseases of Pregnancy

Abstract

Aims: Hypertensive diseases of pregnancy (HDP) may be characterized by changes in the morphometry of the placenta and umbilical cord which may affect normal foetal growth and development. This study aimed to determine changes in the morphometry of the placenta and umbilical cord in HDP. Study Design: A case-control study. Place and Duration of Study: The study was conducted at the Bolgatanga Regional Hospital between September 2015 and May 2016. Methodology: The study included 49 pregnant women (Control=30, HDP=19), aged between 18 to 41 years. The controls and cases were matched by maternal age at the time of sampling. Venous blood and placental tissue samples were analysed for markers of oxidative stress. Also, the morphometric variables of the placenta and the umbilical cord were collected. Results: The independent factors that were associated with HDP [adjusted odds ratios (95% confidence interval)] included: caesarean delivery, relative to spontaneous vaginal delivery [AOR: 32.222(3.162-328.345)], placental malondialdehyde  > 11 nmol/mL [AOR: 5.718(1.513-21.617)], total antioxidant capacity ≥13.0 mmol/L [AOR: 13.775(2.809-67.557)], oxidative stress index > 2 [AOR: 10.762(2.666-43.438)]. However, placental weight >0.50Kg [AOR: 0.146(0.037-0.581)] and non-central, relative to central umbilical cord insertion [AOR: 0.142(0.021-0.966)] were less associated with HDP. Conclusion: Placental weight above 0.50 Kg and non-central umbilical cord insertion may be protective against HDP. These findings are useful reference data for maternal and neonatal health and wellbeing among women of reproductive age in the Bolgatanga Municipality of Ghana.