Morphological, Morphometric, and Histological Evaluation of the Placenta in Cases of Intrauterine Fetal Death.

Background The human placenta is a remarkable organ that develops during pregnancy and is crucial in supporting fetal growth and development. The placenta supplies oxygen and nutrients to the fetus and removes waste products from the fetal bloodstream. It also produces hormones that support pregnancy, such as human chorionic gonadotropin, progesterone, and estrogen. Placental insufficiency occurs when the placenta cannot deliver adequate nutrients and oxygen to the fetus. This can result in intrauterine fetal death (IUFD), stillbirth, intrauterine growth restriction, low birth weight, and premature birth. It can also be associated with developmental delays or long-term health issues for the baby. This study aimed to assess the morphologic, morphometric, and histologic changes in the placenta associated with IUFD and compare it with the placenta of live births. Methodology This study was conducted at the Department of Anatomy in collaboration with the Department of Obstetrics and Gynaecology, Integral Institute of Medical Sciences and Research and King George's Medical University Lucknow, where 60 placentas were studied. Placentas were further categorized into the following two groups: Group A, the study group in which placentas from IUFD were taken (n = 30), and Group B, the control group where placentas from live births were taken (n = 30). Morphological and morphometric features of both groups were recorded and compared. Histological features of placentas from IUFD (Group A) were examined after hematoxylin and eosin staining. Results A total of 60 placentas were observed (Group A and Group B). In Group A (IUFD) and Group B (control group), most pregnancies were multigravidas. Round-shaped placentas were the most common type in both groups (Group A = 46.67%, Group B = 66.67%). The average thickness of placentas from Group A (IUFD) cases was significantly reduced (mean thickness = 1.17 ± 0.07 cm) compared to controls in Group B (mean thickness = 2.04 ± 0.93 cm). The p-value obtained was significant at 0.0001. There was a notable reduction in the average placental diameter in Group A (mean diameter = 241.73 ± 65.54 cm) compared to Group B (mean diameter = 263.72 ± 162.67 cm). The p-value obtained was not significant at 0.49. On histopathological examination of the placentas of Group A (IUFD), perivillous fibrin deposition and high-grade calcification were seen in a significantly high number of placentas (70% and 60%, respectively). Conclusions The knowledge of the placenta's morphologic, morphometric, and histologic changes can be utilized to establish the cause of fetal death. In instances of fetal growth limitation and fetal demise that are clinically inexplicable, they can also explain the causes.