A Prospective Study of Villous Capillary Lesions in Complicated Pregnancies

The vascularity of placental tissue is dependent on various factors of which fetomaternal hypoxia plays a major role. Hypoxia can be of different types and each type influences the vascularity of the villi, especially terminal villi, in its own way. In this study, we attempted to identify villous vascular changes in a group of term placentae from mothers with diseases complicating pregnancy. Chorangiosis was the most frequently identified lesion while chorangioma was found in only 2 cases. There were no cases of chorangiomatosis. A few cases had normal villous vasculature. Maternal diseases have a major role in disrupting the placental vasculogenesis and angiogenesis by creating a hypoxic environment that may affect the fetus adversely. Hence, such conditions need to be identified early in pregnancy and managed appropriately as it is possible to maintain a normal vasculature and prevent neonatal mortality and morbidity if prompt intervention is done. 1. Introduction Placenta is a unique organ derived from both the mother and the fetus and is of prime importance throughout the period of gestation. It is a highly vascular organ whose vasculature is an intricately and tightly regulated complex of vessels from both the mother and the developing fetus. Vasculogenesis and angiogenesis are triggered by numerous growth factors in the molecular microenvironment. Any change that affects the hemodynamics of the maternal blood flow can seriously affect the growth of the placenta and indirectly that of the fetus. Similarly, any change in the hemodynamics of fetal blood flow can also affect the placental growth. Thus, placenta plays a very important role in maintaining homeostasis in both lives during pregnancy. A good antenatal period with adequate nutrition and absence of systemic diseases is essential to achieve this goal. In few unfortunate patients, maternal diseases may adversely affect the growth of the placenta and in turn that of the offspring. Many studies have been done worldwide to unravel the mysteries of the placenta and to add evidence to the existing clinicopathological correlation studies. In our study, we attempt to find one such evidence at the microscopic level relating to villous vasculature and to classify the lesions based on past literature. 2. Materials and Methods A total of 62 placentae were taken for this prospective study. The study group comprised 31 placentae from complicated pregnancies and control group included 31 placentae from normal pregnancies. The control group consisted of antenatal women with adequate hemoglobin values, blood