Material and methods
In this prospective study spanning two years, 50 cases of pre-eclampsia/eclampsia and 50 control subjects with normal placenta were included. The histomorphological changes in the placenta were examined for both groups and a scoring system was formulated to assess the severity of pre-eclampsia/eclampsia syndrome. A maximum score of 2 and a minimum score of 0 was assigned for maternal floor infarcts, calcification, villous basement membrane thickening, and fibrin deposition. Syncytial knots were assigned a minimum score of 0 and a maximum score of 1. The association of various placental histopathological variables with a clinical diagnosis of pre-eclampsia, eclampsia, and control was analyzed using the chi-squared/Fisher’s exact test. A one-way analysis of variance (ANOVA) test was used for comparing objective histopathological scores between pre-eclampsia, eclampsia, and control groups. A p-value of less than 0.05 was considered to be statistically significant.
We found a significant association between each histopathological parameters of the placenta, including fibrin deposition, maternal floor infarction, calcification, villous basement membrane thickening, and syncytial knots, and clinical diagnosis of pre-eclampsia, eclampsia, and control groups. A median score of 2 significantly correlated with the normal group, while median scores of 4 and 6 correlated with pre-eclampsia and eclampsia respectively.
This comprehensive scoring system can be a basis for validating reporting patterns of the placenta in pre-eclampsia and eclampsia patients, as well as other disorders related to maternal uteroplacental insufficiency.