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Placental Histopathological Manifestations and their Relevance to Foetal and Maternal Outcomes - Defining Intrauterine Growth Retardation and Maternal Nutritional Status (Paperback)
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Placental Histopathological Manifestations and their Relevance to Foetal and Maternal Outcomes - Defining Intrauterine Growth Retardation and Maternal Nutritional Status (Paperback)
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This book revisits the macroscopic and microscopic (pathological)
findings in a realistic perspective. There is apparent disinterest
in placental examination. This disinterest is mainly due to the
fact that any information obtained from placental examination is
retrospective and hence of no clinical use in the prospective
management of the pregnancy in question. Many obvious abnormal
features, which vary from abnormal shape, infarction, fibrosis to
abnormal insertions of cord and membranes, can be detected at
birth, but their clinical relevance to intra-partum events and
perinatal outcomes are not well established. Furthermore, many of
these placental features were characterized by remarkable paucity
of clinical symptoms. For example, placental infarctions indicate
vascular injury to placenta in the pregnancy that is being
evaluated but because of the silent nature and the apparent
resilience of the placental function to recover from injury their
clinical importance have been underscored. Objective analysis of
placental features in relation to maternal illnesses and foetal
outcomes were attempted. Placental, foetal and maternal data were
collated from a random sample of mothers. A systematic analysis was
attempted, thereafter from the extracted data. Factors that modify
its growth and abnormal morphological features were defined. Many
factors modify the pregnancy outcome. They include presence or
absence of maternal illnesses, maternal nutrition and optimum
placental function. Relevance to growth restriction of the foetus
given the numerous variables involved namely foetal, maternal and
placental were analyzed. The analysis was completed in several
stages. Following macroscopic morphological features were defined
and their relationship to placental weight, birth weight and
antenatal conditions was analyzed. The macroscopic morphological
features were infarction, fibrosis, calcification, abnormal
insertion of cord or membranes, abnormal shape, inappropriately
small placenta and inappropriately large placenta. Foetal BMI below
two standard deviations was utilized to define IUGR. Maternal
nutritional contribution could not be assessed directly. Low
maternal BMI below 20 was utilized to define poor maternal
nutrition. Both prospective (low maternal BMI) and retrospective
(Low Foetal BMI) parameters were utilized to define poor maternal
nutrition in pregnancy. Critical analysis of microscopic features
were also made in detail.
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