A comparative gross anatomical study of plantae and neonata weight in hypertensive and non hypertensive pregnant women at the University Teaching Hospital LUSAKA, ZAMBIA.

Abstract

A comparative gross anatomica study of placentae and neonatal weight in hypertensive and non hypertensive pregnant women at the University Teaching Hospital Lusaka Zambia BACKGROUND Placenta is an organ that links the mother to the foetus facilitating gaseous exchange, uptake of nutrients and excretion. The placenta reflects intrauterine environment and its size varies depending on ethnicity, pathophysiology and birth weight. Hypertension in pregnancy affects the placental morphological changes and affects neonatal outcome. Placental weight is a significant determinant of birth weight. Birth weight is used as an indicator of intrauterine growth. This study aims to compare the gross anatomy of placentae and neonatal weight in hypertensive and non hypertensive pregnant women at the University Teaching Hospital, in Lusaka, Zambia. METHODS: A case control study design was applied to 100 hypertensive participants and 100 normotensive women, making a total of 200. All the participants were aged between 18 and 44 years, gestational age was between 35 and 40 weeks. Placentas were examined immediately after delivery in the labour ward. The placentae were weighed, longest placental length measured and the maternal placental surface examined. The birth weight was measured. Independent sample T test and Pearson’s Chi Squared test was used to compare the means of measurements in the two groups using birth weight as the dependent variable. RESULTS: Mean standard deviation of the placental weight in the study group was 454 (±118.7) grams and control group was 488(±114.1) grams. Mean difference was statistically different with p value of 0.040. The mean placental diameter difference study group to control group was 18.6(±3) cm to 19.5(±1.95) cm, the difference was statistically significant with a p value of 0.013. The mean (SD) birth weight of the study to control group was 2.87 (±0.61) kg to 3.12(±0.45) kg. The difference in birth weight was statistically significant with a p value of 0.000. CONCLUSION The study established that there was a difference in placental measurements and birth weight among the hypertensive and normotensive mothers, with a p value less than 0.05. The differences in the means were statistically significant. Therefore it can be concluded that hypertension in pregnancy is associated to changes in the morphology of the placenta that consequently affects birth weight. The percentage of low birth weight was higher (31%) in the study group than the control (7%).