Study On The Relationship Between Hypertensive Disorder Complicating Pregnancy And Placental Pathology

Objective: Hypertensive disorder complicating pregnancy(HDCP)is a pregnancy specific disorder that causes multiple system damage and is still a major cause of maternal death worldwide,however,no breakthrough has been made in the study of its pathogenesis.In this paper,we studied the placental pathology of hypertensive disorder complicating pregnancy and followed up its outcome.Methods: A total of 96 patients with placental pathology who were delivered in maternity ward of The First Affiliated Hospital of Dalian Medical University from January to December 2019 were selected.These included 24 cases of normal pregnancy and 72 cases of gestational hypertension.First,according to Fetal Growth Restriction(FGR),patients with gestational hypertension were divided into gestational hypertension combined with FGR group(group A,n=29)and gestational hypertension group(group B,n=43).Then,according to the onset time of preeclampsia(34 weeks gestation),patients with gestational hypertension were divided into early-onset preeclampsia group(group C,n=15)and late-onset preeclampsia group(group D,n=57).The general condition,placental pathology and pregnancy outcome of each group were analyzed.SPSS21.0 was used to analyze the data of each group.Results:1.Comparison between gestational hypertension with FGR(group A),gestational hypertension alone(group B)and normal group.(1)The pre-pregnancy BMI of group A and group B was significantly higher than that of the normal group(P < 0.05).(2)The number of syncytial cell nodules,fibrinoid necrosis,incidence of placental infarction,incidence of poor villi development and placental coefficient in group A were significantly higher than those in group B and the normal group,and both groups were higher than the normal group,(P < 0.05).However,the placental weight of group A was lower than that of group B and the normal group,(P < 0.05).(3)The number of weeks of termination in group A were lower than those in group B and the normal group(P < 0.05).However,the neonatal asphyxia rate of group A was significantly higher than that of group B and the normal group(P < 0.05).2.Comparison between early-onset preeclampsia(group C),late-onset preeclampsia(group D)and normal groups.(1)The pre-pregnancy BMI of group C and group D was higher than that of the normal group(P < 0.05).(2)The number of syncytial cell nodules,fibrinoid necrosis,incidence of placental infarction,incidence of poor villi development and placental coefficient in group C were significantly higher than that in group D and the normal group,and both groups were higher than that in the normal group(P < 0.05).The placental weight of group C was lower than that of group D and the normal group(P < 0.05).(3)The neonatal weight and the number of weeks of termination in group C were smaller than those in group D and the normal group(P < 0.05).The neonatal asphyxia rate of group C was significantly higher than that of group D and the normal group(P <0.05).Conclusion:1.Hypertensive disorder complicating pregnancy can cause a series of changes in placental Anoxia,such as placental weight reduction,poor development of placental Villi and the increase of placental coefficient,syncytial cell nodules,fibrinoid necrosis and placental infarction.We also find that the more severe the condition is,the more obvious the placental involvement can be seen.2.Pathological changes of the placenta will affect the growth and development of the fetus in the womb.The more severe the placental lesions,the greater the possibility of a poor prognosis of the fetus.3.Patients with early-onset preeclampsia have more severe changes in placental ischemia and hypoxia than those with late-onset preeclampsia,and are at higher risk of adverse pregnancy outcomes such as low birth weight and neonatal asphyxia.4.Compared with patients with simple gestational hypertension,those with fetal growth restriction have more serious placental injury.And they are more likely to have complications such as premature delivery and neonatal asphyxia,which affect the prognosis.5.Those with BMI exceeding the normal range before pregnancy have an increased risk of developing hypertension during pregnancy.