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Abstract：
Background The human placenta is a remarkable organ that develops during pregnancy and is crucial in supporting fetal growth and development. The placenta supplies oxygen and nutrients to the fetus and removes waste products from the fetal bloodstream. It also produces hormones that support pregnancy, such as human chorionic gonadotropin, progesterone, and estrogen. Placental insufficiency occurs when the placenta cannot deliver adequate nutrients and oxygen to the fetus. This can result in intrauterine fetal death (IUFD), stillbirth, intrauterine growth restriction, low birth weight, and premature birth. It can also be associated with developmental delays or long-term health issues for the baby. This study aimed to assess the morphologic, morphometric, and histologic changes in the placenta associated with IUFD and compare it with the placenta of live births. Methodology This study was conducted at the Department of Anatomy in collaboration with the Department of Obstetrics and Gynaecology, Integral Institute of Medical Sciences and Research and King George\'s Medical University Lucknow, where 60 placentas were studied. Placentas were further categorized into the following two groups: Group A, the study group in which placentas from IUFD were taken (n = 30), and Group B, the control group where placentas from live births were taken (n = 30). Morphological and morphometric features of both groups were recorded and compared. Histological features of placentas from IUFD (Group A) were examined after hematoxylin and eosin staining. Results A total of 60 placentas were observed (Group A and Group B). In Group A (IUFD) and Group B (control group), most pregnancies were multigravidas. Round-shaped placentas were the most common type in both groups (Group A = 46.67%, Group B = 66.67%). The average thickness of placentas from Group A (IUFD) cases was significantly reduced (mean thickness = 1.17 ± 0.07 cm) compared to controls in Group B (mean thickness = 2.04 ± 0.93 cm). The p-value obtained was significant at 0.0001. There was a notable reduction in the average placental diameter in Group A (mean diameter = 241.73 ± 65.54 cm) compared to Group B (mean diameter = 263.72 ± 162.67 cm). The p-value obtained was not significant at 0.49. On histopathological examination of the placentas of Group A (IUFD), perivillous fibrin deposition and high-grade calcification were seen in a significantly high number of placentas (70% and 60%, respectively). Conclusions The knowledge of the placenta\'s morphologic, morphometric, and histologic changes can be utilized to establish the cause of fetal death. In instances of fetal growth limitation and fetal demise that are clinically inexplicable, they can also explain the causes.
摘要：
背景技术人胎盘是在怀孕期间发育的显著器官,并且在支持胎儿生长和发育中至关重要。胎盘为胎儿提供氧气和营养，并从胎儿血液中清除废物。它还产生支持怀孕的激素，如人类绒毛膜促性腺激素，黄体酮,和雌激素。当胎盘不能为胎儿提供足够的营养和氧气时，就会发生胎盘功能不全。这可能导致宫内胎儿死亡（IUFD），死产,宫内生长受限,低出生体重,和早产。它也可能与婴儿的发育迟缓或长期健康问题有关。本研究旨在评估形态学，形态计量学,与IUFD相关的胎盘组织学变化，并将其与活产胎盘进行比较。方法本研究是在解剖学部门与妇产科合作进行的，综合医学科学研究所和乔治国王医科大学勒克瑙，研究了60个胎盘。胎盘进一步分为以下两组：A组，采取IUFD胎盘的研究组（n=30），B组,对照组采取活产胎盘(n=30)。记录并比较两组的形态学和形态学特征。苏木精和曙红染色后检查IUFD胎盘（A组）的组织学特征。结果共观察到60个胎盘(A组和B组)。在A组（IUFD）和B组（对照组）中，大多数怀孕是多胎。圆形胎盘是两组中最常见的类型（A组=46.67％，B组=66.67%)。与B组的对照组（平均厚度=2.04±0.93cm）相比，A组（IUFD）病例的胎盘平均厚度显着降低（平均厚度=1.17±0.07cm）。获得的p值在0.0001是显著的。与B组（平均直径=263.72±162.67cm）相比，A组（平均直径=241.73±65.54cm）的平均胎盘直径显着降低。获得的p值在0.49不显著。在A组胎盘（IUFD）的组织病理学检查中，绒毛周围纤维蛋白沉积和高度钙化见于显著高数量的胎盘(70%和60%,分别)。结论对胎盘形态的了解，形态计量学,和组织学变化可以用来确定胎儿死亡的原因。在临床上无法解释的胎儿生长受限和胎儿死亡的情况下，他们也可以解释原因。
