Changes in Placenta and Chorioamniotic Membrane Histoarchitecture in Patients With Malaria in Pregnancy

Abstract

Background: Malaria in pregnancy has adverse consequences for both fetal and maternal health. These outcomes result from improper trophoblast invasion concomitant with the reduced transformation of maternal spiral arteries due to inflammation and disturbances in maternal hormonal function. The events may further contribute to fetal growth restriction (FGR) by reducing the transport of maternal blood to the placenta. It is not fully understood how malaria in pregnancy alters the terminal villus and the chorioamniotic membrane and how these relate to pregnancy outcome. Objective: To compare the changes in the placenta and the chorioamniotic membrane in patients with and without malaria in pregnancy Materials and methods: One hundred and sixteen placentae were used for the study. The placenta from mothers who have had malaria in pregnancy and those from mothers without a history of malaria in pregnancy were collected using standard techniques. The placental tissue and the adjacent parts of the fetal membranes were obtained in an aseptic technique immediately after delivery and the specimen were labeled with a sequential study number. The tissues were macroscopically examined to determine any gross changes. Biopsies of both the placentas and the fetal membranes obtained were obtained immediately after delivery and fixed in 10% formalin for 24hrs. They were then prepared for paraffin wax embedding and stained with Hematoxylin and Eosin. Photomicrographs were taken using a Zeiss™ digital photomicroscope (Carl Zeiss AG Oborkochen, Germany) at ×400 magnification for morphometric analysis. Data handling: Statistical analyses were performed using SPSS 23.0 (Version 23.0, Chicago, Illinois). Mean values, Standard Deviations, and frequency tables were generated from the data................................................................................