摘要：This is a one year and four month prospective study of 75 consecutive placentae. A high percentage (90.6%) showed evidence of pathology, the majority of which (92%) were associated with maternal, foetal or placental risk factors, either singly or in combination. The majority were maternal risk factors, the highest being pregnancy induced hypertension (PIH) – 33.3%. Grossly infarcts and retroplacental haematomas and histological features of accelerated maturation were lesions commonly seen in these cases. In case where the foetal outcome was poor i.e. abortions, intra uterine foetal death (IUFD) and still births, 100% of the placenta, showed evidence of pathology. In preterm deliveries (90%) were abnormal and in term deliveries (68.4%) were abnormal. The commonest gross lesions seen with poor fetal outcome were infarcts and retroplacental haematomas and microscopically, chorioamnionitis (CAM). Chorioamnionitis was given special attention as it is a common risk factor in India. 80% of our cases of acute chorioamnionitis were associated with either stillbirths (57.14%) or abortions (22.85%) and most of our cases (97.14%) were in stage II, III and IV. The prognosis worsens if acute CAM is associated with villous oedema. Particularly in preterm gestation (45%) of our cases with villous oedema were associated with acute CAM and all of them were seen in preterm gestation, all of whom had poor foetal outcome, either still birth (77.77%) or abortion (22.22%), indicating that the deadly combination of villous oedema with acute CAM wrecks havoc on the unborn child.
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