A Comparative Study to Assess Relationship of Placental Weight in Normal Pregnant Women and in Anemic Pregnant Women in Selected Hospital of Pune City

Background: Nearly 600,000 women die each year as a result of complications of pregnancy and childbirth; most of these deaths could be prevented with attainable resources and skills (WHO 1996). In India, anemia affects an estimated 50 percent of the population. A key component of Safe Motherhood is the eradication of anemia during pregnancy. Over the course of a pregnancy, maternal blood volume increases by approximately 50%, from 4 to 6 L, the plasma volume increases somewhat more than the total RBC volume, leading to a fall in the hemoglobin concentration and hematocrit values. This decrease is smaller in women who take supplemental iron, whereas the fall may be dramatic in women who do not take supplemental iron and have limited iron stores or are anemic upon becoming pregnant. The placenta is the physiological link between the mother and her unborn infant. Abnormal placental growth is associated with adverse pregnancy outcomes disproportionately heavy placenta, suggestive of placental hypertrophy, may indicate an adaptive response to an adverse intrauterine environment. Placental hypertrophy may occur in the presence of conditions such as maternal anemia, cigarette smoking and lower socio-economic status. Conversely, a disproportionately small placenta may indicate poor nutrient supply to the placenta, or hypoxia resulting in placental growth restriction and subsequently fetal growth restriction. When there is a limitation imposed on fetal growth velocity due to nutritional deficiencies, the placenta may undergo hypertrophy in an attempt to compensate. As well, placental hypertrophy may occur in response to fetal /placental hypoxemia. It is also possible that using the placental ratio as a marker, infants with possible in-utero growth disturbance can be identified so that their postnatal growth and future health status can be monitored. Thus there may be effect of maternal anemic condition on the placental growth in turn may affect the newborns growth and development Thus there may be effect of maternal anemic condition on the placental growth in turn may affect the newborns growth and development.

Objectives:

• To compare the placental weight among normal&anemic pregnant women
• To correlate the placental weight with the baby's weight

Design: A Correlational design was adopted for the study.

Setting: Government hospital of Pune city was selected.

Participants: 100 expectant mothers fulfilling the inclusion criteria were selected by non probability convenient sampling technique. Two groups: Group A consisted of 50 pregnant mother with Hb level above 10gm%.&Group B consisted of 50 pregnant women with Hb level below 10 gm %.

Methodology: The tool consisted of Semi structured interview and observation of placental parameters. The Tool was divided into Section I- Demographic data, Section II- Examination of placenta&Section III- Birth weight. All participants fulfilling the criteria were approached, consent was taken&data was collected over 24 hours according to the patients delivery timing. The average time taken to fill the questionnaire after delivery of the baby and placenta was almost 15-20 minutes.

Results: The findings revealed that, in comparison of placental weight between Group A (Normal cases) and Group B (Anemic cases) shows highly significant difference (P<0.001), similarly in comparison of birth weight in normal and anemic cases shows highly significant difference between Group A (Normal cases) and Group B (Anemic cases) (P<0.001).

In Correlation between placental weight and birth weight Group A (Normal cases) does not show significant difference (P >0.05) but shows a positive correlation in the scatter diagram. This means as the placental weight increases the birth weight also increases and vice-versa. Group B (Anemic cases) shows highly significant difference with a positive correlation (p >0.001) and in the scatter diagram also it shows positive correlation. This means as the placental weight increases the birth weight also increases and vice-versa.

Conclusion: To conclude with the help of above findings this study provides us with evidence that increase or decrease in maternal Hb levels leads to changes in the placental weight. And due to alteration in placental weight it affects the birth weight.