Histopathological changes in placenta in late IUFD cases
My Research question was "Does placenta of late intrauterine fetal death exhibits any specific histopathological changes?" Objectives were: a) To evaluate placental histopathological changes in late IUFD. b) Staging of maternal & fetal inflammatory responses found in placenta of late IUFD. c) To interpret the immunohistochemical expression of CD15 in placenta in some selected late IUFD cases and its grading. d) To see the association between CD15 immunopositivity and delayed villous maturation in placenta of late IUFD cases. A cross sectional study was carried out in the Department of Pathology, SSMC among the late IUFD cases in the Obstetrics and Gynecology department of Sir Salimullah Medical College Mitford Hospital, Dhaka during March 2021 to January 2023. A total of 80 admitted cases of diagnosed late IUFDs were included in this study. Pregnant women aged between 19 to 44 years and presented at or after 28 completed weeks of gestation were enrolled in this study. Written consent was taken from those who agreed to participate in the study. Respective placentas of the deadborns were histopathologically analyzed and CD15 immunohistochemical expression was observed in selected cases. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-26). This data stated that late IUFD do have significant placental histopathological abnormalities & distinctive pattern of CD15 immunohistochemical expression.
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1. Placentas were obtained from 80 pregnancies complicated by IUFD from Department of Obstetrics & Gynaeology. Sir Salimullah Medical College Mitford Hospital. 2. Immediately after delivery, placentas were fixed with 10% neutral buffered formalin for 24 hours. 3. Placentas were weighted after removing cord and membrane. 4. After gross examination, 6 blocks had been submitted : 1 block to include a roll of the extraplacental membranes from the rupture edge to the placental margin, including part of the marginal parenchyma; and 2 cross sections of the umbilical cord, one from the fetal end and another approximately 5 cm from the placental insertion end. Three other blocks each containing a full thickness section of normal-appearing placenta parenchyma was submitted. Full-thickness samples was taken from within the central two-thirds of the disc and include one adjacent to the insertion site itself. If the transmural thickness is greater than the length of the cassette, there are two ways of submission : the upper third (chorionic plate and subjacent tissue) and lower third (basal aspect) of the parenchyma was submitted in one cassette, or the gross slice can be divided into two and submitted in two cassettes. If any gross lesions were visible, a block of the lesion (one of each type of lesion) was sampled, with adjacent normal parenchyma, in up to 3 additional blocks. 5. For all cases sections were cut on a rotatory microtome in 3-5 micron thickness and were mounted on clean gelatinized slides and were stained with H&E. 6. Sections were examined by light microscopy and findings were noted. 7. CD15 immunostain was done and slides were examined by light microscope. Findings were noted.