Original Articles
Coagulation Disorders and Their Impact on Pregnancy Outcomes: A Histological Examination of Placental Pathology | |
Dr. Neeta Kapoor, Dr. Shambhavi Tripathi, Dr. Kanchan Garg | |
Aim: The aim of this study is to investigate the relationship between coagulation disorders and adverse pregnancy outcomes through a histological examination of placental pathology. Material and Methods: The study population consisted of 80 pregnant women with diagnosed coagulation disorders such as thrombophilia, antiphospholipid syndrome (APS), disseminated intravascular coagulation (DIC), and other related conditions. Participants were closely monitored throughout the pregnancy, and data collection was carried out in three main phases. The first phase involved clinical assessments, where regular evaluations were conducted to monitor maternal and fetal well-being. Maternal parameters such as blood pressure, hemoglobin levels, and platelet counts were measured routinely. Any antenatal complications, including preeclampsia, intrauterine growth restriction (IUGR), and preterm delivery, were recorded during these assessments. The second phase focused on the coagulation profile, where specific coagulation parameters were monitored throughout pregnancy. Results: The fibrinogen levels were markedly lower in the DIC group (2.2 g/L), further emphasizing the severity of the disorder (p=0.001). D-dimer levels were also significantly higher in the DIC group (1.8 mg/L), indicating increased fibrinolytic activity (p=0.005). Women with abnormal placental pathology had significantly worse outcomes. Preterm birth was notably more common in women with abnormal placentas (40%) compared to those with normal placentas (12%), with a significant p-value of 0.01. Preeclampsia was also significantly higher in the abnormal placental group (27.27%) compared to the normal group (12%) (p=0.03). IUGR occurred in 20% of women with abnormal placentas, compared to just 8% in women with normal placentas (p=0.02). NICU admissions were significantly higher in the abnormal placental group (34.54%) compared to the normal group (16%) (p=0.01). These findings highlight the strong association between placental pathology and adverse pregnancy outcomes.Vascular occlusions had the highest odds ratio (OR = 3.1), indicating that women with these placental abnormalities were over three times more likely to experience adverse pregnancy outcomes compared to those without. Villous calcifications also had a strong association with adverse outcomes (OR = 3.5). Fibrin deposition (OR = 2.3) and ischemic lesions (OR = 2.7) were also significant predictors. All of these factors had p-values < 0.05, confirming their strong association with adverse pregnancy outcomes. Conclusion: We concluded that a strong correlation between coagulation disorders and placental pathology, with DIC being the most severe condition in terms of coagulation abnormalities and placental damage. These placental abnormalities were significantly associated with adverse pregnancy outcomes, particularly preterm birth, preeclampsia, and IUGR. |
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