Relevance of placental pathological changes of maternal inflammatory syndrome along with the obstetric and clinical parameters in preeclampsia

Preeclampsia is a disorder of pregnancy occurring after midgestation with clinical manifestations of hypertension and proteinuria and has been linked with fetal and maternal morbidity and mortality. Maternal inflammatory syndrome has been associated with preeclampsia. The pathogenetic mechanism proposed behind this syndrome is the maternal endothelial dysfunction caused by atleast of subset of various placental derived factors released into maternal circulation. These are syncytiotrophoblastic microparticles (STBM) or syncytial knots, exosomes or the soluble endoglins. The STBM or the syncytial knots are the end products of trophoblastic life cycle which have been proposed to be altered in the disorder of preeclampsia. So, the aim of the present study was to assess and compare the apoptosis of trophoblastic cells and the syncytial knots in the preeclamptic (20 placentas) and normal (20 placentas) by using TUNEL assay and M30 immunostaining. We also aim to compare various obstetric and clinical parameters affected in preeclampsia (blood pressure, urinary protein, gestational age, birth wt of the babies) between the two groups. In our study, TUNEL Assay as well as M30 immunostaining shows higher trophoblastic as well as syncytial knot apoptotic indices in preeclamptic placentas as compared to normal placentas. The results of our study also show that the clinical parameters (blood pressure, urinary protein) were higher whereas obstetric parameters (gestational age, birth wt of the babies) were lower in preeclamptic patients as compared to controls.