الملخص

Background: Obesity become one of the most universal medical problem that affect women at reproductive periods. . It has complicated drawbacks in mother and child appeared immediately or after long time. Aims: so the aim of this study to evaluate the placental histological changes of obese mothers in comparison to women with normal body mass index. Methods: This work is prospective case- control study which were examined placentas that were obtained from 40 singleton pregnant women who delivered at Al-Khanssa Maternity Teaching Hospital, Mosul, Northern of Iraq starting from December 2019 to February 2020. The women were classified into two groups: Group 1 which includes 20 women with BMI ranged between 18-24.9 kg/m2, and Group 2 which includes 20 women with BMI ≥ 30. Two placental biopsies were obtained from maternal side and fetal side of each case and submitted for histological examination via light examination. Results: The histopathological examination of placental sections obtained from obese mothers showed several placental changes compared to those of control group. The most frequent feature among these sections is the presence of syncytial knotting in 13(65%) out of 20 placentas.In addition, features of hypovascular villi, villous fibrinoid necrosis are noticed in 10 (50%) of these sections, while thickening of trophoblastic basement membrane was occur in 9 (45%) of these sections. On the other hand, the histopathological examination of placental sections obtained from obese mothers revealed presence of perivillous fibrin deposition which was appeared in 10 (50%) of these sections .Features of stromal fibrosis were noticed in (40%) of sections. Other placental changes are seen in placental sections obtained from obese mothers including presence of nucleated red blood cells (NRBC) in fetal capillaries, chorangiosis, villous edema, paucity of vasculosyncytial membrane VSM, inflammation, apoptosis and decidual fibrinoid necrosis. Conclusion: this work revealed a marked increase in the frequencies of different placental changes in obese mothers in comparison with controls. Further studies are recommended to clarify the exact mechanisms that stand behind these histological changes.