Gross morphometry of the human placenta and umbilical cord with reference to neonatal indices

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MARCH, 2015
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In recent years more attention has been focused on the morphology of the placenta and umbilical cord due to their vital roles in foetal development and neonatal survival. While extensive studies have been documented in this area in the developed world, there is very little published information about the morphological variations that occur in human placenta and umbilical cord in Ghana. Therefore this study was designed to evaluate the structural variations in placental indices, umbilical cord indices and neonatal outcome and also compare the data obtained with other samples for regional variation. A total of 236 placentae with attached umbilical cords were obtained from the Kwame Nkrumah University of Science and Technology Hospital in Kumasi between February and July 2013 for this study. Mean placental indices for weight, diameter and thickness were 578.81 g, 17.40 cm and 2.04 cm respectively. The mean neonatal indices were 3.24 kg, 34.27 cm and 50.64 cm for weight, head circumference and length respectively. Neonatal weight correlated significantly with placental weight, neonatal length and neonatal head circumference (P < 0.05). On the contrary, neonatal weight had no significant correlation with placental thickness and diameter. However, there was significant correlation between the umbilical cord length with umbilical cord diameter, umbilical cord artery A1 diameter, umbilical cord artery A2 diameter and volume of Wharton’s jelly (P < 0.001). Based on the results of the present study, the placental weight, umbilical cord length and diameter and neonatal weight values compared with other sampled populations showed significantly lower values. These findings suggest that regional variations exist with these parameters which are likely to contribute to the high neonatal morbidity and mortality rate reported in Ghana. This study further affirms that the placenta and umbilical cord should be critically examined in order to effectively monitor and manage adverse neonatal outcome.
A thesis submitted in partial fulfillment of the requirements for the degree of Master of Philosophy in Human Anatomy and Cell Biology in the department of Anatomy, School of Medical Sciences, College of Health Sciences.