Arjun Chakravarti ¹, Archana Ukey ², Preeti Bajaj ¹, Pradnya Saragade ¹

Affiliations
1 Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik-422003, Maharashtra, IN
2 Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik-422003, Maharashtra, IN

Abstract

The complete blood count, peripheral blood smear, bleeding time, clotting time and renal function tests of 114 patients of chronic renal failure who had required hemodialysis for a period of at least 3 months prior to the commencement of this study were studied. The purpose of this study was to investigate the derangements in the haematological profile of chronic renal patients undergoing hemodialysis and to correlate the same with the duration and severity of the renal failure. The principal finding in the study was a 100% prevalence of anemia among chronic renal failure patients, which was predominantly of the normocytic normochromic type. Red blood cell count was reduced in nearly all (93%) of study patients. There was also a strong negative correlation (r = -0.74) between haemoglobin and duration of hemodialysis. However, a significant proportion of cases showed abnormal cells in the peripheral blood cells such as burr cells, schistocytes and pencil cells, suggesting other contributing factors to the anemia. Female patients also showed a significantly greater prevalence of increased red cell distribution width (>15%) as compared to males (p = 0.001) and a lower prevalence of normocytic normochromic anemia as compared to males (p = 0.009). White blood cell counts, platelet counts, and bleeding and clotting times were largely within normal limits, and none of these variables showed a statistically significant association with the duration of hemodialysis, or serum creatinine, or serum blood urea nitrogen. The inference from the study is that anemia is a major comorbidity in end-stage renal failure patients, with many factors contributing to it, and detailed workup and effective treatment of anemia is necessary in this group of patients.

Keywords

Anemia, Bleeding Time, Clotting Time, Complete Blood Count, Hemodialysis, Normocytic Normochromic.

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Pradnya Saragade ¹, Rajendra Chaudhari ¹, Arjun Chakravarti ¹

Affiliations
1 Department of Pathology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Placentae from 67 mothers were studied, of which 28 were from mothers with uncomplicated pregnancies, and the remaining were associated with various maternal and fetal disorders. The purpose of this study was to describe the various gross and microscopic findings in the placentae, and to correlate them with various clinical and radiological abnormalities. Gross and microscopic examination of all the placentae was carried out. Formalin-fixed, paraffin-embedded tissue sections were used which were stained with hematoxylin and eosin. This study found a significant increase in neonatal weight, placental weight and placental diameter in cases of Gestational Diabetes Mellitus (GDM) as compared to cases of Normal Gestation (NG); while neonatal weight, placental weight and placental diameter were significantly lower in cases of maternal anemia, Pregnancy Induced Hypertension (PIH) and Intrauterine Growth Retardation (IUGR) as compared to cases of NG. This study found a significantly increased prevalence of calcifications, syncytial knots, infarcts and fibrinoid necrosis in cases of PIH as compared to cases of NG. Also, the prevalence of sclerotic villi, syncytial knots and chorangiosis was significantly more in cases of GDM than in cases of NG. In addition, the prevalence of sclerotic villi, syncytial knots, infarcts and fibrinoid necrosis was significantly more in cases of maternal anemia than in cases of NG. Overall, the study showed several significant findings, both gross and microscopic, in placentae from mothers and/or foetuses affected by various pathological processes. It was seen that conditions such as GDM, anemia, PIH etc. have a profound effect upon both the foetus and the placenta. Placental examination thus gives an idea of the type and severity of the condition complicating the pregnancy.

Keywords

Anemia, Histopathology, Placenta, GDM, IUGR, PIH.

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