Type of Article:  Original Research

Volume 5; Issue 4.2 (November 2017)

Page No.: 4538-4542

DOI: https://dx.doi.org/10.16965/ijar.2017.150


Afadhali D. Russa *1, Kelvin Modest Kaziri 2.

*1 Department of Anatomy, School of Medicine, Muhimbili University of Health and Allied Sciences,  P. O. Box 65001, Dares Salaam, Tanzania.

2 Muhimbili National Hospital, Dare s Salaam, Tanzania.

Corresponding Author: Dr. A.D. Russa, Department of Anatomy, School of Medicine, Muhimbili University of Health and Allied Sciences, P. O. Box 65001, Dares Salaam, Tanzania. Tel: +255 755 524 771, Fax: +255 22 2150465. E-Mail: adrussa@yahoo.com; drussa@muhas.ac.tz


Background: The placenta is a feto-maternal organ that supports pregnancy. It forms from second week of pregnancy and is fully functional by the fourth month. The quality of placenta greatly influences the pregnancy, labor and postnatal life. In Tanzania studies on the intrauterine growth, the placenta and their effect on birth outcome are scant. The present study aimed at assessing the effect of placental weight and number of cotyledons to the fetal birth outcome as represented by the fetal birth weight and Apgar scores.

Materials and Methods: This involved 102 near term pregnant women and their newborns at the Mwananyamala hospital in Dar es Salaam Tanzania. Expectant mothers within the age 15-49 years with smooth pregnancy and within the gestation age between 37-42 weeks were followed for the birth outcome during labor. At birth the fetal weight, sex, Apgar scores, placental weight and cotyledon count were recorded. A Pearson correlation coefficient R was calculated and a p-value ≤ 0.05 was considered significant.

Results: Mean fetal birth weight was 3.2kg ± 0.5kg and the mean placental weight was 579.7g ± 142. The average placental-to-fetal weight ratio was 1:5.5. The number of cotyledons ranged between 11 and 26 with a mean count of 17.8 ± 4.0. The mean 1st and 5th minute Apgar scores were 7.8±0.8 and 9.3±0.7 respectively. Placental weight was positively correlated with the fetal weight (R=0.65, p value=0.00) and the heavier the placenta the higher the number of cotyledons (R=0.61, p value=0.00).  The gestational age at term did not influence the fetal birth weight (R= 0.06; p= 0.54), the placental weight (R= 0.07; p= 0.49), the cotyledon count (R= 0.01; p= 0.91), Apgar 1st min (R= 0.06; p=0.55) and the Apgar 5th min (R= 0.09, p=0.38). Fetal weight was not associated with both the Apgar 1st min (R= 0.11; p=0.27) and the Apgar 5th min (R= -0.07, p=0.51).

Conclusion: The placental weight and cotyledon count are associated with the birth weight by 65% and 55% respectively and both can be clinically used in the prediction of birth outcomes.

Key words: Placental weight, cotyledon count, birth weight, Apgar score.



  1. Moore KL, Persaud, TVN, Torchia MG. The Developing Human: Clinically Oriented Embryology. Philadelphia, PA, Saunders/Elsevier 2008; p111-6.
  2. Naeye RL. Do placental weights have clinical significance? Hum Pathol. 1987; 18: 387-91.
  3. Panti AA, Ekele BA, Nwobodo EI, Yakubu A. The relationship between the weight of the placenta and birth weight of the neonate in a Nigerian Hospital. Nigerian Medical Journal : Journal of the Nigeria Medical Association 2012; 53: 80-4.
  4. Azpurua H, Funai EF, Coraluzzi LM et al. Determination of placental weight using two-dimensional sonography and volumetric mathematical modeling. Am J Perinatol 2010; 27: 151-5.
  5. Matteelli A, Donato F, Shein A et al. Malarial infection and birth weight in urban Zanzibar, Tanzania. Ann Trop Med Parasitol 1996; 90: 125-34.
  6. Steketee RW, Nahlen BL, Parise ME, Menendez C. The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med Hyg. 2001; 64 (suppl 1): 28–35.
  7. Perry IJ, Beevers DG, Whincup PH, Bareford D. Predictor of ratio of placental weight to fetal weight in multiethnic community. BMJ 1995; 310: 436–9.
  8. Adesina KT, Ogunlaja OO, Aboyeji AP, Akande HJ, Adeniran AS, Olarinoye A, Fawole AA. Relationship between gross placental characteristics and perinatal outcome of low-risk singleton deliveries. Niger Postgrad Med J 2016; 23:191-5.
  9. Sanin LH, López SR, Olivares ET, Terrazas MC, Silva MA, Carrillo ML. Relation between birth weight and placenta weight. Biol Neonate 2001; 80:113-7.
  10. Little RE, Zadorozhnaja TD, Hulchiy OP, Mendel NA, Shkyryak-Nyzhnyk ZA, Chyslovska N, Gladen BC. Placental weight and its ratio to birthweight in a Ukrainian city. Early Hum Dev 2003; 71: 117-27.
  11. Lo YF, Jeng MJ, Lee YS, Soong WJ, Hwang B. Placental weight and birth characteristics of healthy singleton newborns. Acta Paediatr Taiwan 2002;  43; 21-5.
  12. Jaya DS, Kumar NS, Bai LS. Anthropometric indices, cord length and placental weight in newborns. Indian Pediatr 1995; 32: 1183-8.
  13. Erbil N, Toprak N, Açıkgöz O, Gelen S, Arık N. The relationship between maternal, placental and newborn parameters. Middle Black Sea J. Health Sc 2015; 1: 11-8.
  14. Adinma JIB, Agbai AO. Fetal birth weight in Africa. J Obs Gynae 2009; 15 295-7.
  15. Kabir N, Kawser CA,  Rahman F, Kabir ML, Rahman A. The relationship of placental weight with birth weight. Mymensingh Med J.2007; 16: 177-80.
  16. Balihallimath RL, Shirol VS, Gan AM, Tyagi NK, Bandankar MR. Placental morphometry determines the birth weight. Journal of Clinical and Diagnostic Research : JCDR. 2013; 11: 2428-31.
  17. Hutcheon, JA, McNamara H, Platt RW, Benjamin A,  Kramer MS. Placental weight for gestational age and adverse perinatal outcomes. Obs Gynae 2012; 119 1251-8.

Cite this article: Afadhali D. Russa, Kelvin Modest Kaziri. THE EFFECT OF PLACENTAL WEIGHT AND COTYLEDON COUNT TO THE FETAL BIRTH OUTCOME AT A REGIONAL REFERRAL HOSPITAL IN TANZANIA. Int J Anat Res 2017;5(4.2):4538-4542. DOI: 10.16965/ijar.2017.150