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Objective: To understand the use and to see the effects of smokeless tobacco on placental microstructure. Study Design: From June 2017 to December 2017 at Isra University Hyderabad Methodology: Sixty full-term human placentae from normal and smokeless tobacco users were selected for this study. The placentae were grouped into two categories (Group A) smokeless and (Group B) control of 30 each. For the microscopic observations in the trophoblast of the placenta, the 4m thick paraffin embedded segments were prepared and stained with H&E & Mallory’s trichrome. The count of syncytial knots per unit area square and chorionic villus collagen per square unit area were observed with the help of ocular grid micrometry. The terminal villi were observed by H& E and oil immersion technique accordingly. Results: The microscopic picture showed the marked changes in the placental morphology of smokeless tobacco user animals. The mean count of syncytial knots per square unit area ( 0.0625mm2 ), was 9.3 SD  1.3 in tobacco users and in the control group it was observed as 3.99 SD  1.4. The difference between the two groups was significantly higher (P< 0.001). The terminal villi appeared to be closely packed showing lesser intervillous space. The number of chorionic villi along with unnecessary collagen per unit area 0.0625mm2 in the section of placentae from group A was found to be 5.94  0.32 whereas in group B it was much less i.e. 2.31  0.16. This showed a significant difference between the two groups. Conclusion: This study concluded that smokeless tobacco consumption during pregnancy produce significant changes in the placental morphology and may affect the outcome of pregnancy. It would cause the loss of trophoblasts and impairment of the placental blockade in the form of the number of syncytial knots, chorionic and terminal villi which can lead to hormonal imbalance, premature labor and low birth weight of babies.

Faisal Mughal, Zaheer Ahmed Memon, Shagufta Shaheen Qureshi. (2019) Effects of Use of Smokeless Tobacco on Microstructure of Placenta, Journal of the Society of Obstetrics and Gynaecologists of Pakistan , Volume-09, Issue-1.
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