Download PDF
Open Access
CC BY 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences
DOI: 10.1055/s-0045-1815752
Original Article

Pathological Insights into Placental Calcifications in HIV-Positive and HIV-Negative Pregnancies: Clinical Diagnostic Value of Ultrasound Versus Pathology in Obstetric and Perinatal Care in Uyo, Southern Nigeria

Authors

  • Uchechukwu Brian Eziagu 

    1   Department of Histopathology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria

  • Mumini Wemimo Rasheed 

    2   Department of Anatomic Pathology, Federal University Dutse, Dutse, Jigawa State, Nigeria

  • Ikwo Jonathan Kudamnya 

    1   Department of Histopathology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria

  • Chinedu Onwuka Ndukwe 

    3   Department of Anatomic Pathology and Forensic Medicine, Nnamdi Azikiwe University, Awka/Nnewi, Anambra State, Nigeria

  • Ntiense Macaulay Utuk 

    4   Department of Obstetrics and Gynaecology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria

  • Oyedele Oyewumi Ajayi 

    1   Department of Histopathology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria

  • Evelyn Osemhen Eziagu 

    5   Department of Mental Health, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria

  • Eberechukwu Desmond Eziagu 

    6   Department of Family Medicine, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria

  • Emmanuela Ifunanya Akpu 

    7   Department of Nursing Sciences, Enugu State University of Science and Technology, Enugu, Enugu State, Nigeria

  • Innocent Chibuike Okafor 

    1   Department of Histopathology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria

Funding and Sponsorship This study was self-funded by the authors. No external funding, grants, or sponsorship from public, commercial, or not-for-profit organizations were received for the conduct of this research.
Further Information
Also available at
  Permissions and Reprints

Abstract

Objectives

Placental calcifications are frequently noted on obstetric ultrasound, yet their diagnostic value and clinical significance remain uncertain, especially in human immunodeficiency virus (HIV)-positive pregnancies. This study compared clinical obstetric findings, ultrasound assessments, and pathological examinations to determine the reliability of ultrasound in detecting placental calcifications.

Materials and Methods

In this hospital-based case–control study, obstetric diagnoses, routine antenatal ultrasound reports, and detailed pathological evaluations of placentas from HIV-positive and HIV-negative mothers were analyzed. Diagnostic performance metrics, maternal factors, and the influence of HIV status, disease stage, and highly active antiretroviral therapy (HAART) use were assessed.

Statistical Analysis

Descriptive and inferential statistics assessed concordance between modalities, associations with gestational age, gravidity, parity, and miscarriage, and the influence of HIV status, disease stage, and HAART.

Results

Pathology confirmed placental calcifications in 114/145 cases (78.6%), with similar prevalence in HIV-positive (75.5%) and HIV-negative mothers (80.2%; p = 0.527). Ultrasound showed excellent specificity (100%) but extremely low sensitivity (0.9%), detecting only one case. Calcifications were not associated with gestational age, gravidity, parity, or miscarriage history. Among HIV-positive mothers, calcification prevalence did not differ by HIV stage (p = 0.824) or HAART use (p = 0.823).

Conclusion

Placental calcifications are common near term in both HIV-positive and HIV-negative pregnancies. Routine ultrasound has minimal diagnostic value for detecting these lesions and should not be used as a standalone indicator of placental pathology. Pathological examination remains the definitive diagnostic method and is essential for accurate placental evaluation, particularly in high HIV-prevalence settings.

Keywords

placenta pathology - calcinosis diagnostic imaging - ultrasonography prenatal methods - pregnancy complications infectious etiology - HIV infections complications - Uyo Nigeria epidemiology

Authors' Contributions

We confirm that this manuscript represents original work and has neither been published nor submitted elsewhere. U.B.E.: Conceptualization, methodology, investigation, funding acquisition, writing—original draft preparation, and writing—review and editing and final approval of the manuscript. M.W.R., I.J.K., C.O.N., N.M.U., O.O.A., E.O.E., E.D.E., E.I.A., and I.C.O.: Methodology, investigation, formal analysis, writing—review and editing, and final approval of the manuscript.


Compliance with Ethical Principles

Ethical approval for this study was granted by the Health Research Ethics Committee of the University of Uyo Teaching Hospital (Reference: UUTH/AD/S/96/VOL.XII/115) as part of a broader investigation into placental pathology in HIV-positive pregnancies. Written informed consent was obtained from all participating mothers prior to enrollment. All data were anonymized, and the study was conducted in strict compliance with internationally accepted ethical principles for human research, including respect for participant confidentiality and autonomy.




Publication History

Article published online:
23 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India