Background: Recently, multifractal analysis based on generalized concepts of fractals has been applied to biological tissues composed of complex structures. Methods: Using digitized images of the maternal surface of 278 placentas, multifractal parameters were measured with a fractal analysis software. Results: The values of αmin, α(0), αmax and the degree of multifractality given by the αmax – αmin difference calculated from 278 placentas were 1.840 ± 0.068, 2.089 ± 0.034, 2.856 ± 0.128 and 1.017 ± 0.136, respectively. A significant decrease of αmin and as a consequence a significant increase in the degree of multifractality were observed according to gestational age. The α(0) value of the placenta complicated by pregnancy-induced hypertension (PIH) was significantly higher than that without PIH. The αmin and α(0) values of the placenta having intrauterine growth restriction (IUGR) were significantly higher than those without IUGR. On the other hand, the presence of chorioamnionitis did not change multifractal properties of the maternal surface of the placenta. Conclusion: The multifractal parameters may be objective indices of the heterogeneity or complexity of the macroscopic morphology of the maternal surface of the placenta. Multifractal analysis holds a promise for quantitatively evaluating physiological and pathological development of the placenta.

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