In hypertension, the utero-placental circulation is compromised and the villi are exposed to a more focal hypoxia resulting in a shift towards branching angiogenesis (9,10). Syncytial knots are aggregates of syncytial nuclei at the surface of terminal villi. These knots increase in number with increasing gestational age. It is also increased in conditions of utero-placental malperfusion such as in preeclampsia(11).