Introduction:The role of a simple ultrasonographic evaluation of the placenta and its localization in the 2 nd trimester (16-24weeks) is of interest and easily available in most set-ups. Aims and Objectives: To study the association of placental localization at 16-24 week and pregnancy outcome. To compare the incidence of PIH and IUGR in Unilateral placenta and that of preterm labour and still birth in Posterior placenta. Materials and Methods: A prospective observational study was conducted over a period of 10 months at our hospital which is a tertiary level referral hospital. The placenta was graded as fundal, anterior, posterior or unilateral depending upon the maximum area of attachment (more than 3/4 th ) on USG. The subjects were followed up for the development of PIH, IUGR, preterm labour and PROM. A total of 450 patients were enrolled for the study of which 60 aborted and 55 were lost to follow-up. The number of patients who remained in the study was 335. Results: Majority of cases of pre-eclampsia 48 (65.75%) developederal placent in patients who had either right or left sided placental attachment i.e unilateral placenta. This association was significant (p-value=0.020) There were 3 still births in our study 2 (66.6%) of which had posterior placentas. Majority of IUGR babies 29 (56.68%) had unilateral placentas. The distribution of preterm births was such that 21 (61.7%) had

Caesarean section under local anaesthesia (CSLA) was performed on a patient with a diagnosis of gravida 2 para 1 living 1, with eight months amenorrhea and uncontrolled, refractory, complicated eclampsia with intrauterine fetal demise and a previous lower segment Caesarean section. As she was at very high risk (ASA Grade III) for main stream anaesthesia, i.e. general/regional, lidocaine (0.5%) was used. CSLA should not be seen as a primitive/retrograde step. Instead, it should be considered to be a life-saving procedure, especially for women in rural India. Anaesthetists are not dispensable but with them on standby one can avoid mainstream anaesthesia complications in high-risk patients.

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