A Study on Analysis of Validity of Lateral Placental Location in Prediction of Preeclampsia

Abstract

BACKGROUNDAim of the study is to analyse whether placental location as determined by ultrasound at 18-24 weeks can predict the subsequent development of preeclampsia. MATERIALS AND METHODSThis study was conducted in 300 women at the Department of Obstetrics and Gynaecology for a period of one year. The location of placenta was determined by ultrasound at 18-24 weeks of gestational age in the study population. The placental position was being classified as central, right/left. Prospectively case group and control group were followed up and looked for the occurrence of hypertension. RESULTS50% of mothers were in the 20-25 years age group. Preeclampsia was high between 20-25 years. The incidence of preeclampsia in primigravida was 81% and multigravida was 19%. Among the patients with centrally located placenta, the incidence of preeclampsia was 19.1% whereas in the case group which had laterally located placenta the incidence of preeclampsia was 80.9% with a statistically significant p value of 0.01. This screening test has a very high negative predictive value of 96.4% and a sensitivity of 81%. Hence, routine ultrasound and placental position screening can be used as a predictor for the development of hypertensive disorders of pregnancy. CONCLUSIONThis study shows that placental position as determined by ultrasound between 18-24 weeks of gestation is an excellent screening tool for the prediction of preeclampsia among numerous screening tests with a very high sensitivity. This test is simple, easy to perform, inexpensive and noninvasive. Lateral placentation helps to identify the population who are at a greater risk to be included in the primary prevention programs.

Correlation of placental laterality and uterine artery Doppler in pre-eclampsia

“…In this study by Kannamani et al 81% were primigravidae. 14 In our study, the incidence of preeclampsia was 19.34% which is higher compared to Rodriguesz et al 10.6%, Kumar et al 13.6% and Ramos et al reported as 14%. [23][24][25] Pre-eclampsia here is common in extremes of age group.…”

“…Infants of women with severe preeclampsia have 5-fold increase in mortality compared to infants of normotensive women. 14 Non-invasive doppler velocimetry studies of uterine arteries in second trimester reveal abnormal waveforms suggestive of defective uterine perfusion due to placental implantation. 1 Placental location can be documented by various means, but ultrasound has proved to be safest, easiest and most accurate method.…”

Correlation of lateral placental location with development of preeclampsia

“…10 Kannamani and Narasimhan showed that placental position as determined by ultrasound between 18-20 weeks of gestation is an excellent screening test with a very high sensitivity. 11 The present study was done to know if there is any correlation in lateral placental location with preeclampsia; and maternal and fetal outcome.…”