Association of Placental Localization at 16-24 Week and Pregnancy Outcome

Abstract

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

Study of placental location and pregnancy outcome

“…10 In contrast, studies conducted by Warland et al and Jaisal et al concluded that posterior placenta was associated with increased risk of still birth. 4,7 The number of central placentae having NICU admissions were 62 (16.4%) and the number of lateral placentae with NICU admissions were 19 (26%), the number of central placentae without NICU admission were 315 (83.6%) and lateral placenta without NICU admission were 54 (74%). Results satisfied a just significant p value of 0.05.…”

“…8 Similarly, Zia et al, Jaisal et al and Jackson et al found no association with placental location and NICU admissions. 7,10,20…”

Examination of the relation of localization of placenta at 18-24 weeks of gestation by ultrasonography with the development of preeclampsia later in pregnancy

“…Prevention not only requires knowledge of pathophysiologic mechanism of this disease, but also methods of its early prediction. 4 For this we need a screening test which would help to make an early diagnosis and thence to decrease the overall maternal and fetal complications.…”

Correlation between placental location and maternal fetal outcome

“…This was mainly due to uneven blood supply because of the longer, thicker anatomy of posterior wall of pregnant uterus [11,12]. [6,15,16]. This was contrast to Zia S et al as they found that anterior placenta was associated with IUD [3].…”

“…Preterm, low birth weight, respiratory distress syndrome and meconium stained liquor are the most common causes for NICU admission. However Zia et al, Jaisal et al and Jackson et al found no association between placental location and NICU admissions [3,16,20].…”