Study of association of lateral implantation of placenta with development of preeclampsia and its outcome

Abstract

Background: Pre eclampsia (PE) is a life threatening multisystem disorder, unique to pregnancy, complicating approximately 28% of pregnancies in developed countries and approximately 5-8% in developing countries. It is the 2 nd most important cause of maternal mortality in the world. The search for an ideal predictive test for PE still remains a major challenge for obstetricians. Objectives: To study whether ultrasonologically identified placental laterality can be used as a predictor of pre eclampsia. To assess the incidence of pre eclampsia and other feto-maternal outcome with centrally located placenta and those with laterally located placenta. Methods: This prospective study was conducted on 250 uncomplicated primigravidas with singleton pregnancy attending the antenatal clinic from January 2016 to June 2017. Patients were subjected to ultrasound examination and placental location was determined between 18-24 weeks and again between 32-36 weeks period of gestation. These cases were followed till the delivery. Results: Out of total 250women, 148 had central placenta, in which 8 (5.41%) developed preeclampsia, while 102 had lateral placenta, in which 40 (39.22%) developed preeclampsia. Thus, in total 48 women developing PE, 40 (83.33%) had lateral placenta whereas, only 8 (16.67%) had central placenta. The difference was found to be statistically significant as p value is <0.001, sensitivity is 84% and specificity is 70%. Conclusion: From the above study we concluded that women with laterally located placenta determined by USG have 5 times greater risk of developing PE. So, placental laterality is a simple yet reliable and cost effective predictive screening test for pre-eclampsia.

Correlation of lateral placental location with development of preeclampsia

“…This study is consistent with the study conducted by Kakkar et al, who concluded that 66.6% women with lateral placenta and 36.3% with central placenta developed preeclampsia. 17 Similar results were depicted from study concluded by Sandhya et al, Ambastha et al 18,19 It was demonstrated in our study that out of 83 women who developed preeclampsia, 22 women developed severe preeclampsia. Out of those 22 women, 19 (86.36%) had lateral placenta and three (13.64%) had central placenta.…”

“…In the present study, it was observed that all the complications (preterm labour, eclampsia, HELLP syndrome, IUGR babies, transfer to RICU/ ICU were higher in women with lateral placenta but only eclampsia and IUGR were statistically significant (p value 0.008 and 0.014 respectively). 19,24 In women with lateral placenta, 4.8% developed renal failure and 3.6% women transferred to RICU/ICU. In contrast to this, no women with central placenta developed renal failure and transferred to RICU/ICU.…”

A Cross-Sectional Study to Evaluate the Impact of Placental Location on Maternal and Fetal Outcomes

“…Numerous branches from each of the two uterine arteries nourish the respective side of the uterus [ 4 ]. Both uterine arteries in patients with centrally placed placentas show comparable resistance, and the uteroplacental blood flow requirements are satisfied by equal distribution from both uterine arteries, which is absent when the placenta is laterally positioned [ 5 ].…”