Correlation between placental location and maternal fetal outcome
Abstract
Background: Placenta is the vital link between fetus and the uterine wall. Based on location, it can be classified as anterior, posterior, lateral, fundal and low lying. Placental location can be easily determined in the antenatal period using ultrasound.
Materials and Methods: Design: Prospective observational study.
Study period: One year from January 2018 to February 2019 in a tertiary hospital in Salem district of Tamilnadu.
Study population: After informed consent, 200 women with singleton pregnancy of ≥28 weeks attending antenatal OPD were included in the study. Women were followed up with ultrasound at 28 weeks and 34 weeks to identify any maternal and fetal adverse effects such as gestational hypertension, preeclampsia, preterm birth and NICU admission.
Results: The mean age of the study participants was 24.3 ± 43 years. Of the 200 women, 42% (n=84) of placenta were situated in fundus, 30% (n=60) were anterior, 18% (n=36) were lateral, 8% (n=16) were posterior and 2% (n=4) were low lying. Gestational hypertension was present in 22%, 13%, 12% in lateral, anterior and posterior placental location respectively. Preeclampsia was seen in 22% in lateral placental location. Preterm labour, PROM, low birth weight and NICU admission were common in posterior and lateral placental location.
Conclusion:There was statistically significant association between low lying, posterior and lateral placental location and adverse maternal fetal outcomes. Hence ultrasound can be used as the safe, cost effective, non-invasive tool in predicting the adverse maternal and neonatal outcome.
Downloads
References
2. Priya GP, Veena P, Chaturvedula L, Subitha L. A randomised controlled trial of sublingual misoprostol and intramuscular oxytocin for prevention of postpartum haemorrhage. Arch Gynecol Obstet. 2015;292 (6): 1231-1237. doi: 10.1007/ s00404-015-3763-5.
3. Zia S. Placental location and pregnancy outcome. J Turk Ger Gynecol Assoc. 2013;14(4):190-3. doi: 10. 5152/ jtgga.2013.92609.
4. Seadati N, Najafian M, Cheraghi M, Mohammadi B. Placental location at second trimester and pregnancy outcomes. J Pharm SciInnov. 2013;2(2):32-4.
5. Kofinas AD, Penry M, Swain M, Hatjis CG. Effect of placental laterality on uterine artery resistance and development of preeclampsia and intrauterine growth retardation. Am J Obstet Gynecol. 1989;161(6 Pt 1): 1536–9.doi: http://dx.doi.org/10.1016/0002-9378 (89) 90920-4.
6. Singh N, Gupta R, Pandey K, Gupta N, Chandanan A, Singh P. To study second trimester placental location as a predictor of adverse pregnancy outcome. Int J ReproductContracep, Obstet Gynecol. 2016; 6(6): 1414-7. doi: http://dx. doi.org/10. 18203/2320-1770. ijrcog 20161296
7. Magann EF, Doherty DA, Turner K, Lanneau GS, Jr, Morrison JC, Newnham JP. Second trimester placental location as a predictor of an adverse pregnancy outcome. J Perinatol. 2007;27(1):9–14.doi: http://dx. doi.org/ 10.1038/sj.jp.7211621.
8. Devarajan K, Kives S, Ray JG. Placental location and newborn weight. J ObstetGynaecol Can. 2012;34 (4):325- 9.doi: 10.1016/S1701-2163(16)35212-4.
9. Booth RT, Wood C, Beard RW, Gibson JR, Pinkerton JH. Significance of site of placental attachment in uterus. Br Med J. 1962;1(5294):1732–4.doi: http://dx.doi.org/10.1136/bmj.1.5294.1732.
10. Rajeshwari RR, Rubini M. Maternal and perinatal outcome in placenta previa - one year study in tertiary care center in Tamil Nadu, India. Int J Reprod ContraceptObstetGynecol 2016; 5(8): 2819-22.doi: http://dx.doi.org/10.18203/2320-1770.ijrcog 20162673
11. Andersen KV, Munck O, Larsen JF, Kjeldsen H. Placental flow index in posterior wall placentas measured with 99 mtechnecium-labelled human serum albumen. Clinical Physiology. 1983;3(6):577–80.doi: http://dx.doi.org /10.1111/j.1475-097X.1983.tb00867.x.
12. Degani S, Leibovitz Z, Shapiro I, Gonen R, Ohel G. Myometrial thickness in pregnancy: Longitudinal sonographic study. J Ultrasound Med. 1998;17 (10): 661–5. doi: https://doi.org/10.7863/jum.1998.17.10.661
13. Torricelli M, Vannuccini S, Moncini I, Cannoni A, Voltolini C, Conti N, et al. Anterior placental location influences onset and progress of labor and postpartum outcome. Placenta. 2015;36(4):463-6.doi: 10.1016/j. placenta. 2014.12.018.
14. Cho JY, Lee YH, Moon MH, Lee JH. Difference in migration of placenta according to the location and type of placenta previa. J Clin Ultrasound. 2008;36(2):79–84. doi: http://dx.doi.org/10.1002/jcu.20427.
15. Warland J, McCutcheon H, Baghurst P. Placental position and stillbirth: a case-control study. Journal of Clinical Nursing. 2009;18(11):1602–6.doi: http://dx.doi. org/10.1111/j.1365-2702.2008.02779.x
16. Jaisal P, Bhonsale D. Association of Placental Localization at 16-24 Week and Pregnancy Outcome. Int J Med Res Prof. 2016;2(4):7-9. 8.http://dx.doi.org/ 10.21276/ijmrp.2016.2.4.002.
17. Hadley CB, Main DM, Gabbe SG. Risk factors for premature rupture of the fetal membranes. Am J Perinatol. 1990;7(4):374–9.doi: http://dx.doi.org/10. 1055/ s-2007-999527.
18. Nair VV, Nair SS, Radhamany K. Study of placental location and pregnancy outcome. Int J Reprod Contracept Obstet Gynecol 2019; 8(4): 1393-7. doi: http:// dx.doi.org/10.18203/2320-1770.ijrcog 20191187
19. Kalanithi LE, Illuzzi JL, Nossov VB, Frisbaek Y, Abdel-Razeq S, Copel JA, et al. Intrauterine growth restriction and placental location. J Ultrasound Med. 2007; 26 (11):1481–9. doi:10.7863/jum.2007. 26.11. 1481.
20. Jackson R, Carson M, Melamed N, Barrett JF, Mei Dan E. 469: The impact of placental location on neonatal adverse outcomes. Am J Obstet Gynecol. 2018; 218(1):S282.doi:https://doi.org/10.1016/j.ajog. 2017. 10.405.
Copyright (c) 2019 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
Therapoid
