EC Gynaecology

Background: The human placenta is a complex organ and plays a key role during pregnancy. Normal placentation and placental development are critical for a successful pregnancy. The localisation of the placenta determined by ultrasound in the second trimester has been hypothesised to have an impact on the pregnancy and hence it can be used as a tool to assess the adverse pregnancy outcomes.

Objectives: To assess the relationship between placental location and maternal and perinatal outcomes.

Methods: This is a prospective study conducted at ESIC-MC and PGIMSR Hospital, Bengaluru from January 2020 to June 2021. 350 primigravida attending the antenatal clinic were included in the study. Placental locations was determined by Ultrasound during 18-28 weeks period of gestation. Patients were followed upto term gestation. The maternal and perinatal outcomes was observed.

Results: Among the 350 patients enrolled in the study; the placenta was located laterally in 106 women (30.3%), anteriorly in 96 (27.4%), posteriorly in 96 (27.4%) and fundal in 52 (14.9%) women. 54 (42%) of the study participants with gestational hypertension had laterally located placenta which was statistically significant (p = 0.001). Fundal and lateral placenta had a significant association with malpresentations (p = 0.005). 6 out of 7 pregnant women with abruption had lateral placenta (p = 0.013).

Conclusion: Localisation of placenta by ultrasound in second trimester is an important determinant of pregnancy outcomes. Different placental locations are associated with a number of adverse pregnancy and neonatal outcomes like Preeclampsia, IUGR, preterm labour occur more in lateral placenta. Hence second trimester ultrasound can be used as one of the non invasive predictor of adverse pregnancy and neonatal outcomes.

Keywords: Placental Location; Maternal Outcome; Neonatal Outcome; Lateral Placenta; Ultrasound; Preeclampsia

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