Lateral Placentation by Ultrasonography: A Simple Predictor of Preeclampsia

Bhalerao, Anuja; Kulkarni, Sayali

doi:10.5005/jp-journals-10006-1227

Cited by 19 publications

(26 citation statements)

References 12 publications

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“…The results of present study are close to the study done by Bhalerao AV et al, who stated that ultrasonography in pregnant women during 20-24 weeks of gestation can be a ease, noninvasive, useful and cost-effective tool as a predictor ofpreeclampsia. 10 Futhermore, results are also comparable to the investigations done by Kakkar et al in which out of the total 150 women, 84 (56%) had laterally located placenta and of them, 56 (66.6%) developed preeclampsia, while the remaining 66 (44%) had centrally located placenta and of them, 24 (36.3%) developed preeclampsia.…”

Section: Discussionsupporting

confidence: 88%

Lateral location of placenta on ultrasound as a predictive test for preeclampsia

Kaku¹,

Shivaraju²,

Vimala³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Hypertensive disorders represent the most common medical complication of pregnancy Pre-eclampsia complicates approximately 2-7% of pregnancies and is a major cause of maternal and perinatal morbidity This has led to the interest in screening. The placenta is located laterally in majority of patients with abnormal flow velocity waveforms. In the light of these observations, we designed a prospective study to find out whether the lateral location of placenta as seen by ultrasound at II and III trimester of gestation can be used to predict the development of preeclampsia.Methods: A prospective observational study was done in PESIMSR, Kuppam, Andhra Pradesh. The aim of the study was to find out whether placental laterality as determined by ultrasound can be used as a predictor of development of gestational hypertension, development of preeclampsia/eclampsia During the study period of November 2013 to November 2014, all antenatal women attending the OPD in II and III trimester without any medical disorders likeDM, HTN, renal disease, cardiac disease or smoking, who undergo ultrasound in II and III trimester were included. The location of the placenta was determined by real time ultrasound in II and III trimester. The placenta will be classified as central when it is equally distributed between the right and the left side of the uterus irrespective of anterior, posterior or fundal position. When 75% or more of the placental mass is to one side of the midline, it is classified as unilateral right or left placenta. subjects were followed upto delivery for development of gestational hypertension/ preeclampsia/eclampsia as per the ACOG criteria.Results: 66% patients in the lateral placenta group developed preeclampsia. Only 36%in the central group developed preeclampsia. The association of lateral placenta as a predictor of preeclampsia had a P value of <0.001 which is statistically significant. Incidence of preclampsia is more in primigravidas compared to multigravidas. Most of the pre eclamptics had their onset at 29 – 32 weeks of gestation.Conclusions: The study shows that placental position determined by ultrasonogram in II and III trimester of gestation is an excellent screening tool for the prediction of pre-eclampsia. The test is ideal because it is simple, non-invasive, cost effective and convenient to the women.

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Section: Discussionsupporting

confidence: 88%

Lateral location of placenta on ultrasound as a predictive test for preeclampsia

Kaku¹,

Shivaraju²,

Vimala³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…It is statistically significant (p value <0.001). Many of the other authors like Pai M et al, 1 Patel A et al, 2 Liberti et al, 8 Bhalerao et al, 9 Magann et al, 10 Kartika Devrajan et al, 11 also suggested that central placenta is more common. However various other studies found lateral placenta to be more common like Kofinas et al, 5 Liberti et al, 8 kakkar, and Elena contro et al 12 These differences may be due to differences in criteria defining central and lateral placenta.…”

Section: Discussionmentioning

confidence: 96%

Prediction of Pregnancy Induced Hypertension by Usg Guided Placental Localization

Jaiswal¹,

Jaiswal²,

Nagaria³

et al. 2015

jemds

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OBJECTIVE: To assess the incidence of placental laterality in second trimester and the incidence of hypertensive disorders in laterally situated placenta in comparison to centrally situated placenta. MATERIAL & METHOD: It was an observational randomized study which was conducted between July 2013 to Sept. 2014 at Pt. JNM Medical College, Raipur. Participant were uncomplicated pregnant women having 18-24weeks gestation attending antenatal clinics who underwent obstetric sonography including placental localization. Women were observed till delivery. Analysis was done for site of implantation of placenta and its correlation with PIH or associated complication if any. RESULTS: Total of 130 women considered for the study, 93/130(71.5%) had central implantation of placenta and 37/130(28.4%) have lateral type of placentation. The ratio was almost same in primi as well as in multigravida. Incidence of hypertensive disorder in pregnancy in selected cohort was 28/130(21.5%). High incidence of Pregnancy induced hypertension was associated with lateral placenta i.e. 51.3% (19/37) as compared to central placenta i.e. 9.7% (9/93) (P value <0.0001). This suggests more than 5 times high possibilities of development of PIH in laterally situated placenta in comparison to central implantation. CONCLUSION: Laterally located placenta is associated with increased risk of development of preeclampsia. Prediction of preeclampsia by second trimester USG guided placental localization is simple, cheap, noninvasive, safe and effective screening method.

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“…A study by Kofinas et al (1989) reported a relationship between the lateral location of the placenta and the development of preeclampsia and IUGR as well as abnormal resistive index of the uterine artery in lateral placentas, without respect to confounding factors, such as risk factors for development of preeclampsia (21). According to an important study done by Bhalerao et al during year 2013, ultrasound has been shown as a cost-effective method for prediction of the development of preeclampsia (16), yet in this recent study, statistical analysis of lateral placentas in cases with underlying diseases and older mothers were not apparent.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, previous studies have revealed side-to-side differences in uteroplacental Doppler flow in pregnancies with unilateral placentas as well as the relationship between abnormal Doppler measurements and pre-eclampsia (13)(14)(15)(16)(17)(18)(19)(20)(21). However, reports on the direct association between placental location and development of pre-eclampsia, regardless of confounding factors (22), are limited.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Pre-Eclampsia Development by Placenta Location: A Simple Predictor

Keshavarz

Sadeghian

Hakemi

et al. 2017

J Obstet Gynecol Cancer Res

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Background: Pre-eclampsia complicates 5% to 8% of all pregnancies and annual incidence of pre-eclampsia is about 5% of all pregnancies around the world and is a significant cause of both maternal and fetal mortality and morbidity if left untreated. Objectives: According to previous studies, blood supply distribution within the uterus is not similar in central compared with lateral sites, thus site of implantation and the resulting location of the placenta are likely to have a profound effect on the pregnancy outcome. Methods: The researchers conducted a case-control study over 1-year period at a referral obstetric hospital in the south of Tehran. Overall, 121 females with three degrees of pre-eclampsia were considered as cases and 258 females with normal pregnancy were the controls. The females were aged 20 to 40 years old and their gestational age was between 14 and 26 weeks. Results:The researchers recorded the participants' blood pressures and locations of placenta during this period with consideration of their past and present obstetric history as well as medical and familial history. As a result, pregnancies complicated by pre-eclampsia were more commonly associated with lateral placentation in the second trimester when compared with non-preeclampsia pregnancies. Discussion: This study suggests that placental location, which is easily assessed at middle trimester of pregnancy by routine screening ultrasonography, is an ideal predictive test for evaluating the risk of developing pre-eclampsia.

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Lateral Placentation by Ultrasonography: A Simple Predictor of Preeclampsia

Cited by 19 publications

References 12 publications

Lateral location of placenta on ultrasound as a predictive test for preeclampsia

Lateral location of placenta on ultrasound as a predictive test for preeclampsia

Prediction of Pregnancy Induced Hypertension by Usg Guided Placental Localization

Prediction of Pre-Eclampsia Development by Placenta Location: A Simple Predictor

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