Prospective cohort study in relation of placental location and risk of developing preeclampsia in a tertiary care hospital

Abstract

Background: Preeclampsia is one of the leading and unpredictable causes of maternal morbidity and mortality. This study was done to find the association between location of placenta and the development of preeclampsia as well as its correlation with severity of preeclampsia.Methods: This prospective cohort study was conducted in government medical college hospital, Pudukottai, Tamil Nadu, India between March 2021 to December 2021. The 150 pregnant women were registered in this study. The location of the placenta was determined by ultrasound at 18-24 weeks. The placenta was classified as central and lateral. The endpoint of the study was the development of hypertension or delivery.Results: The incidence of preeclampsia was 32%. Primigravida was a significant high-risk factor. Preeclampsia was more common in 20-25 years (52.1%). Among 48 women who developed preeclampsia, 32 had lateral location of placenta and 16 had central location of placenta. Lateral location of placenta in predicting preeclampsia, p<0.0001, which is clinically significant. Lateral location of placenta has high incidence of both severe 66.7% and non-severe preeclampsia 67.6%. The sensitivity-66.6%, specificity-78.4%, positive predictive value-59.2%, negative predictive value-83.3% and the likelihood ratio of 3.09 of our study are significant.Conclusions: This study shows that placental location determined by ultrasonogram between 18-24 weeks of gestation is an excellent screening tool for the prediction of pre-eclampsia. Lateral placentation helps to identify who are at greatest risk and those requiring careful obstetric management to achieve a more favourable outcome and to decrease the maternal and perinatal morbidity and mortality with preeclampsia.