Abstract
Background: Worldwide, about 5-8% of all pregnant females are affected by hypertensive disorders. In rural India, the incidence is 10%. This entity has become a significant cause of maternal mortality and morbidity, resulting in 10-15% of all maternal fatalities in developing nations, particularly in developing nations. Hence, identifying this entity in pregnant females and its timely management is vital for both mother and baby. Gestational hypertension can cause placental insufficiency due to narrowing and occlusion of uteroplacental vessels leading to intrauterine growth retardation. This study aims to detect placental grading by ultrasonography in the third trimester in cases of hypertensive disorders of pregnancy and to assess its correlation with fetal-maternal outcomes.
 Methodology: This will be a cross-sectional study carried out in the Department of Obstetrics and Gynecology, AVBRH, Wardha. About 130 pregnant normotensive females and 130 hypertensive pregnant females will be included in the study. Baseline data such as age, sex, parity, routine laboratory data, PIH profile, sonography scans will be collected. All the patients will be followed till delivery, and feto-maternal outcomes will be assessed. Data will be analyzed with appropriate statistical tests.
 Expected Outcome: A significant correlation is expected between higher placental grading in hypertensive pregnant females compared to normotensive patients and will have a significant association with perinatal and fetal morbidity.
Highlights
Worldwide, about 5-8% of all pregnant females are affected by hypertensive disorders [1]
In rural India, the incidence is 10% [2]. This entity has become a significant cause of maternal mortality, and morbidity resulting in 10-15% [3] of all maternal fatalities in developing nations [4]
The main cause of reduction in feto placental blood flow in hypertensive disorders in pregnancy is the failure of trophoblastic invasion, which usually occurs around the 16th week of gestation [6]
Summary
About 5-8% of all pregnant females are affected by hypertensive disorders [1]. In rural India, the incidence is 10% [2] This entity has become a significant cause of maternal mortality, and morbidity resulting in 10-15% [3] of all maternal fatalities in developing nations [4]. Extravillous cytotrophoblasts are fetally derived cells that arise from villi and come in contact with maternal decidua to encounter maternal immune cells These tumor-like cells are responsible for invading myometrium of the uterus and upto spiral arteries leading to formation of large vessels with low resistance. The invasion results in the loss of masculo-elastic structure of arteries and conversion into fibrinoid like material, which contains trophoblastic cells inside it This physiological transformation of endovascular invasion occurs in two stages; first into decidual part of spiral arteries at 8-10 wks and second into myometrium at 16-18 wks. Blood pressure > 140/90 before 20 weeks of gestation and not associated with any trophoblastic disorders of pregnancy and without significant proteinuria (
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