Reviewing placental volumetry and thickness and its correlation with adverse feto maternal outcome - A cross sectional study in Western India

Abstract

BACKGROUND: Placenta performs several functions including respiration, nutrition, and excretion for the fetus when playing a central role in regulating metabolic, endocrinological, and immunological functions during pregnancy. OBJECTIVE: To analyze the putative correlation of placental parameters including volume and thickness with adverse maternofetal outcomes. METHODOLOGY: A longitudinal observational study was undertaken for 2 years. The sample size was calculated, which was 140. Data were collected, and fetomaternal outcomes of gestational diabetes mellitus (GDM), gestational hypertension (HTN), preeclampsia, and intrauterine growth retardation (IUGR) were derived. A correlation was studied between placental volume (PV) and placental thickness (PT) with fetomaternal outcomes. RESULTS: Approximately half (42.85%) of the study population were primigravida, with overall mean age being 22.67 ± 2.94 years. 46 subjects had adverse fetomaternal outcomes in the form of gestational HTN, preeclampsia, GDM, and IUGR. The most frequent adverse outcome noted was IUGR in 19 cases (41.29%). Among the study population, 90% were term deliveries and 10% were preterm. Spontaneous vertex delivery was seen in 74.29% of the cases. 24.29% of the cases underwent lower segment cesarean section and 1.43% underwent vacuum-assisted delivery. The PV and PT (mm) were compared in healthy subjects with HTN, GDM, and IUGR pregnancies in all three trimesters. A strong correlation (R = 0.96, 95% confidence interval = 0.95–0.98) between birth weight with placental weight was noted. The difference between the means of PV during the first, second, and third trimester and hypertensive disorders in pregnancy was not statistically significant; among GDM and non-GDM patients, was statistically significant in the first and second trimester; and among IUGR and non-IUGR patients, was seen during the third trimester. Similarly, the difference between the means of PT in all trimesters and hypertensive disorders in pregnancy was not statistically significant; among GDM and non-GDM patients, a statistically significant association was seen during the second trimester; and among IUGR and non-IUGR patients, a statistically significant association was seen during the third trimester. CONCLUSIONS: PV in the 1st, 2nd, and 3rd trimesters is significantly less in patients with HTN and IUGR. PV is a predictor of adverse fetomaternal outcomes. Hypertensive subjects had thin placenta with low PV. Hypertensive subjects had thin placenta with low PV. IUGR subjects had thin placenta with low PV. Diabetic subjects had thick placenta. PT is also a predictor of adverse fetomaternal outcomes. Placental weight is known to correlate with fetal weight at term.