Abstract
Objective: To determine the maturational changes in the placenta by ultrasonography at various gestational ages in low risk vs. high risk pregnancies and their correlation with perinatal outcome.
 Subjects: Study was conducted in 100 patients with singleton pregnancies, divided into two groups: Group A (control group) having no medical or obstetrical complications in the current pregnancy and Group B (study group) having medical or obstetrical complication. All the patients were subjected to ultrasonography between 28-31 weeks, 32-37 weeks and after 37 weeks of gestation. All cases were followed till pregnancy outcome and neonates followed up to 7 days after birth. Perinatal outcome of group A and group B was compared.
 Results: It was observed that placental maturity increased with GA in both groups but placenta matured earlier in high risk cases. 8% patients in group A and 26% in group B showed earlier placental maturation. Patients of diabetes mellitus showed delayed maturity and lower grades were found even at termination. Incidence of LSCS was 44%in group B and 20% in group A. Good apgar score was shown when placental maturity was of higher grade. Respiratory distress syndrome was seen in only 4% neonates in group A and 8% in group B at termination with grade III placenta. 19% neonates in group A required admission to an ICU as compared to 37% in group B. Perinatal mortality was high in patients who had placental grade 0 and 1 at termination in both the groups. There was 10% perinatal mortality (4% still births and 6% neonatal deaths) in group A and 14% (4% still births and 10% neonatal deaths) in group B as high risk patients were there in group B.
 Conclusion: Placental grading by ultrasonography is a reliable index of foetal pulmonary maturity and it can assist the obstetrician in the management of high risk patients, thus making ultrasonography a useful tool for predicting the perinatal outcome and planning treatment modalities for termination of pregnancy. JMS 2014;17(1):6-10
Highlights
The antenatal assessment of foetal maturity is necessary whenever a non-emergent caesarean section or induction of labour is contemplated
The risk of certain adverse perinatal outcome is significantly increased among patients showing higher grades of placental maturity before 37 weeks of gestation
Detection of higher grades by ultrasound early in third trimester can alert the obstetrician for close observation regarding development of PIH, IUGR, abruptio placentae, foetal distress and perinatal outcome
Summary
The antenatal assessment of foetal maturity is necessary whenever a non-emergent caesarean section or induction of labour is contemplated. This is true in high risk pregnancies in which termination is desired at the earliest time conductive to infant survival. Agarwal and Jain (2000)[4] suggested that the placental grading advanced with the gestational age in both low and high risk pregnancies but in patients with hypertension and Journal of Medical Sciences 2014; 17(1):[6,7,8,9,10]. The present study was undertaken to determine the maturational changes in the placenta at various gestational ages in low risk vs high risk pregnancies and their correlation with perinatal outcome
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
