Mean Placental Thickness Research Articles

Ultrasound Evaluation of Placental Thickness: Insights From an Observational Study and Implications for Fetal Growth Assessment.

Introduction A precise gestational age (GA) assessment is critical to monitoring fetal growth and planning delivery. Any disorder that affects the placenta will affect the fetus. Hence, the placenta serves as an indicator of fetal development. So, placental thickness (PT) measurement can be utilized as a parameter in the precise estimation of gestational age and prediction of the fetal outcome. Ultrasound (USG) remains the preferred method for detecting placental abnormalities due to its benefits. This study aimed to evaluate placental thickness by USG in various GA subgroups and to see the correlation of PT with GA and fetal outcome. Methods Cross-sectional observational study with short follow-up. A total of 296 antenatal women between 14 weeks and 40 weeks underwent USG to measure placental thickness and were followed up until delivery. The collected data was compiled systematically and analyzed using IBM SPSS Statistics for Windows, Version 25 (released 2017; IBM Corp., Armonk, New York, United States). The level of significance was taken as p<0.05. Results The mean placental thickness progressed from 1.8 cm to 3.5 cm as the gestational age advanced from 14 weeks to 35 weeks and six days. After that, it decreased until delivery (r-value = 0.531 (<0.8), p-value <0.001). PT was positively correlated only with birth weight (p-value 0.013) amongst all fetal outcome parameters. Conclusion GA can be determined using PT with the help of regression techniques. PT can be used as a replacement when a particular parameter of the composite growth formula is fallacious. The PT increase rate is a more reliable indicator than the actual PT to predict birth weight.

Maternal affective symptoms and sleep quality have sex-specific associations with placental topography

BackgroundThe impacts of prenatal maternal affective symptoms on the placental structure are not well-established. Employing Geographic Information System (GIS) spatial autocorrelation, Moran's I, can help characterize placental thickness uniformity/variability and evaluate the impacts of maternal distress on placental topography. MethodsThis study (N = 126) utilized cohort data on prenatal maternal affective symptoms and placental 2D and 3D morphology. Prenatal maternal depression, stress, anxiety and sleep quality were scored for each trimester using the Edinburgh Postnatal Depression Scale (EPDS), Stressful Life Event Scale (SLE), Penn State Worry Questionnaire (PSWQ), and Pittsburgh Sleep Quality Index (PSQI), respectively. Placental shape was divided into Voronoi cells and thickness variability among these cells was computed using Moran's I for 4-nearest neighbors and neighbors within a 10 cm radius. Sex-stratified Spearman correlations and linear regression were used to study associations between mean placental thickness, placental GIS variables, placental weight and the average score of each maternal variable. ResultsFor mothers carrying boys, poor sleep was associated with higher mean thickness (r = 0.308,p = 0.035) and lower placental thickness uniformity (r = −0.36,p = 0.012). Lower placental weight (r = 0.395,p = 0.003), higher maternal depression (r = −0.318,p = 0.019) and worry/anxiety (r = −0.362,p = 0.007) were associated with lower placental thickness uniformity for mothers carrying girls. LimitationsThe study is exploratory and not all GIS models were developed. Excluding high-risk pregnancies prevented investigating pregnancy complications related hypotheses. A larger sample size is needed for greater confidence for clinical application. ConclusionsPlacental topography can be studied using GIS theory and has shown that prenatal maternal affective symptoms and sleep have sex-specific associations with placental thickness.

Ultrasonographic correlation of placental thickness with some foetal biometry in seemingly normal singleton pregnancies in Taraba State, Nigeria

An accurate assessment of the gestational age (G.A) and evaluation of foetal growth is essential to antenatal care. GA prediction based on the sonographic foetal parameters may be the cornerstone in modern obstetrics and continues to remain an important component of the management of pregnancies. Placental thickness appears to be a promising parameter for the estimation of GA, for it tends to have a positive correlation with it. Ultrasonography helps in the assessment of the placenta and the detection of placental abnormalities using different parameters like placental thickness and volume. This study was conducted to sonographically measure the placental thickness and correlate it with some foetal biometry in apparently normal singleton pregnancies. A prospective cross-sectional design was employed for the study from March to July 2021 in Jalingo, Taraba State. A convenient sampling method was employed and included a total of 314 healthy pregnant women referred for obstetrics ultrasound scans in their 2nd and 3rd trimesters. Ultrasound scans were performed using an ultrasound system equipped with a 3.5 MHz curvilinear transducer. Findings from this study revealed an increasing trend in the values of the mean placental thickness with an increase in G.A, and the placental thickness in mm coincide almost exactly with the GA weeks, indicating there was a positive correlation between placental thickness and G.A from 14-35 weeks of gestation. However, placental thickness gradually declined from 36-40 weeks G. A, thereby, lagging behind the G.A marginally by 1-2 mm. Placental thickness cord insertion site can be used as an accurate sonographic parameter to determine the GA, especially from 14-35 weeks of gestation in apparently normal singleton pregnant women due to its statistically strong positive correlation with G.A.

Influence of Parity on Placenta Thickness and Diameter Among Pregnant Women in Usman Danfodio Teaching Hospital Sokoto

The management of pregnancy requires knowledge of the gestational age. It is usually estimated by ultrasound using parameters like femur length, bi-parietal diameter, and abdominal circumference. A healthy placenta is crucial for fetal well-being, growth, development and neonatal survival. Fetal Sonographic biometric parameters are crucial in obstetric decision making, the placenta’s weight is important in detecting functioning after birth, as placenta’s gross examination could shed light on the new-born’s weight and any pregnancy-related complication fetus .The purpose of the study determine The Influence of Parity on Placenta Thickness and Diameter Among Pregnant Women in Usmanu Danfodiyo University Teaching Hospital Sokoto. A cross-sectional study design was conducted among 72 pregnant women who were between 24 to 40 weeks of gestational age and came for an ultrasound in the Radiology department at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Data were collected using proforma. Data was processed using IBM® SPSS version 25 and analysed using descriptive and inferential statistics. The finding of the results reveals majority of the respondents were in the age group 25-29 years. The majority of the mothers were multigravida 60(83.3%) and about 84% of the respondent was multipara. The mean placental diameter and thickness were 14.10 ? 1.4cm and 4.58 ? 4.2cm respectively. The placental thickness and diameter all rise linearly with increased gestational age (r = 0.422, P&lt;0.001, r=0.24, p=0.044, respectively. Placental thickness and diameter are positively correlated with parity and gestational age. (r=0.24, p=0.044 and r=0.24, p=0.040, respectively).it is recommended Placenta thickness and diameter is an index. it is recommended to incorporated measurement of placenta thickness and diameter as a routine into conventional fetal biometric for fetal age estimation and weight during antenatal ultrasound.

Diagnostic Accuracy of Placental Thickness in Lower Uterine Segment Measured by Ultrasound in Prediction of Placenta Accreta Spectrum in Patients with Placenta Previa. A Diagnostic Test Accuracy Study.

The aim of the study was to evaluate the association between placental thickness and placenta accreta spectrum (PAS) in patients with placenta previa. In this prospective study, 40 patients diagnosed with placenta previa were included. The maximum placental thickness in the lower uterine segment was obtained using a transabdominal scan. For the image to be deemed suitable, a midline sagittal section of the lower uterine segment (with the implanted placenta) and the cervical canal, with the intervening urinary bladder had been required. Intraoperative attendance was ensured for the detection of cases with spontaneous separation and cases with morbid adherence. All specimens removed were sent for histopathology to confirm PAS. The primary outcome of the study was to detect a threshold of placental thickness which can be used as a cut-off value in such screening test. The number of units of packed RBCs transfused during the operation and bladder injury were secondary measures of outcome. Forty patients were included in the study; 20 patients were ultimately diagnosed with PAS while 20 patients did not have PAS. Mean placental thickness was significantly higher in the PAS patients compared with those with no invasive placentation (61.00 mm Vs 43.00 mm, P value 0.000). Using receiver operating characteristic (ROC) curve, a threshold placental thickness of 58mm was associated with 55% sensitivity, 90% specificity, 84.6% positive predictive value, and 66.7% negative predictive value. Multivariate logistic regression showed that placental thickness more than 58mm and having past history of more than three cesarean sections were independent risk factors for PAS among patients with placenta previa. Placental thickness in the lower uterine segment is increased in patients with placenta previa with PAS compared to those with no PAS. Such finding can be implemented into clinical practice by using placental thickness as a screening test for PAS in patients with placenta previa. NCT05500404.

Correlation of Placental Thickness with Gestational Age and Other Fetal Parameters Among Pregnant Women: A prospective cross-sectional study from North India

Background: Placental thickness is the lone parameter that can predict gestational age without relying on the foetus. For many years, the last menstrual period (LMP) date has been used to calculate the foetus gestational age; but, as shown by the studies, approximately 56 percent of females can recall the last menstrual period date with absolute precision. This forgetting might not have a big impact on an uncomplicated pregnancy, but in complicated pregnancies, proper foetal gestational age data is vital. In order to determine the relationship between placental thickness and foetal age and other growth parameters, this study was carried out.Methods: Between July 22, 2021, and July 22, 2022, the Department of Anatomy at Santosh Medical College and Hospital in Ghaziabad, Uttar Pradesh, India, worked with the Departments of Radiology and Obstetrics &amp; Gynaecology on this prospective cross-sectional study. The convenient sampling technique was used to enrol the study subjects, and during the first five months of study, 254 ANC subjects with gestational ages between 11 and 20 weeks were included in the study. The pregnant subjects were examined by USG machine for gestational age (GA), and placental thickness (PT). The analysed data were represented as frequency, percentages, mean, median standard deviation (SD), minimum and maximum values.Results: Among enrolled pregnant subjects, the most common placenta positions were anterior (42.6%) and posterior (30.1%). Between the time of enrolment in the study (1.61±0.26 cms), the first follow-up visit (2.62±0.07 cms), and the second follow-up visit (3.35±0.26 cms), the mean placental thickness significantly increased. A very significant association (r=0.746) was found between gestational age and placental thickness in the Pearson correlation analysis of subjects between 31 and 40 weeks of gestation. Similar to this, a very significant correlation (r=0.965) was found between gestational age and foetus gestational weight.Conclusion: In our study during the first, second, and third trimesters of pregnancy, there was a significant linear association between placental thickness, gestational age, and other foetal parameters. Statistics was found to support the relationship.

Placental thickness and its correlation to gestational age estimated by fetal biometry: A cross-sectional study

Background: Accurate estimation of gestational age is important not only for appropriate antenatal care but also is crucial for undertaking various diagnostics tests such as chorionic villous sampling and amniocentesis. In certain conditions, where biometry cannot be entirely relied on for estimation of gestational age placental thickness (PT) that can be used for estimation of gestational age. Aims and Objectives: The aims of this study were as follows: (1) To analyze relationship between PT and gestational age as determined by fetal biometry in second and third trimester of pregnancy. (2) To find out cutoff PT value for differentiating between preterm and term gestations. Materials and Methods: This was a cross-sectional, in which 140 patients, in 2nd and 3rd trimester, were included on the basis of a predefined inclusion and exclusion criteria. PT was measured in mm along with their respective standard deviation. The correlation between PT and gestational age as determined by biometry. Results: The mean age of the studied cases was found to be 4.15±3.5 years. At 12 weeks of gestation, the mean PT was 14.36 mm. There was a strong positive correlation between gestational age and PT in 2nd (r=0.9943) and 3rd (r=0.9973) trimesters. After 37 weeks of gestation, there was no significant correlation between PT and gestational age (P=0.469). Conclusion: PT has a significant positive correlation with gestational age in 2nd and 3rd trimester of pregnancy (up to 37 weeks of gestation) and can be reliably used for determination of gestational age independent of fetal biometry.

Prospective cross-sectional study to assess the correlation of placental thickness with gestational age and fetal weight among pregnant women

Aim: The goal of the current study was to determine the average placenta thickness and foetus weight for each group of gestational age, as well as the relationship between placenta thickness and foetus weight for pregnant Indian women of various gestational ages. Methods: 202 pregnant women were included as study subjects in the current study utilising a convenient sample technique. The antenatal women underwent an ultrasound examination to measure placental thickness, gestational age, and fetus weight. The correlation between the gestational age in weeks, placental thickness in cm, and foetal weight in gram was determined using the Pearson's Correlation (r value). Statistical significance was defined as a P value of 0.05 or lower. Results: The mean placental thickness increased significantly from first follow up (1.61±0.26 cms) to second follow up (2.62±0.07 cms) and third follow up visit (3.35±0.26 cms). The mean placental thickness increased significantly from first follow up (1.61±0.26 cms) to second follow up (2.62±0.07 cms) and third follow up visit (3.350±0.26 cms). The estimated gestational age (11–20 weeks) had a 79.9% variability (R2) based on placental thickness (mm).

Association of Placental Parameters with Low Birth Weight Among Neonates Born in the Public Hospitals of Hadiya Zone, Southern Ethiopia: An Institution-Based Cross-Sectional Study.

IntroductionPlacenta indices are the significant determinants of perinatal outcome and neonatal mortality. A clinician can predict neonatal status based on the findings from the placental indices. However, there are limited studies on the relationship between placental parameters and neonatal birth weight in Ethiopia. Hence, this study aimed to assess placental parameters and their association with birth weight among neonates born at public hospitals in southern Ethiopia.MethodsA facility-based cross-sectional study was conducted on 249 systematically selected placentae with the attached umbilical cord from normal singleton live birth with known gestational age. A weighing scale, long needle, and standard non-elastic tape were used to measure placental parameters. Maternal and neonatal characteristics were obtained from the medical charts. Bivariable and multivariable logistic regressions analyses were done to assess the association between placental indices with neonatal birth weight. Finally, an adjusted odds ratio with the corresponding 95% CI was used to declare the statistical significance.ResultsIn this study, the mean placental weight, diameter, and thickness were 475.9gm, 17.73cm, and 4.43cm, respectively, and the prevalence of low birth weight was 10% (95% CI: 6–14%). Low placental weight (AOR: 6.57; 95% CI: 2.47–17.48), low placental thickness (AOR: 4.94; 95% CI: 1.42–17.22), and gestational age (AOR: 4.73; 95% CI: 1.49–14.99) were associated with low birth weight.ConclusionThis study revealed that placental parameters, particularly weight and thickness, and gestational age have a significant influence on low birth weight. Therefore, proper examination of the placenta should be performed routinely following delivery for better newborn care.

Correlation of Placental Thickness Measured Sonographically with the Gestational Age Estimated by Fetal Growth Parameters in Normal Singleton Pregnancy

Objective: To correlate the mean placental thickness with the gestational age estimated by fetal growth parameters in normal singleton pregnancy.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Combined Military Hospital, Quetta Pakistan, from Feb to Aug 2020.&#x0D; Methodology: All patients who fulfilled the inclusion criteria at the Department of Radiology, Combined Military Hospital Quetta were included. After taking informed written consent and history, transabdominal-ultrasonography using a low frequency 3-5 MHz curved array transducer was done to assess the outcome.&#x0D; Result: A total of 100 women with a singleton pregnancy were included. The mean age of women was 28.100 ± 3.349 years. The mean placental thickness (PT) was 29.785 ± 5.700 mm. A significant positive correlation of placental thickness was noted with gestational age with a Pearson Correlation of 0.985 and p-value of 0.001.&#x0D; Conclusion: Placental thickness has a linear relationship with gestational age. Placental thickness in millimeters can be an essential parameter for estimating gestational age.

Sonographic Correlation of Placental thickness with Estimated fetal Weight at term among the Pregnants in Lahore

Introduction: Placenta develops in the uterus and provides oxygen and nutrients to the baby. It begins to form in the 2nd month of pregnancy and is usually matured in the 4th month. It can be seen through ultrasonography by 9th or 10th week. The normal functioning of the placenta is determined by measuring placental thickness through ultrasonography which increases with the gestational age and is considered normal when it does not exceed 4 cm at any time during pregnancy. The objective of this study is to find Sonographic Correlation of Placental thickness with fetal weight at term among the pregnant in Lahore. Material and Method: A total of 213 cases were included in this cross-sectional analytical study. All subjects were scanned at term and gestational age, estimated fetal weight and placental thickness were measured. Pearson’s correlation was used to evaluate the correlation of placental thickness and estimated fetal weight. Results:Placental thickness and Estimated Fetal weight showed progressive increase in the value from 36 weeks to 40 weeks in this study. The mean placental thickness ranged from30.15±5.12 mm at 36th week to 37.49±2.31 mm at 40th week. The mean estimated fetal weight ranged from 2885.00±194.18 grams at 36th week to 3919.85±352.88 grams at 40th week. A significantly moderate correlation has been found between estimated fetal weight and placental thickness measured after 36 weeks of pregnancy. Conclusion:It is concluded that placental thickness is directly related to estimated fetal weight after 36 weeks of pregnancy. Therefore, it is helpful to assess placental thickness for the proper evaluation of fetal growth and well-being.

Ultrasound Measurement of Placental Thickness: A Reliable Estimation of Gestational Age in Normal Singleton Pregnancies in Nigerian Women.

Purpose:The aim of this article is to evaluate the accuracy of placental thickness (PT) in determination of gestational age (GA) in normal singleton foetuses.Materials and Methods:The study was a cross-sectional descriptive study which recruited consecutively a total of 406 pregnant women with singleton pregnancies (at 15–40 weeks of gestation), referred for routine obstetric ultrasound (US) scan at the National Hospital, Abuja from October to December 2019. Biparietal diameter (BPD), femur length (FL), head circumference (HC), abdominal circumference (AC), and PT were measured using standard protocols. All measurements were calculated by taking three best measurements, and the mean of the measurements was taken and recorded for each participant. Pearson’s correlation analysis was computed to determine linear relationships between variables. A significant statistical level was determined at a critical value of P < 0.05.Results:The mean age was 31.8 ± 4.8 years. The mean PTs in the second and third trimesters were 23.2 ± 3.1 and 34.1 ± 3.7 mm, respectively. PT had a linear relationship and a statistically significant positive correlation (r=0.99, P = 0.00) with GA. There was also a statistically significant positive correlation between PT on the one hand, and BPD, AC, HC, FL, PT, and GA, on the other hand.Conclusion:There was a significant and strong positive correlation between PT and GA. The study shows that US measurement of PT is a reliable method of estimating GA in singleton pregnancies in Nigeria.

Assessment of use of ultrasonographic placental thickness in prediction of fetal outcome

Background: Any disease process affecting the mother will have impact on both the fetus and the placenta. The present study was conducted to assess use of ultrasonographic placental thickness in prediction of fetal outcome.Materials & Methods: 48 with singleton pregnancy between 18 and 40 years of age, with normal BMI were included. Obstetric ultrasound was performed on using a 3.5-MHz curvilinear transducer. Post-delivery birth weight of the baby, placental weight, Apgar score, maturity of baby and sex of the baby were noted. Birth weight of the baby was recorded. Placental thickness at 32 and 36 weeks was correlated with birth weight and neonatal outcome. Results: The mean placental thickness at 32 weeks was 33.2 mm and at 36 weeks was 35.8 mm. The difference was significant (P< 0.05). There was correlation between between placental thickness and Apgar score at 32 weeks and at 36 weeks (p value = 0.05), which is statistically significant. However, no correlation was found between placental thickness and BMI of the patient (r = 0.007 at 32 weeks and r = −0.006 at 36 weeks).Conclusion: Placental thickness at 32 and 36 weeks corresponds well with gestational age and is a good prognostic factor in assessing neonatal outcome.

PLACENTAL DIAMETER AND THICKNESS AND NUMBER OF COTYLEDONS IN MILD AND SEVERE PREGNANCY INDUCED HYPERTENSIVE WOMEN VERSUS NORMOTENSIVE WOMEN OF DISTRICT D.I.KHAN, PAKISTAN

Background: Pregnancy induced hypertension (PIH) adversely affects the development of placenta and growth of fetus. The objectives of this study were to compare the placental diameter, placental thickness and number of cotyledons in mild PIH and severe PIH women versus normotensive women of District D.I.Khan, Pakistan.Material Methods: This comparative cross-sectional study was conducted in Department of Anatomy, Gomal Medical College, D.I.Khan, Pakistan from January to October 2014. Three samples were selected; each of size 50, group 1 normotensive/ control, group 2 with mild PIH and group 3 with severe PIH. Three research variables; placental diameter (cm), thickness (mm) and number of cotyledons were measured on ratio scale for three groups. Descriptive analysis included mean± SD with 95% confidence intervals for each group separately. With three groups on ratio data, one way-ANOVA test was applied to see significance of difference between three groups. Post hoc Dunnett’s t test was applied at alpha 0.05 to see difference of mild PIH group 2 to normotensive/ control group 1 and of severe PIH group 3 to normotensive/ control group 1separately.Results: Mean placental diameter was 18.28±2.15, 16.57±1.94 and 16.18±1.75 cm and mean placental thickness was 19.33 ±3.70, 19.18±2.78 and 17.60±3.52 mm in group 1, 2 and 3 respectively. Mean number of cotyledons was 14.42±2.25, 14.08±2.30 and 13.16±2.15 in group 1, 2, and 3 respectively. Placental diameter was statistically significantly lower in group 2 (p=.00001) and 3 (p=.00001) than group 1. Placental thickness in group 2 (p=.957) was similar to group 1, while in group 3 (p=.019) it was lower than group 1. Number of cotyledons in group 2 (p=.666) was similar to group 1, while in group 3 (p=.011) it was lower than group 1.Conclusion: In mild pregnancy induced hypertension (PIH), placental diameter was lower than normotensives, while placental thickness and number of cotyledons were similar to normotensives. In severe PIH, placental diameter, placental thickness and number of cotyledons were all lower than normotensives. It is concluded that in mild PIH, the development of placenta is mildly affected, while in severe PIH, the development of placenta is severely affected.

STUDY OF MORPHOLOGY AND HISTOLOGY OF PLACENTA AND ITS CORRELATION WITH MATERNAL PARAMETERS AND BIRTH WEIGHT OF NEWBORN IN ANAEMIC MOTHERS

Abstract: The aim of this study was to determine whether maternal anaemia [Hb &lt;11gm/dl]would affect the morphology and histology of placenta and and correlate it with maternal parameters and birth weight of newborn and compare this with that of non-anaemic mothers. It was a cross-sectional comparative study carried out at the maternity ward and anatomy department of NSCB MEDICAL COLLEGE JABALPUR. Background &amp; Method: Background &amp; Method: The study was carried out on 100 placentae, mothers and their babies. The placenta was collected from Obstetrics and Gynaecology, Department of NSCB Medical College, Jabalpur. Out of 100 placentae 50 from anaemic and 50 from NON anaemic mothers. &#x0D; As soon as the placenta was delivered, the umblical cord was cut it was put into formal saline. It was kept in a tray, to the membranes were trimmed off cord was cut about 10 cm from the insertion. The blood clots adherent to maternal surface were picked up. Morphological parameters like placental weight, volume. diameter, thickness, no of cotyledons were measured .Any abnormality like calcification, accessory lobe, haematoma, etc were noted. histological slides were made and stained with H and stain and Masson’s Trichrome stain. Result: A Macroscopic study of the placenta revealed placental weight, placental volume, diameter, placental thickness were more than non anaemic group and number of cotyledons were less in study group. Mean placental weight in study group was 474gm and in control group was 425 (p&lt;0.05). Mean placental volume in study group &amp; control group were 393.23and352 ml respectively (p&lt;0.05). Mean number of cotyledons were 13.24and 16 in study &amp; control group significant[p&lt;0.05] and mean diameter 18.30cms and17.05cms in study and control group. Mean placental thickness 2.4cms in study and 2.1 in control group respectively. There was an accessory lobe present in one patient of anaemic group. All morphometric parameters of placenta weight, volume, diameter, thickness were increased ,no of cotyledons were reduced .Histological findings were placental tissues shows intense congestion of septal capillaries.In the present study age, parity, height, weight, built, doesn’t found to be related with morphology of placenta. Maternal blood Hb found to be +vely correlated with weight, volume, diameter, thickness and –vely correlated with no of cotyledons and birth weight of baby. Conclusion: From the study it is concluded anaemia in pregnancy affects morphology and histology of placenta and it is correlated with various maternal parameters and birth weight of baby.&#x0D; Keywords: morphology, histology, placenta, anaemia, birth weight &amp; mothers.

ULTRASONOGRAPHIC MEASUREMENT OF PLACENTAL THICKNESS AS A PREDICTOR OF FETAL BIRTH WEIGHT

Background: The human placenta develops with the principal function of providing nutrients and oxygen to the fetus. Objective: to determine the normal sonographically measured placental thickness in millimeters from 18 week onwards and to determine the correlation between measurement and estimated fetal weight. Patients and methods: This prospective observational study was conducted on 100 pregnant women aged between 18 and 35 years at Obstetrics and Gynecology Department, Edfu General Hospital from October 2018 to January 2020. After Institutional Ethics Committee approval all recruited women were observed for baseline demographic and obstetric data including age, parity and past medical events at first antenatal visit. All women provided an informed written consent and underwent ultrasound evaluation of placental thickness at 18 to 40 weeks of gestation. Results: The mean placental thickness at 2nd trimester was 24.67±3.3 and mean Birth weight (g) was 3044.7±523.1 with range of (2200-4000). Conclusion: Placental thickness measured at the level of umbilical cord insertion can be used as an accurate sonographic indicator in the assessment of fetal weight because of its linear correlation.

Correlation of Maternal Anemia with Sonographic Placental Thickness

Anemia is a condition in which hemoglobin (Hb) concentration and/or red blood cell (RBC) numbers are lower than normal and insufficient to meet an individual’s physiological needs, it affects roughly one-third of the world’s population. Objective: To correlate the maternal anemia with placental thickness ultrasonographically . Methodology: Toshiba Nemio17 with Convex array transducer 3-5 MHz frequency was used. Patient were in spine position. Measurements of placental thickness were performed in the mid portion of the placenta, perpendicular to its long axis. The study was conducted at Gillani Ultrasound Centre and Mansoorah Teaching Hospital Lahore. Data of 110 patients was collected through cross-sectional, analytical study. Convenient Sampling Technique was used to analyze data. Statistical software for social sciences (SPSS version 22.0) is used for the analysis of data. Results: Out of 110 patients 44.5% patients were in 2 nd trimester and 55.5% patients were in their 3 rd trimester. In our study 26.4% patients had normal hemoglobin, 43.6% patients were diagnosed with moderate anemia and 30% patients were diagnosed with mild anemia. Hemoglobin rates varied between 7 g/dL to 15.40 g/dL. Placental thickness varied between 10.50mm and to 56.50mm. 9 patients had normal placental thickness, 89 had thick placenta and 12 had thin placenta. In 2 nd trimester minimum placental thickness was noted 15.7 mm and maximum placental thickness was 47.2 mm. In 3 rd trimester minimum placental thickness was noted as 10.5 mm and maximum thickness 56.5 mm. In normal placental thickness minimum hemoglobin was noted as 7 g/dL and maximum was 15.5 g/dL. In thick placenta minimum hemoglobin noted was; 7.8 g/dL and maximum hemoglobin was 15.4 g/dL. In thin placental thickness minimum hemoglobin was 8.9 g/dL and maximum was 11.2 g/dl. Majority patients came with hemoglobin rates between 8 to 11 (g/dL) and less than 5 patients came with hemoglobin 7 g/dL. In patients with mild anemia mean placental thickness was 30.57 mm. In patients with moderate anemia had mean placental thickness of 33.72 mm and in patients with normal anemia had mean placental thickness of 30.39 mm. Out of 110 patients, 29 had no anemia and from these 3 patients were found with normal placental thickness 4 with thick placenta and 2 were with thin. 81 patients who were diagnosed with anemia had normal placental thickness in 6 patients, 65 had thick placenta and 10 patients were found with thick placenta. Conclusion: We concluded that, maternal anemia has adverse effects on placental thickness and gestational age. In the present study we found that morphological and histological changes in placenta of anemic mother is undertaken, to study the effects of anemia on morphology of placenta and fetal outcomes. Keywords: Ultrasound (US), anemia, placenta, placental thickness DOI: 10.7176/JHMN/81-02 Publication date: October 31 st 2020

Placental thickness: A Sonographic Indicator of Gestational Age in Normal Singleton Pregnancies

Background: Presently the most effective way to date pregnancy is by use of ultrasound. Several sonographically derived fetal parameters used to date pregnancy include fetal crown - rump length (CRL), biparietal diameter (BPD), head circumference (HC), femur length (FL),and abdominal circumference (AC). Placental thickness measured at the level of the umbilical cord insertion can be used as a new parameter to estimate gestational age of the fetus. The present study was undertaken to evaluate the relationship between placental thickness and gestational age of the fetus. Methods: Cross-sectional study was conducted in the College of Medical Science and Teaching Hospital, Bharatpur, Nepal among 150 patients with normal singleton pregnancies presenting for routine antenatal visit of all gestational ages from 11 weeks to 40 weeks. Patients with pregnancy induced hypertension, diabetes mellitus, intrauterine growth retardation, hydrops foetalis, congenital malformation and twins are excluded. Placental thickness value, in mm, was calculated by averaging the three best measurements for each case. We studied the relationship of placental thickness, in mm, measured at the level of insertion of umbilical cord with advancing gestational age in weeks. Correlation of mean placental thickness with gestational age from 11 weeks to 40 weeks was calculated. Results: It was observed that the placental thickness gradually increased from approximately 11 mm at 11 weeks to 38.33 mm at 40 weeks of gestation. From 11 to 34 weeks of gestation, the placental thickness (in mm) almost matched the gestational age in weeks, thereafter from 35 to 40 weeks; the placental thickness was lower by 1 to 2 mm. Conclusion: The relationship between the placental thickness and gestational age was linear and direct. Placental thickness (in mm) measurement can be an important additional parameter for estimating gestational age along with other parameters especially from 11 to 34 weeks of gestation.

TO CORRELATE PLACENTAL THICKNESS WITH OTHER FETAL PARAMETER ON USG IN SECOND AND THIRD TRIMESTER OF PREGNANCY

Background: Gestational age is estimated by last menstrual period. Many women are unaware of their last menstrual period due to irregular menses, conception in lactation amenorrhea and due to illiteracy. The best possible ante partum care and successful labor outcome always revolve around the accurate knowledge of gestational age determination, and is an important component of antenatal care&#x0D; Methods: This was a prospective observational study conducted in department of obstetrics and gynecology on 200 pregnant women in second and third trimester with singleton live fetus at Mahila chikitsalay, S.M.S. medical college, Jaipur, from June 2018 to December 2019. All women were subjected to USG for estimation of gestational age by placental thickness (measured at the level of umbilical cord insertion).&#x0D; Results: Mean placental thickness show linear positive correlation with head circumference (HC). (r=0.960, p&lt;0.0001).Mean placental thickness show linear positive correlation with abdominal circumference (AC). (r=0.948,p&lt;0.0001). Mean placental thickness show positive correlation with FL both have linear correlation(r=0.946,&lt;0.0001). Mean placental thickness show linear positive correlation with estimated fetal weight (EFW). (r=0.926,p&lt;0.0001)&#x0D; Conclusion: All fetal parameter FL, HC, EFW, BPD, AC and gestational age showing positive correlation with placental thickness. All parameter have linear relationship with placental thickness. Correlation may be different with different type of parameter.&#x0D; Keywords: Ultrasonography (USG), Placental thickness, Gestation age.

Amniodrainage-Induced Circulatory Dysfunction in Women Treated for Twin-To-Twin Transfusion Syndrome.

Twin-to-twin transfusion syndrome (TTTS) in monochorionic-diamniotic twin pregnancies usually requires fetoscopic laser ablation (FLA) followed by amniodrainage (AD). Perioperative maternal hemodynamic changes and hemodilution have been observed. Little is known about the underlying pathophysiology. We aimed to evaluate the impact of high volume amniodrainage on intrauterine pressure, placental thickness and maternal blood characteristics. A total of 18 cases of TTTS were included in this prospective pilot study. All patients were treated with FLA and subsequent AD. Intrauterine pressure and placental thickness were assessed before, during and after amniodrainage. Maternal hemoglobin, hematocrit and serum albumin were measured at admission and 24 h after the intervention. Amniodrainage led to a decrease in mean intrauterine pressure (from 30.1 ± 8.1 mmHg to 17.6 ± 3.6 mmHg (p < 0.001)) and an increase in mean placental thickness (from 16.8 ± 6.4 mm to 31.83 ± 8.64 mm (p < 0.001)). There was a positive correlation between changes in placental thickness and the amount of amniodrainage during intervention (Pearson’s Rho 0.73; p = 0.001). Hematocrit decreased from 33.4 ± 3.8 (%) to 28.4 ± 3.5 (%), i.e., an increase in relative blood volume by 18 ± 10.2% (p < 0.001). Albumin decreased from 37.9 ± 0.9 g/L to 30.7 ± 2.2 g/L, i.e., an increase in relative plasma volume by 24 ± 8.1% (p < 0.001). Amniodrainage leads to uterine decompression, increased placental thickness and subsequent maternal hemodilution. We propose the term “amniodrainage-induced circulatory dysfunction” for these specific maternal hemodynamic changes in the treatment of twin-to-twin transfusion syndrome.