ABSTRACT
Background: Accurate estimation of gestational age and fetal wellbeing is mandatory to ensure safe pregnancy and healthy delivery. With recent development in USG, basic scan, Doppler imaging and interventional radiology helped greatly in accurate estimation of gestational age and delivering timely care. The objectives of this study was to determine the USG placental thickness at the level of insertion of cord in antenatal women from gestational age 11 to 40 weeks. To correlate placental thickness with gestational age. To calculate composite gestational age from USG parameters; CRL, BPD, HC, AC, FL. To compare the relationship of menstrual gestational age with placental thickness and composite gestational age separatelyMethods: It is a comparative study of 2 years duration. Total 322 patients were included. Gestational age was determined from LMP. Patient’s routine obstetric USG was done and composite gestational age was calculated from fetal parameters like BPD, HC, AC and FL (CRL in 11 to 14 weeks). At the same time placental thickness was determined at the level of insertion of umbilical cord. The plane of USG image was adjusted so that the thickness measured from cord insertion is perpendicular to the margin of uterine wall.Results: The following parameters were noted: correlation of period of gestation (weeks) with composite gestational age (weeks) correlation of period of gestation (weeks) with gestational age calculated by placental thickness (weeks).Conclusions: Placental thickness can give an estimation of gestational age. The linear correlation and statistical compatibility of placental thickness makes it an alternate parameter for gestational age. Knowledge of correct gestational age helps in delivering proper antenatal care, assessing fetal wellbeing, identifying pathology at the earliest and timely decision of termination and providing safe motherhood.
ABSTRACT
Background: The placenta is a multifaceted organ which modulates and modifies the maternal environment resulting in foetal development. It could be assumed that a healthy placenta culminates in a healthy foetus. Hence the morphometric analysis of a placenta during sonogram is inevitable. The aim of the study was to estimate the relationship between placental thickness and estimated foetal weight.Methods: The study was a cross-sectional study and included 450 antenatal women attending the department of Obstetrics and Gynaecology, Tirunelveli Medical College from May 2013 to May 2014. These women had regular cycles with a known Last menstrual period and a singleton foetus. After ethics committee approval, meticulous history including age, parity, demographic factors and past history were recorded. After obtaining consent, these women underwent placental thickness measurement between 14-40 weeks of pregnancy.Results: In the study mean placental thickness between the ranges of 11-49mm was 28.7mm and mean estimated foetal weight was 1.421kilogram. The correlation between the two was 0.943. Hence the positive correlation between the placental thickness and foetal weight is confirmed (p value <0.001).Conclusions: Determining the estimated foetal weight is an important reason for doing a sonogram, especially in third trimester. Placental thickness measured at the level of umbilical cord insertion can serve as an additional parameter in estimating foetal weight in addition to the foetal parameters, since there is a linear correlation between placental thickness and foetal weight.
ABSTRACT
Background: Gestational age is frequently over or under estimated, as the conventional gestational estimation is based on the last menstrual period and on ultrasonography. Many people are unaware of their last menstrual period and irregular menstruation and ultrasonography is bound to have a bias, thereby posing difficulties in the estimation gestational age. Placental thickness measured at the level of umbilical cord insertion appears to be a new promising parameter for estimation of gestational age of fetus as placenta is a maternal foetal organ and its size is a reflection of the health and size of the foetus. It provides the physiological link between a pregnant woman and the fetus.Measurement of placental thickness is relatively simple and very useful. In our present study we have tried to measure Placental thickness at the level of umbilical cord and determine its relationship with gestational age of foetus in normal singleton pregnancy. Methods: The current crossectional study was conducted at the department of radiodiagnosis, Gandhi medical college and Hamidia hospital, Bhopal from April 2012 to December 2014. This is a hospital based study with a sample size of 199 normal antenatal women. All the subjects were enrolled with detailed oral and written consents. All examinations were performed using GE logic 3 expert scanner with 3.5 MHz convex array transducer. Placental thickness in millimeters was measured at the level of insertion of the umbilical cord. Data was compiled in MS excel sheet and analyzed using online statistical calculator, chi square test and pearson correlation coefficient were applied with value of P <0.05 was considered statistically significant. Results: In the total study group of 199 normal antenatal women, the age ranged between 18yrs to 34 years and the mean age was between 20 and 25 years of age. Anterior placenta was noted to be the most common location amongst the study sample. It is observed that placental thickness correlates with gestational age and gradually increases as gestational age increases. To prove that there was a correlation the between placental thickness and the gestational age, the Pearson correlation coefficient was found to be r = 0.98 and the p value was <0.001, thereby establishing a positive correlation between the two variables, indicating placental thickness measured in millimeters increases with gestational age measured in weeks and were statistically significant. Conclusion: A linear increase in mean placental thickness with gestational age was observed using correlation analysis in our present study conducted to determine the relationship between placental thickness and gestational age. Placental thickness measured in millimeters increases with gestational age from 11 weeks to 37 weeks. Placental thickness can be used as a predictor of the gestational age, in women in whom the last menstrual period is unreliable or is not known. In instances when femoral length was difficult to measure due to excessive foetal movements, Placental thickness was found to be a reliable alternative biometric measurement in calculating gestational age.