Résumé
Aim: Placental location affects the outcome of pregnancy. The influence of certain maternal factors on placental location is unknown. This study aimed at investigating the relationship between placenta location, maternal blood group, maternal genotype and parity among Port Harcourt women. Methodology: The study was a retrospective study which investigated the Relationship Between Placental Location, Blood Group and Genotype in Port Harcourt Women in Port Harcourt, Nigeria.A survey of pregnant women from October 1, 2013, to September 30, 2017, as well as delivery of the pregnancy, was undertaken using medical records.250 antenatal/post-natal medical records of parous women were randomly selected at the University of Port Harcourt Teaching Hospital. Original ResearchArticle Placental locations were recorded. Each placenta was categorized as anterior, posterior and fundal. Lateral placentas located on the left or right portion of the anterior and posterior uterine walls were classified as anterior and posterior respectively. Data were also collected for other variables such as maternal blood group, genotype and parity. Results: Anterior placenta was predominant (47%) followed by the posterior placenta (45%) while Fundal was the least (8%). Majority of the women were of the O blood group (67.6%), blood group A (18%) was next, blood group B (13%) while AB (1.2%) was the least. Genotype AA was predominant (83.6%), followed by AS (15.6%) whereas genotype SS (0.8%) was the least. The distribution of parity showed that women who had given birth twice designated as Two were predominant (33.2%), followed by those who had given birth once designated as One, (30.8%), Three (19.2%) while Four and above, (10.8%) were the least. The association between placenta location and blood group was not significant (p>0.05). Similarly, there was no significant association between placenta location and genotype (ρ>0.05). However, there was a significant association (p<0.05) between placenta location and parity.Conclusion: Placental location had no association with blood group and genotype but was associated with parity. There was an absence of a relationship between placental location and these factors.
Résumé
This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta,and that in women with and without previous cesarean section.In this study,placenta previa was defined as a placenta lying within 20 mm of the internal cervical os or overlapping it.We recruited 183 women diagnosed with previa between 20+0 weeks and 25+6 weeks.They were grouped according to their placenta location (anterior or posterior) and history of cesarean section.Comparative analysis was performed on demographic data,resolution rate of previa and pregnancy outcomes between anterior group and posterior group,and on those between cesarean section group and non-cesarean section group.Women with an anterior placenta tended to be advanced in parity (P=0.040) and have increased number of dilatation and curettage (P=0.044).The women in cesarean section group were significantly older (P=0.000) and had more parity (P=0.000),gravidity (P=0.000),and dilatation and curettage (P=0.048) than in non-cesarean section group.Resolution ofprevia at delivery occurred in 87.43％ women in this study.Women with a posterior placenta had a higher rate of resolution (P=0.030),while history of cesarean section made no difference.Gestational age at resolution was earlier in posterior group (P=0.002) and non-cesarean section group (P=0.008) than in anterior group and cesarean section group correspondingly.Placenta location and prior cesarean section did not influence obstetric outcomes and neonatal outcomes.This study indicates that it is more likely to have subsequent resolution of the previa when the placenta is posteriorly located for women who are diagnosed with placenta previa in the second trimester.
Résumé
Background: Placental abnormality is one of the initial events seen in patients who are destined to develop preeclampsia. The objective was to study whether ultrasonically identified; placental laterality and uterine artery resistance can be used as a predictor for development of preeclampsia. Methods: This prospective observational study was conducted at GMERS Medical College, Dharpur-Patan tertiary care teaching institute in North Gujarat from January 2013 to December 2014. A total 400 non high risk primigravida with singleton pregnancy were included, all patients with diabetes, hypertension, renal disease, and history of smoking were excluded. In all these patients, location of placenta was determined by ultrasonography at 18 to 22 weeks of gestation. Patients who had lateral placenta were subjected for colour Doppler study for determining uterine artery resistance index. All 400 patients were followed till delivery for occurrence of preeclampsia as per ACOG guidelines. All data was analyzed and statistical significance was determined by x2 test and value of p<0.05 is considered significant. Results: Out of 400 cases, 80 (20%) cases had laterally located placenta on ultra sound examination done at 18-24 weeks of gestation. Out of the 80 women with laterally located placenta, 28 (35%) developed preeclampsia. This relationship was statistically significant. All 80 patients who had lateral placenta, 26 patients had raised uterine artery resistance and out of those 26 patients, 22 developed preeclampsia and 54 had no change in uterine artery resistance. Out of those 54 only 6 had preeclampsia (p<0. 001). The sensitivity of determining uterine artery resistance as a predictive test was 84.6%, the specificity 88.8 %, positive predictive value 78.5 % and negative predictive value 92.3%. Conclusion: A chance of preeclampsia is more in patients with lateral placenta but its sensitivity and specificity increases significantly when it is combined with uterine artery velocimetric waveform study, and we can predict preeclampsia in patient who is having lateral placenta and raised uterine artery resistance.