Correlation between placental location and development of preeclampsia

ABSTRACT

Background: Preeclampsia occurs in presence of placenta. Blood supply distribution within the uterus is not similar in central versus lateral sites implicating that, the site of placenta is likely to have a profound effect on the pregnancy outcome. In the light of these observations, a prospective study was designed to find out if the lateral location of placenta as seen by ultrasound between 18-24 weeks of gestation can be used to predict the development of preeclampsia.Methods: This prospective study was conducted in the department of Obstetrics and Gynaecology in IGGMC, Nagpur between January 2017 and June 2018. Pregnant women, with singleton pregnancy and without any risk factor, attending the antenatal clinic were subjected to USG between 18-24 weeks of gestation. Accordingly, patients were divided into 2 groups, 51 with lateral placenta and 51 with central placenta. All 102 women were followed till term. The end point of the study was development of preeclampsia i.e. BP >140/90 and urine albumin >300 mg in 24 hours sample. The data obtained was analysed using appropriate statistical tests.Results: Out of 102 patients, 80.9% were from lateral placenta group and only 19.1% were from central placenta. Sensitivity of this as screening test for preeclampsia was 80.9% while specificity was 58%, Odds ratio being 5.875. In predicting preeclampsia, lateral placenta had a meaningful effect with p value <0.001.Conclusions: Placental laterality, as determined by USG between 18-24 weeks of gestation, is a simple and cost-effective screening test for development of preeclampsia.