Second trimester placental location as a predictor of adverse pregnancy outcomes

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dc.contributor.authorVS, Ben_US
dc.contributor.authorGopal, AKen_US
dc.contributor.authorKM, B.en_US
dc.date.accessioned2025-05-14T09:32:52Z
dc.date.available2025-05-14T09:32:52Z
dc.date.issued2024-12
dc.description.abstractBackground: Placenta forms an important anatomical and physiological connection between the mother and fetus. Placenta is associated with many fetal and maternal problems. It has a key role in the nutrition of the fetus, oxygena- tion, endocrine, and other body functions. Hence it is important for a healthy pregnancy and its outcomes. The uterine blood supply is not uniformly distributed. The site of the implantation and the resultant location of the placenta within the uterus are likely to be the important determinants of placental blood flow and therefore pregnancy success. Placen- tal location has been implicated in preterm birth, fetal mal-position and mal-presentation, IUGR, Low APGAR score, and development of preeclampsia. Objectives: The objective of the study is to find out whether there is any significant correlation between second trimester placental location with the following Fetal outcomes like intra uterine growth restriction (IUGR), preterm birth, low APGAR at 1 minute (i.e. <7), NICU admission, abnormal presentation and maternal outcomes such as preeclampsia, abruption, ante partum hemorrhage due to placental praevia, postpartum hemorrhage. Materials and Methods Study Design: A prospective observational study was conducted at the Department of Obstetrics and Gynaecology, Government Medical College Hospital in Kerala for a period of 12 months after getting the approval of the Institu- tional Ethic Committee (IEC)/Institutional Review Board (IRB) of the Institution. Population for the study is antenatal women of the age group 18 to 35 years without any high risk factors. Sample size is calculated as 390 with criteria for inclusion and exclusion. Sampling procedure used is simple random sampling (SRS). The main tools used for the study were case records, obstetric USG, clinical examination findings, and lab reports. The placental location was identified by Ultra Sonography done between 18 and 24 weeks. Location of the placenta was classified as fundal, uni- lateral, and low for the study. The outcome variables selected for the study comes under two categories i.e. maternal outcomes and fetal outcomes. The maternal outcomes are preeclampsia, placental abruption, ante partum hemorrhage due to placental praevia and post-partum hemorrhage and fetal outcomes are intra uterine growth restriction (IUGR), preterm birth, low APGAR at 1 minute (i.e. <7), NICU admission and abnormal presentation. Analysis: In chi square test we get a p value. If p value is less than 0.05 then we treat it as a significant association between the variables. If the p value is less than 0.01 then there is highly significant association between the variables in the study. Results: There is a significant relation between the placental location in the second trimester and the maternal out- comes such as preeclampsia, APH in placental praevia and fetal outcomes such as IUGR, low APGAR at 1 minute (i.e. <7), and NICU admission. It is also found that there is no significant association between placental location in the second trimester and maternal outcomes such as placental abruption, postpartum hemorrhage, and fetal outcomes such as preterm birth and abnormal presentation. Conclusion: With the help of Ultra Sonography, a simple, noninvasive, easy to perform, cost effective diagnostic method, the location of placenta can easily made out and thereby identifying the above high-risk cases such as IUGR, low APGAR at 1 minute (i.e. <7), preeclampsia and APH in placental praevia. By identifying such patients appropriate treatment can be initiated and regular follow-up can be done in advance.en_US
dc.identifier.affiliationsAssistant Professor, Department of Obstetrics and Gynaecology, Government Medical College Trivandrum, Keralaen_US
dc.identifier.affiliationsAdditional Professor, Department of Obstetrics and Gynaecology, Government Medical College Kottayam, Keralaen_US
dc.identifier.affiliationsAssociate Professor, Department of Obstetrics and Gynaecology, Government Medical College Kottayam, Keralaen_US
dc.identifier.citationVS B, Gopal AK, KM B.. Second trimester placental location as a predictor of adverse pregnancy outcomes . National Journal of Physiology, Pharmacy and Pharmacology. 2024 Dec; 14(12): 2636-2651en_US
dc.identifier.issn2231-3206
dc.identifier.issn2320-4672
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/247844
dc.languageenen_US
dc.publisher?Eldaghayes Publisheren_US
dc.relation.issuenumber12en_US
dc.relation.volume14en_US
dc.source.urihttps://doi.org/10.5455/NJPPP.2024.v14.i12.23en_US
dc.subjectPlacenta locationen_US
dc.subjectSecond trimesteren_US
dc.subjectPreeclampsiaen_US
dc.subjectPlacental abruptionen_US
dc.subjectAnte partum hemorrhage due to placental praeviaen_US
dc.subjectPost partum hemorrhageen_US
dc.subjectIUGRen_US
dc.subjectPreterm birthen_US
dc.subjectLow APGARen_US
dc.subjectAbnormal presentationen_US
dc.titleSecond trimester placental location as a predictor of adverse pregnancy outcomesen_US
dc.typeJournal Articleen_US
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