CORRELATION OF PLACENTAL LOCATION WITH DEVELOPMENT OF PREECLAMPSIA: A CROSS-SECTIONAL STUDY
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Keywords
Preeclampsia, Placental Laterality, Central Placenta, Lateral Placenta, Ultrasonography, Maternal Outcome, Fetal Outcome.
Abstract
Preeclampsia is a multisystem hypertensive disorder arising after 20 weeks of gestation and remains a major contributor to maternal and perinatal morbidity and mortality. Abnormal placental implantation and impaired uteroplacental perfusion are central to its pathogenesis. Placental laterality detected by mid-trimester ultrasonography has emerged as a simple, non-invasive, and cost-effective screening marker for early identification of women at risk. This study was conducted to evaluate the correlation between placental location and the development of preeclampsia.
Methods: A cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, RIMS, Imphal, from May 2023 to October 2024. A total of 362 pregnant women with singleton gestations beyond 20 weeks were enrolled using convenience sampling. Women with chronic hypertension, renal disease, diabetes, cardiovascular disorders, epilepsy, vascular disease, or coagulopathies were excluded. Placental location at 18–24 weeks was retrieved from ultrasound reports and classified as central or lateral. Maternal blood pressure, laboratory parameters, and obstetric outcomes were recorded. Data were analyzed using SPSS v26, applying descriptive statistics and Chi-square tests, with p < 0.05 considered significant.
Results: Among 362 participants, the placenta was centrally located in 57.7% and laterally in 42.3%. Overall, 25.1% developed preeclampsia. The incidence of preeclampsia was significantly higher in women with a lateral placenta (31.4%) compared to a central placenta (20.6%) (p = 0.019). Lateral placentation was also associated with adverse maternal and fetal outcomes: increased rates of cesarean delivery (48%), low birth weight (28.8%), IUGR (32%), NICU admission (23.6%), and stillbirth (4.6%). These outcomes were significantly higher compared to centrally located placenta (p < 0.05 across parameters).
Conclusion: Placental laterality at 18–24 weeks is significantly associated with the development of preeclampsia and poorer perinatal outcomes. Early identification of lateral placenta can aid in risk stratification, closer surveillance, and timely interventions to reduce morbidity.
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Dr. Preeti
Senior Resident, Department of Obstetrics & Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Dr. Telen Thangkhojam Kom
Associate Professor, Department of Obstetrics & Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Dr. Victor Khuman
Assistant Professor, Department of Obstetrics & Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Dr. Usharani Akoijam
Professor, Department of Obstetrics & Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
