CLINICAL SIGNIFICANCE OF ULTRASONIC PLACENTAL GRADING DURING THIRD TRIMESTER IN HYPERTENSIVE DISORDERS OF PREGNANCY AND ITS CORRELATION WITH FETAL OUTCOME
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2014, Vol 1, Issue 7
Abstract
Pre-eclampsia is a common (7% of all pregnancies) disorder in which normal haemodynamic response is compromised. Pre-eclampsia is an important cause of maternal and fetal morbidity and mortality. Inspite of its relevant epidemiological impact, the complete pathogenesis of this disease still remains an enigma underlining a multifactorial aetiology. AIMS AND OBJECTIVES: To study the placental grading by USG in pregnancy complicated by hypertensive disorders and compare the fetal outcome parameters like mode of delivery, fetal distress, birth asphyxia, fetal maturity and perinatal mortality and morbidity in relation to placental grading. MATERIALS AND METHODS: This study was conducted for a period of 2 years. Data was collected from 200 patients attending the Department of OBG in Vani Vilas Hospital attached to Bangalore Medical College and Research institute. It Included 100 pregnant women with Pre eclampsia and 100 normotensive women as controls. Ultrasound placental grading was done and the placental grading was correlated with fetal outcome. RESULTS: Majority of the patients were in the age group of 20-25 years (70%), with a mean age of 20.92 years in the control group and 20.88 in the study group. In the control group 33%, 50%, and 17% women had placental grading of I, II and III respectively as against 18%, 56% and 26% in the women in the study group. Preterm delivery was significantly more in the study group (24%). Spontaneous delivery was 87% in controls versus 59% in the study group. Induced delivery was 8% amongst controls and 21% in study group. Caesarean was 25% in study group and 5% in controls. Foetal distress was more in the study group. Perinatal mortality was 12% in study group versus 3% in the controls. Grade III placenta in the study group showed a perinatal mortality of 7% versus 0% in the controls. CONCLUSION: Foetal complications were significantly more in the study group compared to controls. Placental grading did not show significant correlations with perinatal outcomes except for the small for gestation babies. The study concludes that there is no significant correlation of placental grading with perinatal outcomes.
Authors and Affiliations
Sunanda K. M. , Srinivas K. , Satyanarayana Satyanarayana
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