Malay Sarkar1 , Jaydeb Mandal2 , Dibyendu Roy3 , Sunit Kumar Sarkar4
BACKGROUND An efficient utero placental vascular system is a prerequisite for successful pregnancy outcome. The site of placental attachment in the uterus may be an important determinant of placental blood flow. Centrally located placentas receive adequate blood flow from both the uterine arteries by virtue of their position. In contrast, laterally located placentas may depend on a high degree anastomosis between ipsilateral and contralateral uterine arteries. Therefore, any difficulty in collateral circulation could lead to decreased blood flow and hence thereby lead to poor obstetric outcomes. Hence this study was done to assess the obstetric outcomes and to see the association with age, parity and other demographic features. METHODS After ethical committee permission, this study was conducted in the Department of Gynaecology and Obstetrics with the help of Radiology Department of Malda Medical College. The study was carried out from 1st January 2016 to 31st December 2017. Two groups of pregnant women, one group as case and another group as control group were screened for placental localisation by USG. Fifty pregnant women with USG proved lateral placenta were included in the study group and another fifty pregnant women with central placentas in the control group. Those pregnant women who attended antenatal clinic at first trimester for registration were screened for placental localisation by USG after 24 weeks of pregnancy. All women of study group and control group were studied and followed up from 24 weeks till delivery and subsequently up to discharge of newborn babies from hospital. RESULTS Incidence of preeclampsia was high 16% (8/50) in the study group compared to control group 4% (2/50). Incidence of foetal intrauterine growth restriction (IUGR) in lateral placenta group is 20% (10/50); whereas, in central placenta group it is 6% (3/50). These are statistically significant p=0.037. In study group women, 76% were up to 25 years of age and 72% were primigravida. Socioeconomic status has little impact on placental lateralisation. CONCLUSIONS Preeclampsia and IUGR are commonly associated with lateral placental location. These two obstetric conditions may lead to poor obstetric outcomes i.e. intrauterine foetal death (IUFD), stillbirths and neonatal deaths and hence timely identification of laterally located placenta in uterus and early detection of pregnancy complications like IUGR and preeclampsia and initiation of careful prophylaxis and proper management may reduce foetal morbidity and mortality and may improve perinatal outcome and may reduce maternal morbidity and mortality.
