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Gebeliğin Üçüncü Trimesterindeki Plasenta Lokalizasyonu İntrauterin Ultrasonografi ve Postpartum Parametrelerle İlişkili midir?

Year 2022, Volume: 19 Issue: 1, 169 - 175, 28.04.2022
https://doi.org/10.35440/hutfd.1091904

Abstract

Amaç: Plasenta lokalizasyonu ve fetüs arasındaki ilişki belirsizdir. Bu çalışmada, gebeliğin üçüncü trimesterindeki plasenta lokalizasyonu ile ultrasonografi bulguları ve gebelik sonuçları arasındaki ilişkilerin belirlenmesi amaçlanmıştır.
Materyal ve metod: Çalışmaya 302 kadın dahil edildi. Anne yaşı, gravidite, parite, düşük ve canlı doğum sayısı, önceki doğum şekilleri, gebelik yaşı, femur uzunluğu (FL), biparietal çap (BPD), baş çevresi (HC), abdominal çevre (AC), plasenta lokalizasyonu (anterior/posterior/lateral/fundus), umblikal arter sistolik/diyastolik oranı (S/D), fetal prezentasyon, doğum şekli, bebeğin doğum sonrası parametreleri arşiv kayıtlarından elde edildi.
Bulgular: Plasenta lokalizasyonları sırasıyla bireylerin %38.1, %30.1, %19.9 ve %11.9'unda anterior, posterior, fundal ve lateral uterin duvarda bulunuyordu. Üçüncü trimesterde HC ölçümleri plasenta lokalizasyonuna göre farklılık gösteriyordu ve plasenta lokalizasyonu anteriorda ise HC ölçümleri anlamlı olarak daha yüksekti (p=0.045). Diğer ultrasonografik ölçümlerde (S/D, BPD, AC ve FL), bebeğin boy, kilo ve cinsiyeti, doğum haftası, APGAR skorları ve doğum şeklinde plasenta lokalizasyonuna göre farklılık yoktu (p>0.05).
Sonuç: Bu çalışmada üçüncü trimesterdeki risksiz, spontan ve tekil gebeliklerde plasenta lokalizasyonunun fetal sonuçları, doğum şeklini ve fetal cinsiyeti etkilemediğini saptadık. Ayrıca önceki doğum şeklinin plasenta lokalizasyonu hakkında fikir vermediğini tespit ettik. Plasenta lokalizasyon anomalisi ve invazyon anomalisi dışındaki plasenta implantasyonlarının fetal sonuçlar ve doğum şekli hakkında kesin bilgi vermediğini düşünmekteyiz.

References

  • Köroğlu N, Sudolmuş S, Ölmez H, Tunca AF, Gülkılık A, Yetkin Yıldırım G. İkinci Trimester Plasenta Lokalizasyonunun Gebelik Sonuçlarına Etkisi. JOPP Derg. 2013;5(2):70-5.
  • Murphy VE, Smith R, Giles WB, Clifton VL. Endocrine regulation of human fetal growth: the role of the mother, placenta, and fetus. Endocrine Reviews. 2006;27(2):141-69.
  • Erdolu MD, Köşüş A, Köşüş N, Dilmen G, Kafalı H. Relationship between placental localisation, birth weight, umbilical Doppler parameters, and foetal sex. Turk J Med Sci. 2014;44(6):1114-7.
  • Fidan U, Ulubay M, Bodur S, Kinci MF, Karaşahin KE, Yenen MC. The effect of anatomical placental location on the third stage of labor. Clin Anat. 2017;30(4):508-11.
  • Granfors M, Stephansson O, Endler M, Jonsson M, Sandström A, Wikström AK. Placental location and pregnancy outcomes in nulliparous women: A population based cohort study. Acta Obstet Gynecol Scand. 2019;98(8):988-96.
  • Nagwani M, Sharma PK, Singh U, Rani A, Mehrotra S. Ultrasonographic evaluation of placental location in third trimester of pregnancy in relation to fetal weight. IOSR-JDMS. 2016;15(10):29-33.
  • Suresh KK, BhAgwAt AR. Ultrasonographic measurement of placental thickness and its correlation with femur length. Int J Anat Radiol Surg. 2017;6(1):46-51.
  • Zia S. Placental location and pregnancy outcome. J Turkish-German Gynecol Assoc. 2013;14:190-3.
  • Mohammad Jafari R, Barati M, Bagheri S, Shajirat Z. Fetal gender screening based on placental location by 2-dimentional ultrasonography. Tehran Univ Med J. 2014;72(5):323-8.
  • Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic ultrasound. 4th ed. Mosby, Philadelphia; 2011, p. 1502-4.
  • Filly RA, Hadlock FP. Sonographic determination of menstrual age. In: Ultrasonography in Obstetrics and Gynecology. 4th ed. WB Saunders, Philadelphia; 2000, p. 146-70.
  • Goldstein RB, Filly RA, Simpson G. Pitfalls in femur length measurements. J Ultrasound Med. 1987;6(4):203-7.
  • Chinn DH, Filly RA, Callen PW. Ultrasonic evaluation of fetal umbilical and hepatic vascular anatomy. Radiology. 1982;144(1):153-7.
  • Lim KI, Butt K, Naud K, Smithies M. Amniotic fluid: technical update on physiology and measurement. J Obstet Gynaecol Can. 2017;39(1):52-8.
  • Klar M, Michels KB. Cesarean section and placental disorders in subsequent pregnancies-a meta-analysis. J Perinat Med. 2014;42(5):571-83.
  • Ananth CV, Smulian JC, Vintzileos AM. The association of placenta previa with history of cesarean delivery and abortion: a metaanalysis. Am J Obstet Gynecol. 1997;177(5):1071-8.
  • Mirbolouk F, Mohammadi M, Leili EK, Heirati SF. The Association between Placental Location in the First Trimester and Fetal Sex. JPRI. 2019;27(5):1-8.
  • Magann EF, Doherty DA, Turner K, Lanneau GS, Morrison JC, Newnham JP. Second trimester placental location as a predictor of an adverse pregnancy outcome. J Perinatol. 2007;27(1):9-14.
  • Filipov E, Borisov I, Kolarov G. Placental location and its influence on the position of the fetus in the uterus. Akush Ginekol (Sofiia). 2000;40(4):11-2.
  • Devarajan K, Kives S, Ray JG. Placental location and newborn weight. J Obstet Gynaecol Can. 2012;34(4):325-9.
  • Hammad HM, Elgyoum AMA, Abdelrahim A. Role of ultrasound in finding the relationship between placental location and fetal gender. IJMCR. 2016;47:216-9.
  • Torricelli M, Vannuccini S, Moncini I, Cannoni A, Voltolini C, Conti N, et al. Anterior placental location influences onset and progress of labor and postpartum outcome. Placenta. 2015;36(4):463-6.

Is Placental Localization in the Third Trimester of Pregnancy Related to the Intrauterine Ultrasound and Postpartum Parameters?

Year 2022, Volume: 19 Issue: 1, 169 - 175, 28.04.2022
https://doi.org/10.35440/hutfd.1091904

Abstract

Background: The relationship between placental localization and fetus is unclear. This study was aimed to determine the relationships between placental localization, ultrasound findings and pregnancy outcomes of the third trimester of pregnancies.
Materials and Methods: Three-hundred and two women were included in the study. Maternal age, gravidi-ty, parity, abortion and live birth numbers, types of previous births, gestational age, femur length (FL), bipa-rietal diameter (BPD), head circumference (HC), abdominal circumference (AC), placental localization (ante-rior/posterior/lateral/fundus), umbilical artery systolic/diastolic ratio (S/D), fetal presentation, type of deliv-ery, post-partum parameters of infant were obtained from archive records.
Results: The placentas were located in the anterior, posterior, fundal and lateral uterine wall in 38.1%, 30.1%, 19.9%, and 11.9% of individuals, respectively. Measurements of the HC in the third trimester were differed according to the localization of the placenta, and the HC measurements were significantly higher if the placental localization was anteriorly (p=0.045). There were no differences in other ultrasonographic measurements (S/D, BPD, AC ve FL), in the height, weight, and gender of the baby, gestational week at delivery, APGAR scores and type of delivery according to the placental localization (p>0.05).
Conclusions: In this study, we found that placental localization did not affect pregnancy outcomes, type of delivery and gender of the baby in risk-free, spontaneous and single pregnancies in the third trimester. Also, we stated that the previous birth type did not give an idea about placental localization. We think that placenta implantations, except placental location anomaly and invasion anomaly, do not provide precise information about pregnancy outcomes and type of delivery.

References

  • Köroğlu N, Sudolmuş S, Ölmez H, Tunca AF, Gülkılık A, Yetkin Yıldırım G. İkinci Trimester Plasenta Lokalizasyonunun Gebelik Sonuçlarına Etkisi. JOPP Derg. 2013;5(2):70-5.
  • Murphy VE, Smith R, Giles WB, Clifton VL. Endocrine regulation of human fetal growth: the role of the mother, placenta, and fetus. Endocrine Reviews. 2006;27(2):141-69.
  • Erdolu MD, Köşüş A, Köşüş N, Dilmen G, Kafalı H. Relationship between placental localisation, birth weight, umbilical Doppler parameters, and foetal sex. Turk J Med Sci. 2014;44(6):1114-7.
  • Fidan U, Ulubay M, Bodur S, Kinci MF, Karaşahin KE, Yenen MC. The effect of anatomical placental location on the third stage of labor. Clin Anat. 2017;30(4):508-11.
  • Granfors M, Stephansson O, Endler M, Jonsson M, Sandström A, Wikström AK. Placental location and pregnancy outcomes in nulliparous women: A population based cohort study. Acta Obstet Gynecol Scand. 2019;98(8):988-96.
  • Nagwani M, Sharma PK, Singh U, Rani A, Mehrotra S. Ultrasonographic evaluation of placental location in third trimester of pregnancy in relation to fetal weight. IOSR-JDMS. 2016;15(10):29-33.
  • Suresh KK, BhAgwAt AR. Ultrasonographic measurement of placental thickness and its correlation with femur length. Int J Anat Radiol Surg. 2017;6(1):46-51.
  • Zia S. Placental location and pregnancy outcome. J Turkish-German Gynecol Assoc. 2013;14:190-3.
  • Mohammad Jafari R, Barati M, Bagheri S, Shajirat Z. Fetal gender screening based on placental location by 2-dimentional ultrasonography. Tehran Univ Med J. 2014;72(5):323-8.
  • Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic ultrasound. 4th ed. Mosby, Philadelphia; 2011, p. 1502-4.
  • Filly RA, Hadlock FP. Sonographic determination of menstrual age. In: Ultrasonography in Obstetrics and Gynecology. 4th ed. WB Saunders, Philadelphia; 2000, p. 146-70.
  • Goldstein RB, Filly RA, Simpson G. Pitfalls in femur length measurements. J Ultrasound Med. 1987;6(4):203-7.
  • Chinn DH, Filly RA, Callen PW. Ultrasonic evaluation of fetal umbilical and hepatic vascular anatomy. Radiology. 1982;144(1):153-7.
  • Lim KI, Butt K, Naud K, Smithies M. Amniotic fluid: technical update on physiology and measurement. J Obstet Gynaecol Can. 2017;39(1):52-8.
  • Klar M, Michels KB. Cesarean section and placental disorders in subsequent pregnancies-a meta-analysis. J Perinat Med. 2014;42(5):571-83.
  • Ananth CV, Smulian JC, Vintzileos AM. The association of placenta previa with history of cesarean delivery and abortion: a metaanalysis. Am J Obstet Gynecol. 1997;177(5):1071-8.
  • Mirbolouk F, Mohammadi M, Leili EK, Heirati SF. The Association between Placental Location in the First Trimester and Fetal Sex. JPRI. 2019;27(5):1-8.
  • Magann EF, Doherty DA, Turner K, Lanneau GS, Morrison JC, Newnham JP. Second trimester placental location as a predictor of an adverse pregnancy outcome. J Perinatol. 2007;27(1):9-14.
  • Filipov E, Borisov I, Kolarov G. Placental location and its influence on the position of the fetus in the uterus. Akush Ginekol (Sofiia). 2000;40(4):11-2.
  • Devarajan K, Kives S, Ray JG. Placental location and newborn weight. J Obstet Gynaecol Can. 2012;34(4):325-9.
  • Hammad HM, Elgyoum AMA, Abdelrahim A. Role of ultrasound in finding the relationship between placental location and fetal gender. IJMCR. 2016;47:216-9.
  • Torricelli M, Vannuccini S, Moncini I, Cannoni A, Voltolini C, Conti N, et al. Anterior placental location influences onset and progress of labor and postpartum outcome. Placenta. 2015;36(4):463-6.
There are 22 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Reyhan Gündüz 0000-0001-8468-7038

Begümhan Turhan 0000-0003-0842-2059

Mulaim Sizer 0000-0003-4864-7287

Senem Yaman Tunç 0000-0003-2583-2770

Elif Ağaçayak 0000-0002-4215-1371

Publication Date April 28, 2022
Submission Date March 23, 2022
Acceptance Date April 13, 2022
Published in Issue Year 2022 Volume: 19 Issue: 1

Cite

Vancouver Gündüz R, Turhan B, Sizer M, Yaman Tunç S, Ağaçayak E. Is Placental Localization in the Third Trimester of Pregnancy Related to the Intrauterine Ultrasound and Postpartum Parameters?. Harran Üniversitesi Tıp Fakültesi Dergisi. 2022;19(1):169-75.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty