Impact of mid-trimester placental location on maternal and fetal outcome

Sonal Tyagi; Juhi Srivastava; Nishi Makhija; Nikhil Gupta; Sunil Gupta

doi:10.18203/2320-1770.ijrcog20263045

Authors

Sonal Tyagi Department of Obstetrics and Gynaecology, Tirath Ram Shah Hospital, Civil Lines, Delhi, India
Juhi Srivastava Department of Obstetrics and Gynaecology, Tirath Ram Shah Hospital, Civil Lines, Delhi, India
Nishi Makhija Department of Obstetrics and Gynaecology, Tirath Ram Shah Hospital, Civil Lines, Delhi, India
Nikhil Gupta Department of Radiodiagnosis, Tirath Ram Shah Hospital, Civil Lines, Delhi, India
Sunil Gupta Department of Paediatrics, Tirath Ram Shah Hospital, Civil Lines, Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20263045

Keywords:

Fetal outcome, Maternal outcome, Mid-trimester, Placental location, Pre-eclampsia

Abstract

Background: Mid-trimester placental location is routinely documented during fetal anatomy scans, but its potential to predict maternal and fetal complications remain under-researched. This study evaluated the impact of implantation sites anterior, posterior, fundal, or lateral on pregnancy outcomes.

Methods: A prospective cohort study of 200 singleton pregnancies was conducted between January 2024 and January 2026. Placental location was assessed via ultrasound between 18-24 weeks and correlated with subsequent maternal and neonatal events.

Results: Anterior placentas were most common (44%), followed by fundal (26.5%) and posterior (21%). Lateral placentation (8.5%) was significantly associated with maternal complications (70.6%), including pre-eclampsia (40%). Posterior location was linked to higher rates of GDM (64.3%), PROM (55.6%), low birth weight (23.8%), and poor 1-minute APGAR scores (44.4%).

Conclusions: Mid-trimester placental localization is a significant prognostic indicator of maternal and neonatal risk. Routine placental mapping at 18–24 weeks serves as a cost-effective screening tool for identifying high-risk pregnancies.

References

Kl M. The Developing Human Clinically oriented embryology. Urogenital system. 1988:279-80.

Sadler TW. Uterine vascular anatomy. Langman's medical embryology. Lippincott Williams & Wilkins; 2018.

Zia S. Placental location and pregnancy outcome. J Turk Ger Gynecol Assoc. 2013;14(4):190-3.

Dhingra S, Premapriya G, Bhuvaneshwari K, Gayathri N, Vimala D. Correlation between placental location and maternal foetal outcome. Lateral. 2019;36:18.

Torricelli M, Vannuccini S, Moncini I, Cannoni A, Voltolini C, Conti N, et al. Anterior placental location influences onset and progress of labour and postpartum outcome. Placenta. 2015;36(4):463-6.

Simioni C, Araujo Júnior E. The role of mid-trimester ultrasound scan: scope and limitations. Rev Assoc Med Bras (1992). 2023;69(8):e20230567.

Whitcombe DD, Hu Z, Ounpraseuth ST, Magann EF. Placental location site and associated intrapartum, postpartum, and neonatal complications: a comprehensive review and meta-analysis. J Clin Med. 2025;14(5):1649.

Espinoza J, Romero R, Mee Kim Y, Kusanovic JP, Hassan S, Erez O, et al. Normal and abnormal transformation of the spiral arteries during pregnancy. J Perinat Med. 2006;34(6):447-58.

Cheema HK, Arora R, Joshi H. Study of placental localisation and pregnancy outcome at a medical college in North India. J Evolution Med Dent Sci. 2018;7(09):1136-8.

Patel A, Dabhadkar S, Taralekar V, Wagh G: Placental laterality and uterine artery resistance for prediction of preeclampsia. Indian J Appl Res. 2012;2:118-9.

Devarajan K, Kives S, Ray JG: Placental location and newborn weight. J Obstet Gynaecol Can. 2012;34(4):325- 9.

Calvo MJ, Parra H, Santeliz R, Bautista J, Luzardo E, Villasmil N, et al. The Placental Role in GDM Mellitus: A Molecular Perspective. touchREV Endocrinol. 2024;20(1):10-8.

Aggarwal P, Chauhan N, Agarwal A. Placental location and fetomaternal outcome: a prospective study. Int J Reprod Contracept Obstet Gynecol 2025;14:2170-5.

Yadav S, Chaudhary N, Yadav N, Sharma A, Patras E. Role of placental localisation in determining pregnancy outcome. Int J Acad Med Pharm. 2023;5(1):216-21.

Fung TY, Sahota DS, Lau TK, Leung TY, Chan LW, Chung TK. Placental site in the second trimester of pregnancy and its association with subsequent Obstetrics outcome. Prenat Diagn. 2011;31(6):548-54.

Degani S. Foetal cerebrovascular circulation: a review of prenatal ultrasound assessment. Gynecol Obstetr Investigat. 2008;66(3):184-96.

Srushti SB, Varsha VD, Shrinivas SG, Apurva AT. Clinical study of association of placental location and maternal-neonatal outcomes. J Contemp Clin Pract. 2025;11(3):860-5.

Patil A, Badade B, Thavare S. Study of neonatal outcome in relation to placental location in tertiary care centre. Med Pulse Int J Gynaecol. 2021;18(1):0914.

Jaisal P, Bhonsale D. Association of placental localization at 16-24 week and pregnancy outcome. Int J Med Res Prof. 2016;2(4):7-9.