Correlation between placental location and development of preeclampsia


  • Prashaant Uikey Department of Obstetrics and Gynecology, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
  • Vaishali Gurwani Department of Obstetrics and Gynecology, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
  • Megha Tajne Department of Anaesthesiology, NKP Salve Institute of Medical Sciences, Nagpur, Maharashtra, India



Central placenta, Perinatal outcome, Placental laterality, Preeclampsia, Screening test, Ultrasonography


Background: Preeclampsia occurs in presence of placenta. Blood supply distribution within the uterus is not similar in central versus lateral sites implicating that, the site of placenta is likely to have a profound effect on the pregnancy outcome. In the light of these observations, a prospective study was designed to find out if the lateral location of placenta as seen by ultrasound between 18-24 weeks of gestation can be used to predict the development of preeclampsia.

Methods: This prospective study was conducted in the department of Obstetrics and Gynaecology in IGGMC, Nagpur between January 2017 and June 2018. Pregnant women, with singleton pregnancy and without any risk factor, attending the antenatal clinic were subjected to USG between 18-24 weeks of gestation. Accordingly, patients were divided into 2 groups, 51 with lateral placenta and 51 with central placenta. All 102 women were followed till term. The end point of the study was development of preeclampsia i.e. BP >140/90 and urine albumin >300 mg in 24 hours sample. The data obtained was analysed using appropriate statistical tests.

Results: Out of 102 patients, 80.9% were from lateral placenta group and only 19.1% were from central placenta. Sensitivity of this as screening test for preeclampsia was 80.9% while specificity was 58%, Odds ratio being 5.875. In predicting preeclampsia, lateral placenta had a meaningful effect with p value <0.001.

Conclusions: Placental laterality, as determined by USG between 18-24 weeks of gestation, is a simple and cost-effective screening test for development of preeclampsia.


Kuklina EV, Ayala C, Callaghan WM. Hypertensive disorders and severe obstetric morbidity in the United States. Obstet Gynecol. 2009;113(6):1299-306.

WHO, World Health Statistics, 2012. Available at: Accessed on 5th September 2018.

Organization, W, Bank W, Fund U. Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA, and The World Bank, 2007. Available at: /10665/43807. Accessed on 1st September 2018.

Studd J, Baker F. Screening tests for pregnancy induced hypertension in progress. Obstet Gynecol. 1990;10:69.

Walker JJ. Current thoughts on the pathophysi ology of preeclampsia/eclampsia. In: Studd J, editor. Progress in obstetrics and gynecology. Edinburgh: Livingstone-Churchill; 1998:177-88.

Fleischer A, Schulman H, Farmakides G. Uterine artery Doppler velocimetry in pregnant women with hypertension. Am J Obstet Gynecol. 1986;154:806-13.

Schulman H, Winter D, Farmakides G. Pregnancy surveillance with Doppler velocimetry of uterine and umbilical arteries. Am J Obstet Gynecol. 1989;160:192-6.

Belogolovkin V, Engel SM, Ferrara L, Eddleman KA, Stone JL. Does sonographic determination of placental location predict fetal birth weight in diamniotic-dichorionic twins? J Ultrasound Med. 2007;26(2):187-91.

Guiot C, Gaglioti P, Oberto M, Piccoli E, Rosato R, Todros T. Is threedimensional power Doppler ultrasound useful in the assessment of placental perfusion in normal and growth-restricted pregnancies? Ultrasound Obstet Gynecol. 2008;31(2):171-6.

Chhabra S, Yadav Y, Srujana D, Tyagi S, Kutchi I. Maternal neonatal outcome in relation to placental location, dimensions in early pregnancy. J Basic Clin Reprod Sci. 2013;2(2):105-9.

Moore RJ, Strachan BK, Tyler DJ, Duncan KR, Baker PN, Worthington BS, et al. In utero perfusing fraction maps in normal and growth restricted pregnancy measured using IVIM echo-planar MRI. Placenta. 2000;21(7):726-32.

Francis ST, Duncan KR, Moore RJ, Baker PN, Johnson IR, Gowland PA. Non-invasive mapping of placental perfusion. Lancet. 1998;351(9113):1397-9.

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

Van E Beek, Peters LLH. Pathogenesis of preeclampsia. A comprehensive model. Obstet Gynaecol Survey. 1998;53(4):233-9.

Kore S, Khot R, Supe P, Kanavia D, Thunga C, Nandanwar Y. Prediction of pre-eclampsia: role of placental laterality by ultrasonography. Int J Repro Contracept Obstet Gynaecol. 2016:1433-1437.

Sibai BM. First-trimester screening with combined maternal clinical factors, biophysical and biomarkers to predict preterm pre-eclampsia and hypertensive disorders: are they ready for clinical use? BJOG. 2015;122(3):282-3.

Sandhya, G Madhavi. Placental laterality as a predictor of preeclampsia. Am J Phytomed Clin Therap. 2015;3(3):231-6.

Kakkar T, Singh V, Razdan R, Digra S, Gupta A, Kakkar M. Placental laterality as a predictor for development of preeclampsia. J Obstet Gynaecol India. 2012;63(1):22-5.

Keshavarz E, Sadeghian A, Ganjalikhan Hakemi A, TalebiKhtibi F. Prediction of preeclampsia development by placental location: a simple predictor. J Obstet Gynaecol Cancer Res. 2017;2:4.

Muralidhar P, Jothi P. Placental laterality by ultrasonogram a simple yet reliable predictive test for pre-eclampsia prediction. J Obstet Gynecol. 1989;161:153-69.

Kalanithi LE, Illuzzi JL, Nossov VB. Intrauterine growth restriction and placental location. J Ultrasound Med. 2007;26:1481-9.

Kofinas AD, Penry M, Swain M, Hatjis CG. Effect of placental laterality on uterine artery resistance and development of preeclampsia and intrauterine growth retardation. Am J Obstet Gynecol. 1989;161:1536-9.

Vaillant P, Best MC, Cynober E, Devulder G. Pathological Doppler uterine readings when the placenta is laterally situated. J Gynecol Obstet Biol Reprod. 1993;22:301-7.






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