Abstract
In a study of 2000 unselected pregnant women the development of a mature placental appearance (grade 3) on ultrasonography by 34-36 weeks' gestation, observed in 15% of cases, was associated with maternal smoking, low parity, low maternal age, and being white. These women had an increased risk of problems during labour and their babies had an increased risk of low birth weight, poor condition at birth, and perinatal death. The women were randomly allocated to two groups: in one group the result of the placental grading was reported to the clinician responsible for care; in the second the result was noted but not reported. There was a significant decrease in the risk of perinatal death in the group where the grading was known. This reduction was responsible for a difference in the principal outcome index, a heterogeneous group of measures of mortality and morbidity, but this difference was not significant. This study alone does not justify routine late scanning, and further, larger trials are required. Nevertheless, the results do provide a basis for the reporting of placental grading when ultrasound examination is performed during the third trimester.
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Selected References
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- Ashton S. S., Russo M. P., Simon N. V., Shearer D. M. Relationship between Grade III placentas and biparietal diameter determinations. J Ultrasound Med. 1983 Mar;2(3):127–129. doi: 10.7863/jum.1983.2.3.127. [DOI] [PubMed] [Google Scholar]
- Cole S. K., Hey E. N., Thomson A. M. Classifying perinatal death: an obstetric approach. Br J Obstet Gynaecol. 1986 Dec;93(12):1204–1212. doi: 10.1111/j.1471-0528.1986.tb07853.x. [DOI] [PubMed] [Google Scholar]
- Crawford D. C., Fenton D. W., Price W. I. Ultrasonic tissue characterization of the placenta: is it of clinical value? J Clin Ultrasound. 1985 Oct;13(8):533–537. doi: 10.1002/1097-0096(199010)13:8<533::aid-jcu1870130804>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
- Grannum P. A., Berkowitz R. L., Hobbins J. C. The ultrasonic changes in the maturing placenta and their relation to fetal pulmonic maturity. Am J Obstet Gynecol. 1979 Apr 15;133(8):915–922. doi: 10.1016/0002-9378(79)90312-0. [DOI] [PubMed] [Google Scholar]
- Grannum P. A., Hobbins J. C. The placenta. Radiol Clin North Am. 1982 Jun;20(2):353–365. [PubMed] [Google Scholar]
- Hill L. M., Breckle R., Ragozzino M. W., Wolfgram K. R., O'Brien P. C. Grade 3 placentation: incidence and neonatal outcome. Obstet Gynecol. 1983 Jun;61(6):728–732. [PubMed] [Google Scholar]
- Kazzi G. M., Gross T. L., Sokol R. J., Kazzi N. J. Detection of intrauterine growth retardation: a new use for sonographic placental grading. Am J Obstet Gynecol. 1983 Mar 15;145(6):733–737. doi: 10.1016/0002-9378(83)90582-3. [DOI] [PubMed] [Google Scholar]
- Miettinen O. Estimability and estimation in case-referent studies. Am J Epidemiol. 1976 Feb;103(2):226–235. doi: 10.1093/oxfordjournals.aje.a112220. [DOI] [PubMed] [Google Scholar]
- Quinlan R. W., Cruz A. C., Buhi W. C., Martin M. Changes in placental ultrasonic appearance. I. Incidence of Grade III changes in the placenta in correlation to fetal pulmonary maturity. Am J Obstet Gynecol. 1982 Oct 15;144(4):468–470. [PubMed] [Google Scholar]
- Quinlan R. W., Cruz A. C., Buhi W. C., Martin M. Changes in placental ultrasonic appearance. II. Pathologic significance of Grade III placental changes. Am J Obstet Gynecol. 1982 Oct 15;144(4):471–473. doi: 10.1016/0002-9378(82)90257-5. [DOI] [PubMed] [Google Scholar]
- Secher N. J., Hansen P. K., Lenstrup C., Pedersen-Bjergaard L., Eriksen P. S., Thomsen B. L., Keiding N. Birthweight-for-gestational age charts based on early ultrasound estimation of gestational age. Br J Obstet Gynaecol. 1986 Feb;93(2):128–134. doi: 10.1111/j.1471-0528.1986.tb07877.x. [DOI] [PubMed] [Google Scholar]