A sonographic study of fetal in normal and hypertensive pregnant female in Central India
Main Article Content
Abstract
Background: Hypertensive disorders in pregnancy are a significant cause of maternal and fetal morbidity. The placenta's aging and senescence, reflected in these changes, are critical markers in assessing pregnancy complications. This study aims to sonographic study of fetal between hypertensive and normotensive pregnancies in Northern India, aiming to elucidate differences that could contribute to better management and outcomes in high-risk pregnancies.
Objective: A sonographic study of fetal in normotensive and hypertensive pregnant women in Central India.
Methods: The present prospective case-control study involving 200 pregnant women (100 normotensive, 100 hypertensive) of third trimester gestation. Placental grading was assessed using ultrasonography.
Results: General examination findings, however, highlighted significant differences in pulse rate, systolic and diastolic blood pressure, and respiratory rate, all higher in the case group (p < 0.001). Placental grading showed most patients in both groups had Grade II, and no significant difference was observed between groups. Fetal weight was significantly lower in the case group (2.5 ± 0.2 kg) compared to controls (2.7 ± 0.3 kg). Perinatal morbidity and mortality were higher in the case group but not statistically significant.
Conclusion: This study demonstrates placenta is mirror image of the fetal outcome. Examination of placenta by ultrasonography, there is definite evidence of changes in placental morphology and grading in pregnancy-induced hypertensive mothers.
Article Details
References
Singh M, Pathak MS, Paul A. A study on atherogenic indices of pregnancy induced hypertension patients as compared to normal pregnant women. Journal of clinical and diagnostic research: JCDR. 2015;9(7): BC05.
Barker DJ, Thornburg KL, Osmond C, Kajantie E, Eriksson JG. The surface area of the placenta and hypertension in the offspring in later life. The International journal of developmental biology. 2010; 54:525.
Risk WI, a Doctor WT. Preeclampsia and High Blood Pressure During Pregnancy.
Xiong X, Fraser WD. Impact of pregnancyinduced hypertension on birthweight by gestational age. Paediatric and Perinatal Epidemiology. 2004;18(3):186-91.
Roberts JM, Escudero C. The placenta in preeclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2012;2(2):72-83.
Tuovinen S, Aalto-Viljakainen T, Eriksson JG, Kajantie E, Lahti J, Pesonen AK, et al.
Maternal hypertensive disorders during pregnancy: adaptive functioning and psychiatric and psychological problems of the older offspring. BJOG: An International Journal of Obstetrics & Gynaecology. 2014;121(12):1482-91.
Seely EW, Ecker J. Chronic hypertension in pregnancy. New England Journal of Medicine. 2011;365(5):439-46.
Ultrasound of the placenta. Donald school journal of ultrasound in obstetrics and gynecology. 2007; 1(4): 47-60.
Petrucha RA, Platt LD. Relationship of placental grade to gestational age. Am J Obstet Gynecol. 1982; 144(6):733-5.
Broek VN, Ntonya C, Kayira E, White S, Neilson JP. Preterm birth in rural Malawi: high incidence in ultrasound-dated population. Human Reproduction, 2005; 20(11):3235–3237.
Krielessi V, Papantoniou N, Papageorgiou L, Chatzipapas I, Manios E, Zakopoulos N, et al. Placental pathology and blood pressure’s level in women with hypertensive disorders in pregnancy. Obstet GynecolInt 2012;684083.
Patterson RM, Hayashi RH, Cavazos D. Ultrasonographically observed early placental maturation and perinatal outcome. Am J Obstet Gynecol 1983; 147(7):773-7.
Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol 2011;25(4):391–403.
Nazir S, Aamir M, Malik SS, Fatima M. Sonographic Placental Grading in 3 Trimester of Hypertensive Patients. AJAHS 2017; 02(02):37-41
Chhatwal J, Chaudhary DN, Chauhan N. Placental changes in hypertensive pregnancy: a comparison with normotensive pregnancy. Int J Reprod Contracept Obstet Gynecol. 2018;7(9):3808-3813
Zhang L-Y, Yu Y-H, Hu M-L. Association between ultrasonographic signs of placental premature aging and pregnancy outcome. Di Yi Jun Yi Da Xue Xue Bao 2005; 25(3):318-20
Begum F, Jesmin S, Khatun R, Parvin S & Rahman A. Third Trimester Placental Grading by Ultrasonography and its Relationship with Fetal Outcome. TAJ: Journal of Teachers Association, 2020;33(2):94-99
Petrucha RA, ColdeSH, Platt LD. Real Time ultrasound of the placenta in assessment of foetal pulmonic maturity. Am J Obstet Gynecol. 1982; 142:463.
Mishra N. Clinical significance of placental grading by ultrasound in hypertensive disorders of pregnancy and its correlation with foetal outcome. JDMS. 2006; 6:5.
Sunanda KM, Srinivas K, Satyanarayana. Clinical Significance of Ultrasonic Placental Grading during Third Trimester in Hypertensive Disorders of Pregnancy and its Correlation with Fetal Outcome. Journal of Evidence Based Medicine and Healthcare. 2014;1(7):599-607.
Vidyarthi A, Bharti D, Toppo D & Kumari D. Comparative Study of Ultrasonic Placental Grading in Hypertensive Disorder in Pregnancy with Normal Pregnancy. IOSR J. Dental Med. Sci., 2017;16(5):25-30
Naik A, Khoiwal S, Sharma N & Aarthy P. Clinical significance of ultrasonic placental grading during third trimester in hypertensive disorders in pregnancy and its correlation with fetal outcome in tertiary care centre. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2021;10(9):3325-3331
Gupta N, Santhaliya P, Dayal M, Ranjan R. Comparative Study of Placental Grading During ThirdTrimester in Hypertensive Disorders of Pregnancy and Normal Pregnancy. International Journal of Pharmaceutical and Clinical Research 2022; 14(5); 365-372.
Saliha. The effect of hypertension on grade of placental maturation and its relation to neonatal weight. Kufa Medical Journal. 2009; 12(1).
Krielessi V, Papantoniou N, Papageorgiou L, Chatzipapas I, Manios E, Zakopoulos N, et al. Placental pathology and blood pressure’s level in women with hypertensive disorders in pregnancy. Obstet GynecolInt 2012;684083
Backes CH, Markham, Moorehead KP, Cordero L, Nankervis CA, Giannone PJ. Maternal preeclampsia and neonatal outcomes. J Pregnancy 2011;13(2):1-7
Misra DP, Salafia CM, Miller RK, Charles AK. Non -linear and gender-specific relationships among placental growth measures and the fetoplacental weight ratio. Placenta 2009;30(12):1052 –7
Afzal E, Sherin F, Seema N. Corelation of adverse perinatal out comes and placental infarcts in hypertensive preterm pregnancies. Journal of Ayub Medical College Abbottabad. 2015 ;27(3):647-9.