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Early placental maturation evaluated by ultrasound and perinatal prognosis

PURPOSE: to describe perinatal and obstetric characteristics of pregnant women with ultrasonographic early placental aging. METHODS: using a retrospective, descriptive, series of cases, with group comparison, the authors analyzed the data of 146 pregnant women, whose diagnosis of placental early aging (presence of grade II placenta before 32 gestational weeks or grade III, before 35 gestational weeks), and maternal-fetal conditions had been recorded in the medical charts at the "Maternidade Prof. Monteiro de Moraes", Recife, Pernambuco Brazil, from January 2000 to December 2002, where they had been attended as inpatients. The exclusion criteria were diagnoses of: premature amniorrhexis, multiple pregnancies, acute premature detachment of a normally located placenta, and fetal malformation. The clinical and obstetric complications were: hypertensive diseases, intrauterine growth restriction, changes of amniotic fluid volume, infections, maternal diabetes, falciform anemia, HIV seropositivity, drug addiction, renal lithiasis, epilepsy and bronchial asthma. In the medical records, 106 pregnant women were identified as having clinical and obstetric complications (Gwith group) and 40 as not having any of these complications (Gwithout group). For group comparisons, chi2 and exact Fisher statistical tests were used, with significance level of 0.05. RESULTS: Gwith group was associated with higher incidence of oligoamnion (27.3%), intrauterine growth restriction (44.3%) and caesarean section prior to labor (36.8%). Compared to Gwithout, the Gwith group was characterized by high incidence of: fetal death, prematurity (58.8% versus 40%), lower 5th minute Apgar index, birth weight less than 2.500g (67.9% versus 40%); small body size for gestational age (39.2% versus 10%) and more severe intercurrents events. CONCLUSIONS: perinatal prognosis does not depend upon placental early aging, but on clinical and obstetric maternal complications.

Placenta; Ultrasonography, prenatal; Prognosis


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