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Category: Volume 07 Issue 01 January 2019
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Title: Evaluation of Gestational age by Sonological Measurement of Placental Thickness

Author: Dr Himanshu Kumar Jaiswal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.47

Abstract

 

Introduction

The role of sonography in the evaluation of morphology and detection of placental abnormalities in clinical conditions such as non-immune hydrops, gestational diabetes, chorioangioma, intraplacental hemorrhage and intrauterine growth restriction has been well established.

Placenta is primarily a fetal organ and its size is a reflection of the health and size of the fetus. One additional ultrasonographic parameter frequently used to assess the placenta is placental size. [1]

The measurement of placental thickness is relatively simple and clinically useful. Abnormal thickness of placenta is well recognized as a diagnostic harbinger in a wide spectrum of pathologic events. Placental thickness can contribute to the management of fetus at risk.[2] Virtually, all the important clinical decisions, which include caesarean section, elective labour induction, etc., depend on the knowledge of the gestational age and placental position.

The role of placental thickness as a new parameter for estimating gestational age and placental thickness normograms in relation to gestational age have been published. Placental thickness measurement can differentiate normal from abnormal pregnancy.[3]

Ultrasonography (USG) is commonly used to estimate the gestational age by measuring the fetal dimensions like the Biparietal Diameter (BPD), the Abdominal Circumference (AC), the Head Circumference (HC) and the Femur Length (FL).

There are some drawbacks in those above said parameters in estimating the gestational age. So, there is a need of another parameter for supplementing the gestational age estimation with minimal error. Nyberg and Finberg reported that the placental thickness parallels the gestational age [4].

In our present study we have tried to measure placental thickness at the level of umbilical cord and determine its relationship with gestational age of fetus in normal singleton pregnancy.

References

  1. Heera Tongsong, Pongrak Boonyanurak. Placental thickness in the first half of pregnancy. J Clin Ultrasound 2004; 32:5: 231-234
  2. Jauniaux E. Placental ultrasonographic measurements: What can we learn and is it worth doing routinely Ultrasound Obstet. Gynaecol. 1992; 2:241-242
  3. Ghosh A, Tang MH, Lam YH et al. Ultrasound measurement of the placental thickness to detect pregnancies affected by homozygous alpha thalassaemia-1. Lancet 1994; 344: 988-989
  4. Nyberg DA, Finberg HJ. The placenta, placental membranes and umbilical cord. Journal on diagnostic ultrasound of fetal anomalies. 1990;21(4):623–75.
  5. Hoddick WK, Mahoney BS, Callen FW, Filly RA Placental thickness. J Ultrasound Med. 1985; 4:479-482.
  6. Mittal P, Hooja N, Mehndiratta. Placental thickness- a sonographic parameter for estimating gestational age of the fetus. Ind J Radiol Imag. 2002; 12:4: 553- 554
  7. Jain A, Kumar G, Agarwal U, Kharakwal S. Pacental thickness – a sonographic indicator of gestational age. Journal of Obstret. and Gynaecol. of India. 2001;51:48-49
  8. Granum PAT, Hobbins JC. The placenta. Radiology Clinic North America. 1982; 20:353.
  9. Granum PAT, Berkowitz RL, Hobbins JC. The ultrasonic changes in the maturing placenta and their relation of fetal pulmonic maturity. Am J Obstret. and Gynecol. 1979; 133:915-922.
  10. Hadlock FP, Harrist RB, Martinez-Poyer J. How accurate is second trimester fetal dating? J Ultrasound Med. 1991;10:557-61.

Corresponding Author

Dr Himanshu Kumar Jaiswal

Junior Resident, Department of Radiology, Katihar Medical College