Dash Sudarshan, Das Banya, Panda Soumya Ranjan, Rajguru Monalisa, Jena Pramila, Mishra Abheepsa, Rath Sudhanshu Kumar
Department of Obstetrics and Gynaecology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar 751024, India.
IMO-JB, ESIC Hospital, Bhubaneswar 751022, India.
Clin Pract. 2021 Nov 9;11(4):841-849. doi: 10.3390/clinpract11040099.
Placental calcification, identified before the 36th week of gestational age, is known as premature placental calcification (PPC). PPC could be a clue for the poor fetal outcome. However, its association with adverse perinatal outcomes is yet to be confirmed. The primary objective was to determine and compare the perinatal outcomes in pregnancies with and without documented premature placental calcification. The present study was a prospective cohort study performed from October 2017 to September 2019. We consecutively enrolled 494 antenatal women who presented to our antenatal OPD after taking consent to participate in our study. Transabdominal sonographies were conducted between 28-36 weeks of gestation to document placental maturity. We compared maternal and fetal outcomes between those who were identified with grade III placental calcification (n = 140) and those without grade III placental calcification (n = 354). The incidence of preeclampsia, at least one abnormal Doppler index, obstetrics cholestasis, placental abruption, and FGR (fetal growth restriction) pregnancies were significantly higher in the group premature placental calcification. We also found a significantly increased incidence of Low APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scores, NICU (Neonatal Intensive Care Unit) Admission, Abnormal CTG (cardiotocography), meconium-stained liquor, and low birth weight babies in those with grade III placental calcification. Clinicians should be aware of documenting placental grading while performing ultrasonography during 28 to 36 weeks. Ultrasonographically, the absence of PPC can define a subcategory of low-risk pregnant populations which probably need no referral to specialized centers and can be managed in these settings.
胎盘钙化若在孕36周前被发现,则称为早产胎盘钙化(PPC)。PPC可能提示胎儿预后不良。然而,其与围产期不良结局的关联尚未得到证实。本研究的主要目的是确定并比较有早产胎盘钙化记录和无早产胎盘钙化记录的孕妇的围产期结局。本研究为前瞻性队列研究,于2017年10月至2019年9月开展。我们连续纳入了494名同意参与本研究的产前门诊孕妇。在妊娠28至36周期间进行经腹超声检查以记录胎盘成熟度。我们比较了被诊断为III级胎盘钙化的孕妇(n = 140)和无III级胎盘钙化的孕妇(n = 354)的母婴结局。早产胎盘钙化组的子痫前期、至少一项异常多普勒指数、产科胆汁淤积症、胎盘早剥和胎儿生长受限(FGR)妊娠的发生率显著更高。我们还发现,III级胎盘钙化的孕妇中,阿氏评分(外观、脉搏、 grimace、活动和呼吸)低、入住新生儿重症监护病房(NICU)、胎心监护(CTG)异常、羊水粪染和低体重儿的发生率显著增加。临床医生在妊娠28至36周进行超声检查时应注意记录胎盘分级。超声检查中,无PPC可界定一类低风险孕妇群体,这类孕妇可能无需转诊至专科中心,可在当前环境下进行管理。