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Year : 2002  |  Volume : 12  |  Issue : 4  |  Page : 553-554
Placental thickness : a sonographic parameter for estimating gestational age of the fetus


Department of Obstetrics & Gynecology, S.M.S Medical College Jawahar Lal Nehru Marg, Jaipur, (Rajasthan), India

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   Abstract 

Aim: The study was conducted with the aim of evaluating placental thickness, measured at the insertion of the umbilical cord, as a parameter for estimating gestational age of the fetus. Materials and Methods: The study was conducted on 600 normal antenatal women of all gestational ages ( 10 weeks of gestation) attending Antenatal Clinic at the Department of Obstetrics and Gynecology, S.M.S. Medical College, Jaipur (Rajasthan) from August 2001 to February 2002. USG was done by using Toshiba Canasee II machine with a 3.75 MHz sector probe. After estimating the fetal age by CRL, BPD, HC, AC, and FL, the placental thickness with standard deviation was calculated for all gestational ages. Results: It was observed that the placental thickness gradually increased from 15 mm at 11 weeks of gestation to 37.5 mm at 39 weeks. From the 22nd week to the 35th week of gestation the placental thickness coincide almost exactly with the gestational age in weeks. Conclusion: To conclude, the measurement of the placental thickness is an important parameter for estimation of fetal age along with other parameters especially in the late mid trimester and early third trimester, where the exact duration of pregnancy is not known.

Keywords: Placental Hormones, Pregnancy, Gestational Age, Pregnancy Proteins, Data Interpretation, Statistical, Human,

How to cite this article:
Mital P, Hooja N, Mehndiratta K. Placental thickness : a sonographic parameter for estimating gestational age of the fetus. Indian J Radiol Imaging 2002;12:553-4

How to cite this URL:
Mital P, Hooja N, Mehndiratta K. Placental thickness : a sonographic parameter for estimating gestational age of the fetus. Indian J Radiol Imaging [serial online] 2002 [cited 2014 Oct 31];12:553-4. Available from: http://www.ijri.org/text.asp?2002/12/4/553/28540

   Introduction Top


The placenta is a fetal organ with important metabolic, endocrine and immunologic functions besides being responsible for nutrition, respiration and excretion for the fetus. Lastly acting as a barrier, it has a role in protecting the fetus from noxious agents [1]. Placental formation begins in the later half of the 2nd month of the pregnancy and is usually completed by the 4th month. It reaches its maximum growth at term [2].

With the new advances in grey scale and doppler sonography, we are able to study the placental sonographic appearance and its relationship to uteroplacental blood flow measurement and intrauterine growth. Presently the most effective way to date pregnancy is by use of ultrasound. Several sonographically derived fetal parameters used to date pregnancy include fetal crown - rump length (CRL), biparietal diameter (BPD), head circumference (HC), femur length (FL),and abdominal circumference (AC) [3]. Placental thickness measured at the level of the umbilical cord insertion can be used as a new parameter to estimate gestational age of the fetus. The present study was undertaken to evaluate the relationship between placental thickness and gestational age of the fetus.


   Material and Methods Top


The study was conducted in the Department of Obstetrics and Gynecology and Department of Radiodiagnosis, Jaipur. 600 antenatal cases of all gestational ages (> 10 weeks of gestation) were selected. Patients with PIH, DM, IUGR, hydrops fetalis, congenital malformation, twins were excluded from the study. The USG was done with Toshiba Canasee II machine with a 3.75 MHz sector probe.

The patients were scanned with a full bladder in a supine position. The gestational age was determined by measuring the CRL upto the 11th week and thereafter by measuring the BPD, HC, AC and FL.

The placental thickness was measured at the level of the cord insertion.


   Results Top


The mean values of placental thickness along with respective standard deviation (SD) were calculated for different gestational ages from the 11th week to the 39th week.

It was observed that the placental thickness gradually increased from approximately 15 mm at 11 weeks of gestation to 37.5 mm at 39 weeks of gestation.

In our study, up to 21 weeks of gestation the mean placental thickness was slightly higher than the gestational age (1-4 mm). From the 22nd week to the 35th week of gestation the placental thickness almost matched the gestational age in weeks, thereafter the placental thickness was lower by(1-2 mm) [Table 1].

The value of mean placental thickness increases with advancing gestational age almost matching from the 22nd week to the 35th week as shown in graph 1. [Graph 1]


   Discussion Top


The present study assessed the relationship between gestational age (in weeks) and placental thickness (in millimeter) by USG.

Early reports of placental localization by ultrasound examination were published by Donald (1968), Kobayashi (1970) and Gottesfield (1966). Nyberg and Finberg (1990) also reported that placental thickness in millimeter parallel gestational age in weeks.

Our findings are consistent with the observations made by Anupama Jain, Ganesh Kumar, U Agarwal, S Kharakwal (2001) who reported that the value of mean placental thickness increases with advancing gestational age and almost match from 27 to 33 weeks.

To conclude, we can say that the measurement of placental thickness is an important parameter for estimation of fetal age. It is helpful in cases where the exact duration of pregnancy is not known (especially between the 22nd week and 35th week) where the placental thickness almost matches with the gestational age.[8]



 
   References Top

1.Holland and Brews, Manual of Obstetrics 16th edition, B L Churchill Livingstone pvt. Ltd 1998: 23  Back to cited text no. 1    
2.Cunningham FG, Gant NF, Leveno KS,Gilstap LC, Hanth JC, Wenstrom KD, in Williams Obstetrics, 21st Edition 2001, McGrewHill Pg 85 - 108.  Back to cited text no. 2    
3.Rudy E Sabbagha, Diagnostic Ultrasound applied to obstetrics and Gynecology, 2nd Edition Pg 91- 111.  Back to cited text no. 3    
4.Donald I, Abdulla U: Placentography by sonar. J of Obstet gynaecol Br Commonw 75: 993, 1968.  Back to cited text no. 4    
5.Kobayashi M,Hellman LM, Fillisti l: Placental lcalization by ultrasound. Am J of Obstet Gyaecol 106: 279, 1970.  Back to cited text no. 5    
6.Gottesfield KR, Thompson HE, Holmes JH et al : Ultrasonic placentography- a new method of placental localization. Am J of Obstet Gyaecol 96: 538, 1966.  Back to cited text no. 6    
7.Nyberg DA, Finberg HJ: the placenta, placental membranes and umbilical cord. In New burgh DA, Mahony BS, Pretorius DH, eds Diagnostic ultrasound of fetal anomalies St. Louis: Mosby year book 1990: 623- 675.  Back to cited text no. 7    
8.Anupama Jain, Ganesh Kumar, U Agarwal, S Kharakwal: Placental thickness - A sonographic indicator of gestational age, J of Obst and Gyne of India vol 51, no 3, 48-49, 2001.  Back to cited text no. 8    

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Correspondence Address:
P Mital
Department of Obstetrics & Gynecology, S.M.S Medical College Jawahar Lal Nehru Marg, Jaipur, (Rajasthan)
India
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    Figures

[Figure - 1], [Figure - 2]

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    Abstract
    Introduction
    Material and Methods
    Results
    Discussion
    References
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