The Relationship between Placenta Location with Occurrence of Pre-Eclampsia: A Single Centre Study in Port Harcourt, Nigeria

Background:Over the years, several screening tests have been developed, yet none is clinically useful for the prediction of pre-eclampsia. Currently, biochemical and biophysical markers of abnormal placentation are being studied as a link to the pathogenesis of pre-eclampsia.

Objectives: The aim of the study was to determine the relationship between the type of placentalocation determined by the use of ultrasound scan and occurrence of pre-eclampsia.

Methodology: The study was carried out at the department of Obstetrics and Gynaecology of the University of Port Harcourt Teaching Hospital (UPTH). Women admitted with the diagnosis of pre-eclampsia as well as those without pre-eclampsia at 28 to 42 weeks of gestation who satisfied the eligibility criteria, and consented for the study were enrolled. A structured proforma was used to obtain relevant information from the participants. Data was entered and analysed with SPSS Statistics for windows, version 20. Results were presented infrequency tables. Chi square and student ‘t’ test were used to respectively compare discrete and continuous variables with p value < 0.05 set as significant.

Results: The results showed that majority 41 (75%) of women with pre-eclampsia had the severe form of the disorder and majority 35 (65%) were referrals from peripheral health centres. Generally, the most common 42 (38.2%) placenta location was anterior placenta. The majority 26 (47.27%) of womenwithout pre-eclampsia had anterior placenta and the relationship was significant, p = 0.0049, (OR 0.45; 95% CI 0.20 – 1.00). While the majority 18 (32.73%)of women with pre-eclampsia had posterior placenta, p = 0.1298, (OR 1.94; 95% CI: 0.81 – 4.63). Lateral placenta was observed in 9 (16.3%) of women with pre-eclampsia, and the association with pre-eclampsia was significant, p = 0.0017.

Conclusion: Ultrasound location of the placenta is relatively safe and cost effective. Lateral placenta may be another risk factor for pre-eclampsia and its detection may raise the index of suspicion for the risk of pre-eclampsia. This may enhance early and prompt institution of preventive measures in order to improve outcome.