Diagnosis of Placental Position by Early First-Trimester Ultrasound: A Pilot Study

Laura Detti, Jennifer C. Gordon, Mary E. Christiansen, Nicole A. Van de Velde, Ludwig Francillon, Irene Peregrin-Alvarez, Robert A. Roman, Anna Joy G. Rogers

Research output: Contribution to journalArticle

Abstract

Objective: Conventional wisdom is that placental location cannot be identified before 8 weeks’ gestation when the placenta first becomes hyperechogenic on ultrasound. We sought to evaluate whether placental location could be reliably diagnosed between 5 and 6 weeks’ gestation. Materials and Methods: This was a retrospective analysis of prospectively acquired data. Early placental location was diagnosed by evaluation of the embryonal and yolk sac position inside the gestational sac on transvaginal ultrasound. Placental position was described as anterior, posterior, fundal, or lateral. Early and mid-pregnancy placental locations were compared and coded as being the same, having migrated to an adjacent surface, or being on an opposite surface. Results: A total of 111 patients met study criteria, providing 141 placental locations, comprising 85 singleton and reduced pregnancies and 28 dichorionic twin pregnancies. The most common placental location was anterior in both singleton and twin/triplet pregnancies. Placental location at the mid-pregnancy ultrasound was consistent with early pregnancy location in 100% of cases, with 79.5% (112/141) being on the same surface and 20.5% (29/141) having expanded onto an adjacent surface. Placental location was not associated with pregnancy outcome, although our study may have been underpowered to detect a significant difference. Conclusions: Placental location diagnosed at 5 to 6 weeks’ gestation is consistent with the location on mid-pregnancy ultrasound. Excluding the presence of an ectopic, cornual, or cesarean section scar and uterine subseptation pregnancy in early first trimester would allow a more effective tailoring of pregnancy follow-up.

Original languageEnglish (US)
JournalReproductive Sciences
DOIs
StatePublished - Jan 1 2019

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First Pregnancy Trimester
Pregnancy
Twin Pregnancy
Triplet Pregnancy
Gestational Sac
Yolk Sac
Pregnancy Outcome
Cesarean Section
Placenta
Cicatrix

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Detti, L., Gordon, J. C., Christiansen, M. E., Van de Velde, N. A., Francillon, L., Peregrin-Alvarez, I., ... Rogers, A. J. G. (2019). Diagnosis of Placental Position by Early First-Trimester Ultrasound: A Pilot Study. Reproductive Sciences. https://doi.org/10.1177/1933719119831778

Diagnosis of Placental Position by Early First-Trimester Ultrasound : A Pilot Study. / Detti, Laura; Gordon, Jennifer C.; Christiansen, Mary E.; Van de Velde, Nicole A.; Francillon, Ludwig; Peregrin-Alvarez, Irene; Roman, Robert A.; Rogers, Anna Joy G.

In: Reproductive Sciences, 01.01.2019.

Research output: Contribution to journalArticle

Detti, L, Gordon, JC, Christiansen, ME, Van de Velde, NA, Francillon, L, Peregrin-Alvarez, I, Roman, RA & Rogers, AJG 2019, 'Diagnosis of Placental Position by Early First-Trimester Ultrasound: A Pilot Study', Reproductive Sciences. https://doi.org/10.1177/1933719119831778
Detti L, Gordon JC, Christiansen ME, Van de Velde NA, Francillon L, Peregrin-Alvarez I et al. Diagnosis of Placental Position by Early First-Trimester Ultrasound: A Pilot Study. Reproductive Sciences. 2019 Jan 1. https://doi.org/10.1177/1933719119831778
Detti, Laura ; Gordon, Jennifer C. ; Christiansen, Mary E. ; Van de Velde, Nicole A. ; Francillon, Ludwig ; Peregrin-Alvarez, Irene ; Roman, Robert A. ; Rogers, Anna Joy G. / Diagnosis of Placental Position by Early First-Trimester Ultrasound : A Pilot Study. In: Reproductive Sciences. 2019.
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abstract = "Objective: Conventional wisdom is that placental location cannot be identified before 8 weeks’ gestation when the placenta first becomes hyperechogenic on ultrasound. We sought to evaluate whether placental location could be reliably diagnosed between 5 and 6 weeks’ gestation. Materials and Methods: This was a retrospective analysis of prospectively acquired data. Early placental location was diagnosed by evaluation of the embryonal and yolk sac position inside the gestational sac on transvaginal ultrasound. Placental position was described as anterior, posterior, fundal, or lateral. Early and mid-pregnancy placental locations were compared and coded as being the same, having migrated to an adjacent surface, or being on an opposite surface. Results: A total of 111 patients met study criteria, providing 141 placental locations, comprising 85 singleton and reduced pregnancies and 28 dichorionic twin pregnancies. The most common placental location was anterior in both singleton and twin/triplet pregnancies. Placental location at the mid-pregnancy ultrasound was consistent with early pregnancy location in 100{\%} of cases, with 79.5{\%} (112/141) being on the same surface and 20.5{\%} (29/141) having expanded onto an adjacent surface. Placental location was not associated with pregnancy outcome, although our study may have been underpowered to detect a significant difference. Conclusions: Placental location diagnosed at 5 to 6 weeks’ gestation is consistent with the location on mid-pregnancy ultrasound. Excluding the presence of an ectopic, cornual, or cesarean section scar and uterine subseptation pregnancy in early first trimester would allow a more effective tailoring of pregnancy follow-up.",
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