Relationship between placenta location and adverse pregnancy outcomes in a nigerian tertiary health facility

Background: There is evidence that placenta site location might be associated with some adverse maternal and fetal outcomes, however, there is lack of information on this observation in Nigeria and many other developing countries where routine ultrasound is performed as part of antenatal care. Aim: To determine the relationship between placenta location on ultrasonography and adverse pregnancy outcomes among a cohort of women with singleton pregnancies. Materials and Methods: In a longitudinal study among pregnant women from the antenatal clinic of a tertiary health institution in Nigeria. The demographic, clinical parameters, the ultrasonographic placenta location, and pregnancy outcomes of women followed until delivery, or pregnancy termination were documented and analyzed; P > 0.05 was statistically significant. Result: One hundred and fifty singleton pregnant women (43 high risk and 107 normal gestations) were studied. The placenta location was anterior in 72 (48%), posterior in 59 (39.3%), fundal in 10 (6.7%) and lateral in 9 (6.0%) cases. Pregnancies with fundal placenta 8/10 (80%) had more preterm birth compared to 23/72 (31.9%), 11/59 (18.6%) and 2/9 (22.2%) that had anterior, posterior and lateral placenta (P = 0.001) respectively. The mean gestational age (GA) at delivery in those with fundal (34.0 +/- 3.9 weeks), anterior (37.0 +/- 2.7 weeks), lateral (37.7 +/- 1.8 weeks), and posterior placenta (37.7 +/- 1.8 weeks) was significantly different P < 0.001. In addition, there was a significant difference in the mean birth weight at delivery in women with fundal (2.09 +/- 0.99 kg), anterior (2.84 +/- 0.7 kg), posterior (3.0 +/- 0.65 kg) and lateral placenta (3.0 +/- 0.65 kg) respectively P = 0.002. Conclusion: This study showed that placenta location by ultrasound may be associated with some adverse pregnancy outcomes. The placenta located in the fundus was more likely to be associated with preterm birth and prematurity.