Placenta abnormalities; sonographic patterns and associated factors in pregnancy at Muhimbili national hospital

Abstract

ABSTRACT Background. Placenta pathologies are often overlooked and receive attention only when complications arise. In most settings, placenta reporting is often limited to the location and presence of calcification. A complete fetal ultrasound should include a full assessment of the placenta for any possible abnormalities. Placental diseases range from abnormal morphology, size, location, extent, and degree of placentation, to abruption and the presence of rare placental neoplasms of benign or malignant nature. Familiarity with the placenta's normal and abnormal imaging appearance is necessary for the radiologist and physician. Abnormalities of the placenta will lead to poor maternal and fetal outcomes. Objective: To demonstrate the sonographic patterns and proportions of placenta abnormalities and their associated factors among pregnant women at Muhimbili National Hospital (MNH) Methodology: A hospital-based cross-sectional prospective study was carried out between January and March 2023 at MNH. Real-time placenta ultrasound findings were taken and documented from all pregnant women who met the inclusion criteria using a standard ultrasound machine with similar optimal settings on each visit until the sample size was reached. A bivariate analysis was performed to find placenta abnormalities associated factors Results: A total of 220 pregnant women were enrolled in a study. Prevalence of placenta pathologies were 32.7 %, 27.3% and 35.4 % for placenta morphology, placenta parenchyma and placenta maternal surface respectively. Placenta pathologies excluding those related to location and abruption were overlooked in 200 (91.7%) pregnant women. Pathologies related to placenta parenchyma and morphology had a strong association with chronic illness and chronic medication both with p <0.001. Placentomegally was very strongly associated with chronic illness (p <0.001) which was highly associated with fetal complications. Unexplained fetal loss and neonatal death had a strong association with placenta parenchyma pathologies (p -value < 0.001) v Conclusion: There was a high prevalence of placenta abnormalities. Placenta abnormalities patterns should be evaluated documented and followed up in subsequent scans to improve fetal and maternal outcomes. Recommendation: A study with large sample size will add more value. A Standardized placenta reporting format based on the reported placenta patterns should be established to ensure practitioner examines and report all possible placenta pathologies