Ultrasonographic Correlation of Placenta Previa with Gestational Diabetes

Abstract

Placenta previa and gestational diabetes mellitus (GDM) are two significant obstetric conditions that independently contribute to increased maternal and fetal morbidity. Placenta previa, characterized by abnormal implantation of the placenta over or near the cervical os, is a major cause of painless antepartum hemorrhage. GDM, defined as glucose intolerance with onset during pregnancy, is associated with adverse perinatal outcomes. When these conditions coexist, they may potentiate each other's risks, necessitating early diagnosis and close monitoring, particularly through imaging modalities such as obstetric ultrasound. The aim of this study was to evaluate the clinical and sonographic association between placenta previa and gestational diabetes in pregnant women, and to assess the accuracy of ultrasound in detecting placenta previa in the presence of GDM. A cross-sectional study was conducted at the Department of Radiology, Civil Hospital Karachi, over a period of six months. A total of 127 pregnant women diagnosed with both placenta previa and GDM were included using a non-probability convenient sampling technique. Data were collected through a combination of patient interviews, medical record reviews, and transabdominal obstetric ultrasounds. Placenta previa was classified into four types based on standard ultrasound criteria. Statistical analysis was performed to determine the association between clinical variables and placenta previa types, and to assess the sensitivity and specificity of ultrasound in diagnosis. The survey included people whose mean age was 31.85 years, plus or minus 4.52 years. The most often found presentation was complete placenta previa (Type 4), present in 36.2% of patients. Just under half of the patients studied had a prior cesarean section and most came to the hospital in their third trimester. A total of 76.4% of participants had vaginal bleeding and 61.4% were found to have unchecked blood sugar levels. The presence of placenta previa was accurately identified in 91.3% of patients and correctly excluded in 85.7% by ultrasound. This study highlights a strong association between complete placenta previa and uncontrolled GDM, especially in women with a prior cesarean section. Obstetric ultrasound proved to be a highly sensitive and specific diagnostic tool for placenta previa, underscoring its critical role in antenatal care of high-risk pregnancies. Integrated screening protocols are recommended for identification and management of coexisting conditions.

Keywords: Placenta previa, Gestational diabetes mellitus, Obstetric ultrasound, Antenatal screening, Cesarean section, Vaginal bleeding, High-risk pregnancy