Ultrasound-Based Assessment of Placental Characteristics and Fetal Well-Being in Second and Third Trimester Pregnancies: A Hospital-Based Cross-Sectional Study in Faisalabad

Abstract

Background: Ultrasonography is a vital non-invasive imaging modality for assessing the placental morphology and fetal well-being during the period of pregnancy. Sonographic assessment of placental location, placental maturity, placental grade, amniotic fluid, fetal growth, fetal presentation and fetal cardiac activity provide important information for identifying pregnancy requiring closer antenatal surveillance. This research observed the sonographic characteristics of the placenta and selected fetal well-being indicators among pregnant females attending a tertiary-care hospital in Faisalabad.

Objective: The present study aims at describing the sonographic characteristics of the placenta and assess selected maternal and fetal parameters among women in the second and third trimesters of pregnancy.

Methodology: The study employed an observational cross-sectional method at Madinah Teaching Hospital, Faisalabad over a period of four months. A sample of 80 pregnant women was selected using convenient sampling technique and women in the second and third trimesters were included whereas multiple pregnancies and women with previous pregnancy complications were excluded from the study. A standardized data collection proforma and obstetric ultrasonography were used for data collection. Moreover, placental location, placental grade according to the Grannum classification, placental maturity according to gestational age, amniotic fluid index (AFI), fetal growth pattern, fetal presentation and fetal heart activities were recorded. The collected information was analyzed on SPSS version 26.0 through descriptive statistics and chi-square test.

Results: 60.0% respondents age group was 21–30 years and multigravida women constituted 60.0% of the sample whereas 40.0% respondents were primigravida. 76.3 % participants reported regular antenatal care. Anterior placentation was the most frequent placental location as reported by 33.8% respondents which were followed by posterior and fundal locations 30.0% each. Moreover, the Grade I placenta was frequently observed sonographic grade as reported by 36.3% respondents. 90.0% women reported Placental maturity as appropriate for gestational age while Normal AFI was observed in 90.0% pregnancies. The Fetal growth was appropriate for gestational age in 86.3%pregnancies while Cephalic presentation was observed in 77.5% cases. Normal fetal heart activity was documented in 93.8%. Hypertension was the most frequently reported pregnancy-related complication 40.0% followed by gestational diabetes 26.3% and anemia 15.0%.

Conclusion: The study highlighted predominantly normal sonographic placental and fetal findings among inspected second and third-trimester pregnancies. Grade I placenta and maturity appropriate for gestational age were the most common placental findings while most fetuses reported normal growth, AFI, presentation and cardiac activity. Moreover, the hypertension, gestational diabetes, premature placental maturation, oligohydramnios, small-for-gestational-age growth and abnormal fetal cardiac activity were explored in a proportion of participants despite these generally favorable findings. Therefore, routine obstetric ultrasonography may contribute early identification and monitoring of pregnancies demanding increased clinical attention.