ORIGINAL ARTICLE Is lateral localisation of placenta a risk factor for adverse perinatal outcomes? K. D. Seckin 1 , B. Cakmak 2 , M. F. Karsli 3 , M. I. Yeral 1 , I. B. Gultekin 3 , M. Oz 1 & N. Danisman 1 1 Zekai Tahir Burak Women Health Care Education and Research Hospital, Ankara, Turkey, 2 Department of Obstetrics and Gynaecology, School of Medicine, Gaziosmanpasa University, Tokat, Turkey, and 3 Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey Introduction he primary vascular supply of the uterus is the uterine artery which is a branch of the hypogastric artery. he blood low is not distributed homogenously in the uterus and this is the reason for importance of localisation of the placenta (Ito et al. 1998; Koinas et al. 1989). he low segmental localisation of placenta such as placenta previa and low lying placenta results in diminished and disturbed blood low. Most of the previous studies aimed to evaluate the efect of localisation in low segmental localised placentas and reported that they are related with poor neonatal outcomes and post-partum haemorrhages (Bobrowski and Jones 1995; Leiberman et al. 1991). As a result of diminished blood low in laterally located pla- centa, preeclampsia (Gonser et al. 1996). foetal growth restriction (FGR) (Kalanithi et al. 2007) and foetal distress (Vaillant et al. 1993) were reported higher incidence; however, there are fewer studies evaluating the relation of placental location with perinatal and neonatal outcomes. he aim of our study was to evaluate the relationship between placental localisation, and perinatal and neonatal outcomes. Correspondence: Bulent Cakmak, Assistant Professor, MD, Department of Obstetrics and Gynaecology, Faculty of Medicine, Gaziosmanpasa University, Sevki Erek Yerleskesi, 60100, Tokat, Turkey. Tel: + 90 356 2125000/1064. Fax: + 90 356 2122142. E-mail: drbulentcakmak@hotmail.com Materials and methods his study was performed in a tertiary centre hospital by retro- spectively analysing the medical records of 1,052 patients who were followed up and underwent delivery in the same hospital between January 2012 and May 2012. he exclusion criteria were pregestational diabetes, chronic hypertension, smoking, any foetal and/or chromosomal anomalies, multiple pregnancy, intrauterine demise before 24 weeks’ gestation, placenta previa, history of previous uterine surgery including caesarean section, history of previous preeclampsia, preterm birth, and preterm premature rupture of membrane (PPROM). All eligible patients underwent routine ultrasonography between 18 and 24 weeks’ gestation and localisations of the placentas were recorded. When the measurement of biparietal diameter (BPD), head circumfer- ence, abdominal circumference (AC), femur length (FL) and/or estimated foetal weight (EFW) were out of normal range (  10% or  90%), the record of irst trimester (until 12 weeks’ gestation) crown–rump length (CRL) measurement was re-evaluated, and dating was made according to the CRL measurement. When the diference of measurement between CRL and last menstrual period (LMP) was more than 4 days, we used CRL measurement instead of LMP. At that point, we utilised CRL measurement for dating in 381 patients in this study, and changed LMP dating in 137 patients according to CRL measurement. According to the placental localisation, patients were divided into two groups as central and lateral. All placentas located on anterior, posterior or fundal uterine wall were classiied as central; all placentas located on right or let uterine wall were classiied as lateral. Placentas located anterolaterally or posterolaterally, or all types of placenta previa were excluded from the study. When three quarters of placenta was on the anterior, posterior or lateral wall, it was con- sidered as anterior, posterior or lateral, respectively. In contrast, when 50% of placenta covered lateral and anterior (or lateral and posterior), it was considered as anterolateral (or posterolateral). he others were unclassiied (diferent percentages of placenta) (e.g. anterolateral unclassiied or posterolateral unclassiied). We did not use unclassiied placental location groups. On the other hand, anterolateral and posterolateral locations of placentas were not included into study, because the number of these groups was very low. All patients had routine follow-up during their pregnan- cies and post-partum periods, and all newborns were followed Journal of Obstetrics and Gynaecology, 2015; Early Online: 1–3 © 2015 Informa UK, Ltd. ISSN 0144-3615 print/ISSN 1364-6893 online DOI: 10.3109/01443615.2015.1007343 The aim of this study was to evaluate the relationship between placental localisation and perinatal outcomes. This study was performed in a tertiary centre hospital by retrospectively analysing the medical records of patients who were followed up and underwent delivery in the same hospital. The patients were divided into two groups according to the placental locations (central and lateral) in their routine sonographic indings between the 18 and 24 weeks’ gestation. Out of 1,057 patients, 87.4% ( n  919) had centrally located placentas and 12.6% ( n  133) had laterally located placentas. Preeclampsia was found to be signiicantly higher in the lateral placental location group (4.5% vs. 1.6%; p  0.027). There was a signiicant correlation with foetal growth restriction (FGR), preterm birth rates, low Apgar scores and need for neonatal intensive care unit in the lateral placental location group ( p  0.05). The pregnant women with laterally located placentas should be followed up promptly with special care for the risk of preeclampsia and FGR, and poor neonatal outcomes. Keywords: placental location, pregnancy outcome, preeclampsia J Obstet Gynaecol Downloaded from informahealthcare.com by Gaziosmanpasa Universitesi on 02/19/15 For personal use only.