Third-Trimester Lateral Placental Location and Its Association with Adverse Maternal and Perinatal Outcomes in Singleton Pregnancies: A Prospective Observational Study from South India
Keywords:
Lateral placenta, placental location, preeclampsia, fetal growth restriction, ultrasound, pregnancy outcomesAbstract
Background: Placental location can influence pregnancy outcomes. While anterior and posterior placements are generally benign, lateral placentation has been associated with altered uteroplacental blood flow and adverse outcomes. Data from South India on this association are limited.
Objectives: To evaluate whether third-trimester lateral placental location predicts adverse maternal and neonatal outcomes in a South Indian population.
Methods: This prospective observational study was conducted at a tertiary care hospital from June 2023 to May 2024, including 300 singleton pregnancies with confirmed placental location on mid- and third-trimester ultrasound. Women with multiple gestations, chronic hypertension, or chronic renal disease were excluded. Placental location was classified as anterior, posterior, fundal, lateral, or low-lying. Maternal and neonatal outcomes were compared across groups. Statistical analysis was performed using Chi-square/Fisher’s exact test and ANOVA, with p < 0.05 considered significant.
Results: Lateral placenta in the third trimester was significantly associated with preeclampsia/eclampsia (51.28% vs. 9.96%, p < 0.001), fetal growth restriction (43.59% vs. 6.90%, p < 0.001), antepartum haemorrhage (25.64% vs. 1.92%, p < 0.001), preterm delivery (15.38%, p = 0.0019), and PPROM/PROM (23.08%, p < 0.001). Mean birth weight was lowest in the lateral group (2.34 +/- 0.74 kg, p < 0.001). A history of prior abortions was more frequent in women with lateral placenta (61.54%, p < 0.001).
Conclusions: Lateral placental location in the third trimester is associated with higher risks of preeclampsia, growth restriction, antepartum haemorrhage, preterm birth, and low birth weight. Early identification through routine ultrasound could help in targeted antenatal surveillance, especially in resource-limited settings.
Downloads
References
Alakonda N, Patil N, Yaliwal R, Biradar A, Shiragur S, Kori S, et al. A Cross-Sectional Study to Evaluate the Impact of Placental Location on Maternal and Fetal Outcomes. Cureus. 15(6):e40291.
Granfors M, Stephansson O, Endler M, Jonsson M, Sandström A, Wikström AK. Placental location and pregnancy outcomes in nulliparous women: A population-based cohort study. Acta Obstet Gynecol Scand. 2019; 98(8):988–96.
The Effects of Placental Location on Maternal and Neonatal Outcomes: A Retrospective Cohort Study - Arthur Babayan, Rivka Hellmann, Iryna Struk, Marie-Claire Roberts, 2024 [Internet]. [cited 2025 Aug 13]. Available from: https://journals.sagepub.com/doi/10.1177/87564793231221754?utm_source=chatgpt.com
Porto L, Aviram A, Jackson R, Carson M, Melamed N, Barrett J, et al. Lateral placentation and adverse perinatal outcomes. Placenta. 2020 Nov 1; 101:1–3.
Gupta A, Bansal P, Sen J, Singhal SR. Correlation of lateral placental location with development of preeclampsia. Int J Reprod Contracept Obstet Gynecol. 2020 Feb 27; 9(3):1017–22.
(PDF) The impact of lateral placenta on preeclampsia and small for gestational age neonates: a systematic review and meta-analysis [Internet]. [cited 2025 Aug 13]. Available from: https://www.researchgate.net/publication/364085382_The_impact_of_lateral_placenta_on_preeclampsia_and_small_for_gestational_age_neonates_a_systematic_review_and_meta-analysis
Begum A, Jalem A, Soumya N. A Prospective Study on Placental Location during 18-24 Weeks Of Gestation And Its Pregnancy Outcome.
C R, Sundaram A, G S. Prospective cohort study in relation of placental location and risk of developing preeclampsia in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2022 Feb 25; 11(3):759–64.
Aggarwal P, Chauhan N, Agarwal A. Placental location and fetomaternal outcome: a prospective study. Int J Reprod Contracept Obstet Gynecol. 2025 Jun 26; 14(7):2170–5.
Schreiber H, Cohen G, Markovitch O, Weitzner O, Farladansky-Gershnabel S, Biron-Shental T, et al. Is there an association between lateral uterine localization of the placenta and pregnancy outcomes? Arch Gynecol Obstet. 2025; 312(1):93–8.
Journal of Medical Ultrasound [Internet]. [cited 2025 Aug 13]. Available from: https://journals.lww.com/jmut/fulltext/2024/32020/comparison_of_placental_location_on_ultrasound_in.11.aspx?utm_source=chatgpt.com
Burton GJ, Jauniaux E. Pathophysiology of placental-derived fetal growth restriction. Am J Obstet Gynecol. 2018 Feb 1; 218(2):S745–61.
Rai A, Thatal A, Sharma BK, Narwat Y. Lateral placenta as a predictor for development of preeclampsia. Indian J Obstet Gynecol Res. 2025 Jul 23; 7(2):216–21.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
