title: Utility of Placental Laterality and Uterine Artery Doppler Abnormalities for Prediction of Preeclampsia.
abstract: OBJECTIVE
  To find out whether placental laterality and abnormal uterine artery waveform and resistance index, as determined by antenatal ultrasonography and Doppler, can be used as a predictor for the development of preeclampsia.
  
  
  METHODS
  This prospective observational cohort study was conducted from August 2013 to October 2014. Two hundred and one (201) normotensive, primigravida women with singleton pregnancies attending the antenatal clinics without any high-risk factor for development of hypertension were subjected to ultrasonography at 18-22 weeks of gestation to determine the placenta location. All the subjects with lateral placentas were subjected to Doppler ultrasonography to look for abnormal Doppler waveform and resistance index. They were followed for the development of preeclampsia till 40 weeks of gestation or delivery.
  
  
  RESULTS
  Out of the total 201 women, 71 (24.5 %) had laterally located placentas and of them 37 (52 %) developed preeclampsia, while the remaining 130 (75.5 %) had centrally located placentas and of them 14 (10.8 %) developed preeclampsia (p < 0.001). In subjects with lateral placentas alone (n = 33), 2 (6 %) developed preeclampsia while as those with lateral placentas with Doppler abnormality (n = 38), 35 (92 %) developed preeclampsia (p < 0.001). The overall risk of developing preeclampsia with laterally located placenta was 9.27 (odds ratio), and 95 % confidence interval was (4.30-19.98).
  
  
  CONCLUSIONS
  Pregnant women with lateral placentas are at significant risk for development of preeclampsia. Lateral placentas when associated with uterine artery Doppler abnormality, risk for development of preeclampsia increases significantly as compared to lateral placentas alone.
authors.affiliation: Department of Gynecology and Obstetrics, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, 190011 J and K India.
authors.forename: Shagufta
authors.initials: S
authors.lastname: Yousuf
authors.affiliation: Department of Gynecology and Obstetrics, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, 190011 J and K India.
authors.forename: Abida
authors.initials: A
authors.lastname: Ahmad
authors.affiliation: Department of Gynecology and Obstetrics, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, 190011 J and K India.
authors.forename: Shazia
authors.initials: S
authors.lastname: Qadir
authors.affiliation: Department of Gynecology and Obstetrics, Sheri Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, 190011 J and K India.
authors.forename: Sabia
authors.initials: S
authors.lastname: Gul
authors.affiliation: Department of Neonatology, Surya Children's Hospital, SV Road, Santacruz (West), Mumbai, 100054 India.
authors.forename: Showkat Hussain
authors.identifier: 0000-0002-4030-9884
authors.initials: SH
authors.lastname: Tali
authors.affiliation: Department of Radio-diagnosis and Neuro-radiology, SKIMS, Srinagar, 190011 India.
authors.forename: Feroz
authors.initials: F
authors.lastname: Shaheen
authors.affiliation: Department of Pathology, SKIMS, Srinagar, 190011 India.
authors.forename: Shareefa
authors.initials: S
authors.lastname: Akhtar
authors.affiliation: Department of Biostatistics, SKIMS, Srinagar, India.
authors.forename: Rayees
authors.initials: R
authors.lastname: Dar
keywords: Abnormal Doppler waveform; Placenta; Placental laterality; Preeclampsia