Journal of Ultrasound in Medicine, Vol 2, Issue 7 297-301, Copyright © 1983 by American Institute of Ultrasound in Medicine
Placental grading in the complicated or high-risk pregnancy
M. R. Clair, E. Rosenberg, D. Tempkin, R. F. Andreotti and J. D. Bowie
A classification of the changes seen in the placentas of nondiabetic,
non-high-risk obstetrical patients, and its relationship to fetal pulmonary
maturity, has been the subject of two recent reports. Successful (100 per
cent) correlation has been concluded from these studies when a Grade III
placenta has been demonstrated in gestations of 33 weeks to term. To
determine whether the same high degree of reliability would hold for the
diabetic and high-risk obstetrical patient, 78 such patients were analyzed.
All except one delivered at 33 weeks to term, and all had amniotic fluid
lecithin-sphingomyelin (L/S) ratio determinations within 48 hours of
sonographic placental grading and within seven days of delivery. Of the
Grade III placentas (n = 13), 23 per cent had "immature" L/S ratios.
However, there was no case of infantile respiratory distress syndrome
(IRDS) in infants of patients with Grade III placentas. These findings
suggest that placental grading may need to be part of a multifactorial
assessment of fetal maturity in the diabetic or high-risk pregnancy.
