The sonographically thick placenta: a predictor of increased perinatal morbidity and mortality

In order to determine the prevalence and significance of sonographically thick placentas, we reviewed the computerized records of 18 827 viable, singleton pregnancies. Of these, 116 (0.6%) had thick placentas diagnosed by ultrasound examination. Perinatal mortality was markedly increased among pregnancies with thick placentas (odds ratio = 13.1, 95% confidence limits (CL) = 8.3-20.8), accounting for 6.2%; of the total. The rates of abruptio placentae (odds ratio = 2.9, CL = 1.1-8.1), neonatal intensive care unit admissions (odds ratio = 4.6, CL = 3.1-6.9) and anomalies (odds ratio = 8.4, CL = 4.9-14.4) were also significantly increased among the thick placenta cohort compared to controls. The 106 liveborn neonates with thick placentas had lower Apgar scores, were delivered at an earlier gestational age, and weighed less than controls. Anomalies, hydrops fetalis and abruptio placentae complicated 16 of the 24 cases of perinatal mortalities. Sonographically thick placentas should alert the clinician to the possibility of compromised perinatal outcome.