International Journal of Clinical Obstetrics and Gynaecology

Background: The placenta's structural integrity fundamentally governs fetal well-being, yet the clinical utility of ultrasonographic placental thickness (PT) in predicting immediate neonatal outcomes remains inadequately characterized in resource-limited settings. While conventional fetal biometry exhibits diminished accuracy near term, placental thickness offers a reproducible biometric parameter that may enhance prognostic precision.

Objectives: This study evaluated the predictive value of ultrasonographic placental thickness measured at 36-40 weeks of gestation for neonatal birth weight and APGAR scores, while examining the potential influence of maternal gravida status on placental dimensions.

Material and Methods: A cross-sectional investigation was conducted across 112 antenatal women with uncomplicated singleton pregnancies at a tertiary obstetric facility in Central India. Placental thickness was measured sonographically at the umbilical cord insertion level between 36-40 weeks, with subsequent correlation to birth weight and 0-minute APGAR scores. Statistical analysis utilized SPSS version 25.0 (IBM Corp.), with significance set at p< 0.05.

Results: The median placental thickness was 3.4 cm (interquartile range 2.8-3.8 cm). Placental thickness exceeding 4.0 cm demonstrated a robust association with low birth weight (<2.5 kg, p< 0.001) and depressed APGAR scores (<7, p = 0.001). Receiver operating characteristic analysis identified an optimal cut-off of 4.35 cm, yielding 93.33% specificity and 98.00% negative predictive value for adverse neonatal outcomes. Maternal gravida status showed no significant correlation with placental dimensions.

Conclusion: Ultrasonographic placental thickness at term constitutes a reliable, readily obtainable biometric parameter for stratifying neonatal risk. A thickness exceeding 4.0 cm should prompt heightened vigilance for growth restriction and neonatal compromise, warranting integration into routine third-trimester surveillance protocols.