Relationship between placental thickness, grading, and heterogeneity in fetal growth restriction in the third trimester of pregnancy by ultrasonography and pathology tests and their relationship with estimated fetal weight and neonatal outcome

Introduction: The placenta is the influencing factor on the fetal weight and is as the first organ that reveals the pathological changes of pregnancy. Therefore, placental ultrasound findings influence the diagnosis of fetal growth restriction (FGR). Objectives: This study examines the relationship between placental thickness, grading and heterogeneity during ultrasound and placental pathology in third trimester FGR fetuses and its effect on neonatal outcome. Patients and Methods: This prospective observational study included 67 pregnant women with FGR fetuses in the third trimester of pregnancy with the mean gestational age of 34.52 ± 2.65 weeks and possible termination of pregnancy within the next seven days. The placental thickness, grading, and heterogeneity in ultrasonography were examined and compared with thickness and grading. Their effect was also considered in neonatal outcome and the results were analyzed. Results: In this study, there is a significant relationship between the thickness of the placenta before and after birth with the weight of the placenta, weight and Apgar score, neonatal arterial pH at birth and fetal growth restriction grading in ultrasound, and neonatal outcome. Conclusion: This study shows that ultrasonic placental findings can be effective in determining the final weight of the placenta and fetus and also the final outcome of the baby at birth. Therefore, ultrasound of the placenta should be performed along with pregnancy ultrasound.