Logo of bmjcredLink to Publisher's site
Br Med J (Clin Res Ed). 1987 Jun 27; 294(6588): 1641–1644.
PMCID: PMC1246821

Third trimester placental grading by ultrasonography as a test of fetal wellbeing.


In a study of 2000 unselected pregnant women the development of a mature placental appearance (grade 3) on ultrasonography by 34-36 weeks' gestation, observed in 15% of cases, was associated with maternal smoking, low parity, low maternal age, and being white. These women had an increased risk of problems during labour and their babies had an increased risk of low birth weight, poor condition at birth, and perinatal death. The women were randomly allocated to two groups: in one group the result of the placental grading was reported to the clinician responsible for care; in the second the result was noted but not reported. There was a significant decrease in the risk of perinatal death in the group where the grading was known. This reduction was responsible for a difference in the principal outcome index, a heterogeneous group of measures of mortality and morbidity, but this difference was not significant. This study alone does not justify routine late scanning, and further, larger trials are required. Nevertheless, the results do provide a basis for the reporting of placental grading when ultrasound examination is performed during the third trimester.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (909K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Grannum PA, Berkowitz RL, Hobbins JC. The ultrasonic changes in the maturing placenta and their relation to fetal pulmonic maturity. Am J Obstet Gynecol. 1979 Apr 15;133(8):915–922. [PubMed]
  • Quinlan RW, Cruz AC, Buhi WC, Martin M. Changes in placental ultrasonic appearance. I. Incidence of Grade III changes in the placenta in correlation to fetal pulmonary maturity. Am J Obstet Gynecol. 1982 Oct 15;144(4):468–470. [PubMed]
  • Quinlan RW, Cruz AC, Buhi WC, Martin M. Changes in placental ultrasonic appearance. II. Pathologic significance of Grade III placental changes. Am J Obstet Gynecol. 1982 Oct 15;144(4):471–473. [PubMed]
  • Grannum PA, Hobbins JC. The placenta. Radiol Clin North Am. 1982 Jun;20(2):353–365. [PubMed]
  • Kazzi GM, Gross TL, Sokol RJ, Kazzi NJ. Detection of intrauterine growth retardation: a new use for sonographic placental grading. Am J Obstet Gynecol. 1983 Mar 15;145(6):733–737. [PubMed]
  • Miettinen O. Estimability and estimation in case-referent studies. Am J Epidemiol. 1976 Feb;103(2):226–235. [PubMed]
  • Secher NJ, Hansen PK, Lenstrup C, Pedersen-Bjergaard L, Eriksen PS, Thomsen BL, Keiding N. Birthweight-for-gestational age charts based on early ultrasound estimation of gestational age. Br J Obstet Gynaecol. 1986 Feb;93(2):128–134. [PubMed]
  • Cole SK, Hey EN, Thomson AM. Classifying perinatal death: an obstetric approach. Br J Obstet Gynaecol. 1986 Dec;93(12):1204–1212. [PubMed]
  • Hill LM, Breckle R, Ragozzino MW, Wolfgram KR, O'Brien PC. Grade 3 placentation: incidence and neonatal outcome. Obstet Gynecol. 1983 Jun;61(6):728–732. [PubMed]
  • Ashton SS, Russo MP, Simon NV, Shearer DM. Relationship between Grade III placentas and biparietal diameter determinations. J Ultrasound Med. 1983 Mar;2(3):127–129. [PubMed]
  • Crawford DC, Fenton DW, Price WI. Ultrasonic tissue characterization of the placenta: is it of clinical value? J Clin Ultrasound. 1985 Oct;13(8):533–537. [PubMed]

Articles from British Medical Journal (Clinical Research Ed.) are provided here courtesy of BMJ Publishing Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...