The ultrasonic changes in the maturing placenta and their relation to fetal pulmonic maturity
Abstract
A practical classification of placental maturity changes has been developed based on a review of multiple ultrasound evaluations of placental texture over a 4 year period. This classification grades placentas from 0 to 3 according to specific ultrasonic findings at the basal and chorionic plates as well as within the substance of the organ itself. The placentas of 129 patients were graded according to this system at the time of ultrasound evaluation. Eighty-six patients had placentas classified as Grade 1 or greater and all of these had lecithin-sphingomyelin (L/S) ratio determinations performed. Mature L/S ratios (2.0) were found in 68% of Grade I (21/31), 88% of Grade II (28/32), and 100% of Grade III placentas (23/23). These results suggest a correlation between maturational changes of the placenta as seen by ultrasound and fetal pulmonic maturity as indicated by L/S ratio.
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Grannum et al. first proposed a placental maturity staging method dividing the chorionic, substance, and basal plates of the placenta into four stages.
“in 1979, the first placental maturity staging method14 was proposed by Grannum et al. to divide the chorionic, substance, and basal plates of the placenta into four stages.”
From Discriminative Learning for Automatic Staging of Placental Maturity via Multi-layer Fisher Vector (2015) · cites this paper as [14]
Grannum's method relied on visual observation of placental US images to determine calcification degree and was highly dependent on the subjective judgment of the operator.
“However, this method relied on visual observation of placental US images to determine the calcification degree, which was highly dependent on the subjective judgment of the operator.”
From Discriminative Learning for Automatic Staging of Placental Maturity via Multi-layer Fisher Vector (2015) · cites this paper as [14]
Grannum et al. [6] presented the first PMG method on grayscale ultrasound images to classify the chorionic plate, substance, and basal plate of the placenta into four grades.
“Grannum et al. [6] presented the fi rst PMG method on grayscale ultrasound images to classify the chorionic plate, substance, and basal plate of the placenta into four grades, as shown in Figure 1.”
From DilatedFormer: dilated granularity transformer network for placental maturity grading in ultrasound (2023) · cites this paper as [6]
Grannum et al.'s method largely relied on visual inspection, which is subjective and time-consuming and lacks objective measurement.
“Although achieving promising results, this method largely relied on the visual inspection of ultrasound images to stage the placental maturity, which is subjective and time-consuming and lacks objective measurement.”
From DilatedFormer: dilated granularity transformer network for placental maturity grading in ultrasound (2023) · cites this paper as [6]
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“first proposed to automatically grade the placental maturity into four grades in 1979 [2] based on the chorionic, substance, and basal plates.”
BackgroundMethodPoor agreement between operators on grading of the placenta
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Changes in placental ultrasonic appearance
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Real-time ultrasound of the placenta in assessment of fetal pulmonic maturity
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Placental villous hypermaturation is associated with improved neonatal outcomes
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Comprehensive Imaging Review of Abnormalities of the Placenta
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Evaluation of placental maturity by the sonographic textures
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- Authors
- Grannum, P. A. T., Berkowitz, R. L., & Hobbins, J. C.
- Affiliations
- Yale University (US)
- Corresponding author
- Grannum, Peter A.T.
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 1979-04
- Volume
- 133
- Issue
- 8
- Pages
- 915-922
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W1871835765
- Cited by
- 408
- References
- 7
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 7 · 2023: 12 · 2022: 10 · 2021: 14 · 2020: 11 · 2019: 15 · 2018: 11 · 2017: 14 · 2016: 19 · 2015: 16 · 2014: 9 · 2013: 6 · 2012: 17
- FWCI
- 17.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- placental maturity, placental ultrasound, fetal lung maturity, lecithin/sphingomyelin ratio, chorionic plate, basal plate, fetal lung maturation
- MeSH terms
- Amniotic Fluid, Classification, Female, Fetus, Humans, Lung, Phosphatidylcholines, Placenta, Pregnancy, Sphingomyelins, Ultrasonography
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