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The Association between Placental Location in the First Trimester and Fetal Sex

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Background: Because advance knowledge of fetal sex can satisfy parental curiosity and allay anxiety, attempts at its determination prior to birth have a long history. There may also be reason to determine fetal sex when sex-specific genetic disorders are suspected. The aim of this study was to investigate the association between gestational sac (GS) location and fetal sex. Materials and Methods: This cross-sectional study was conducted on 751 pregnant women. Transvaginal ultrasound was performed during 7-8 weeks of gestation for prenatal care and assessment of pregnancy sac and GS location. Age, parity, gravidity and GS location were recorded. Abdominal ultrasound was performed at 16-20 weeks of gestation to determine fetal health and sex and finally data was analyzed and compared to sex of the fetus after birth using SPSS software version 21. Results: There was a significant relationship between GS location and fetal sex (P<0.0001). However, pregnancy outcomes (male or female) and GS location (anterior or posterior) were not significant correlated (P= 0.290). There was, on the other hand, a significant relationship between outcomes and GS location (right or left) (P<0.0001). Conclusion: Maybe GS location could be considered as a helpful method for earlier fetal sex determination.
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*Corresponding author: E-mail: Maryammohamadigooraji@gmail.com;
Journal of Pharmaceutical Research International
27(5): 1-8, 2019; Article no.JPRI.48851
ISSN: 2456-9119
(Past name: British Journal of Pharmaceutical Research, Past ISSN: 2231-2919,
NLM ID: 101631759)
The Association between Placental Location in the
First Trimester and Fetal Sex
Fariba Mirbolouk
1
, Maryam Mohammadi
1*
, Ehsan Kazemnejad Leili
2
,
and Seyedeh Fatemeh Dalil Heirati
1
1
Reproductive Health Research Center, Department of Obstetrics and Gynecology, Alzahra Hospital,
School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
2
Faculty of Midwifery and Nursing, Guilan University of Medical Sciences, Rasht, Iran.
Authors’ contributions
This work was carried out in collaboration among all authors. Author FM designed the study and wrote
the protocol. Author MM performed the statistical analysis. Author EKL wrote the protocol, wrote the
first draft of the manuscript and managed the analyses of the study. Author SFDH managed the
literature searches and wrote the manuscript. All authors read and approved the final manuscript.
Article Information
DOI: 10.9734/JPRI/2019/v27i530183
Editor(s):
(1)
Dr. Jinyong Pen, Professor, College of Pharmacy, Dalian Medical University, Dalian, China.
Reviewers:
(1) M. V. Seeman, University of Toronto, Canada.
(2)
Shigeki Matsubara, Jichi Medical University, Japan.
(3)
Sreelatha S. Ramesh, International Medical University, Malaysia.
Complete Peer review History:
http://www.sdiarticle3.com/review-history/48851
Received 26 February 2019
Accepted 05 May 2019
Published 23 May 2019
ABSTRACT
Background:
Because advance knowledge of fetal sex can satisfy parental curiosity and allay
anxiety, attempts at its determination prior to birth have a long history. There may also be reason to
determine fetal sex when sex-specific genetic disorders are suspected. The aim of this study was to
investigate the association between gestational sac (GS) location and fetal sex.
Materials and Methods: This cross-sectional study was conducted on 751 pregnant women.
Transvaginal ultrasound was performed during 7-8 weeks of gestation for prenatal care and
assessment of pregnancy sac and GS location. Age, parity, gravidity and GS location were
recorded. Abdominal ultrasound was performed at 16-20 weeks of gestation to determine fetal
health and sex and finally data was analyzed and compared to sex of the fetus after birth using
SPSS software version 21.
Results: There was a significant relationship between GS location and fetal sex (P<0.0001).
Original Research Article
Mirbolouk et al.; JPRI, 27(5): 1-8, 2019; Article no.JPRI.48851
2
However, pregnancy outcomes (male or female) and GS location (anterior or posterior) were not
significant correlated (P= 0.290). There was, on the other hand, a significant relationship between
outcomes and GS location (right or left) (P<0.0001).
Conclusion: Maybe GS location could be considered as a helpful method for earlier fetal sex
determination.
Keywords: Sex; gestational sac location; placental location; ultrasound; fetus.
1. INTRODUCTION
The determination of fetal sex is carried out for a
variety of reasons, including medical reasons
(diagnosis of diseases), convenience reasons
(knowing what clothes and colours to purchas in
advance) [1,2]. Furthermore, early detection of
fetal sex is important for researchers and
parents. Some fetal diseases are sex dependent
and if one of the parents or both had specific
diseases, early detection can help families
receive on time genetic consultations. They can
consequently decide on whether or not to
continue the pregnancy [3]. Fetal sex
determination can also be requested by parents
for unethical reasons e.g. to determine whether
fetuses, if they are female, are worth keeping.
This unlawful practice is carried out in many
regions of the world, fetal sex can be determined
by different methods, including Chorionic villus
sampling (at 10-11 weeks of gestation) and
amniocentesis (at 15-16 weeks of gestation).
These methods are invasive and sometimes fail
[4-6]. Commonly, clinicians determine fetal sex
by ultrasound, which is a noninvasive and cost
effective method compared to other methods
[4,7]. Ultrasound has been the key technology for
assessing fetal disease during the late 3 decades
[8,9]. Recently, clinicians use ultrasound as an
alternative screening method to determine fetal
abnormalities, fetal growth disorders, GS location
and gestational age; it is widely applied during
pregnancy [10-12].
Fetal sex determination can reveal important
information regarding fetal health. It can be
helpful for deciding on the necessity for invasive
methods in patients with family history of sex
dependent abnormalities, including hemophilia
and Duchenne’s muscular dystrophy. Ultrasound
can facilitate the diagnosis of fetal anomalies,
including posterior urethral valve in male fetuses
and Turner syndrome in female fetuses,
dichorionic twin pregnancies and
hermaphroditism [12].
Furthermore, it has been reported that fetal sex
determination could help identify the high risk
pregnancies as preeclampsia occurs at higher
rates in male fetus pregnancies [13,14]. Fetal sex
determination can also help reduce the risk of
female masculinization in 21 hydroxylase
deficient fetuses by early sex detection and
prompt corticosteroid therapy [6].
Previous investigations assessed the effect of
placental location on fetal sex and reported
inconsistent results. Ismail et al. reported a
significant relationship between placental
location and fetal sex. They mentioned that male
fetuses had right chorionic villi/placenta location
[15], However, The et al. observed a weak
relationship between placental location and fetal
sex [16] and Erdolu et al. [11] noted only a
probable effect of fetal sex on placental location.
Fetal sex can be determined with
ultrasonography at eleven or twelve weeks of
gestation. Otherwise, sex detection is not reliable
by ultrasound in earlier gestational ages. Though
fetal sex determination is made possible before
14 weeks gestation by 3D ultrasound, the use of
three or four-dimensional ultrasounds costs more
and may be associated with complications [3,17].
Therefore, there is a need for a low cost and
non-invasive diagnostic tool for the determination
of embryonic sex in early gestational weeks. It is
hypothesized that GS location can help as a
predictor of fetal sex by the sixth week of
pregnancy. However, this is not actual used in
clinically and just we suggest it. As there is no
consensus on the effect of GS location on fetal
sex and due to the importance of early fetal sex
determination in some cases, we aimed to
assess the association between GS location
(gestational sac) and fetal sex in pregnant
women.
2. METHODS
2.1 Study Population
This analytic cross-sectional study was
conducted on pregnant women, who referred to
Al-Zahra hospital and Private offices in Rasht,
Mirbolouk et al.; JPRI, 27(5): 1-8, 2019; Article no.JPRI.48851
3
Iran. Sample size was calculated based on the
findings of a study by Erdolu et al. [11] using the
following equation. The calculated sample size
was 800 women.
(z
1- α /2
+ z
1- β
)
2
[P
1
(1- P
1
) + P
2
(1- P
2
) ]
(P
1
- P
2
)
2
Z
1
-2
= 1.96
z
1-β
=Z
80
= 0.84
P
1
= 0.62
P
2
=0.481
2.2 Inclusion and Exclusion Criteria
The inclusion criteria were age between 20 and
31 years old, no previous history of diseases
including chronic hypertension, diabetes mellitus,
chronic renal disease, cigarette smoking or
alcohol consumption, as well as no history of
diseases known to affect fetal growth, including
early miscarriage and assisted conception, and
determined normal uterus. Exclusion criteria
were twin pregnancy, ectopic pregnancy, fetal
death, abortion, polyhydramnios or
oligohydramnios, as well as existence of
congenital anomalies.
2.3 Data Collection
Pregnant women at their 8
th
week of gestation
underwent transvaginal ultrasound by a single
radiologist in a single radiology center.
Transvaginal ultrasound was performed as a
component of prenatal care with the aim of
observing the location of the gestational sac and
the placental location (anterior- posterior, right-
left).
Data (age graviity, parity) were gathered through
interviews At 16-20 weeks of gestation, routine
transabdominal ultrasound was performed to
assess fetal health and sex determination. After
birth, the investigators confirmed the neonatal
sex through phone call and matched the actual
sex with the transabdominal ultrasound result. A
single radiologist performed the ultrasound -
coronal and sagittal planes. (Medison V 20 and
3- 7 MHz).
2.4 Statistical Analysis
Data were collected and analyzed by SPSS v.21.
The chi square test was used to assess the
relationship between the frequency distribution of
sex and placental location. The relation between
sex and placental location based on age,
gravidity and parity were assessed by logistic
regression. P<0.05 was considered as statistical
significance and 95% confidence interval was
used.
3. RESULTS
A total of 800 pregnant women enrolled in this
study. Forty-nine women were excluded (8 twin
pregnancy, 26 abortion, 5 fetal death and 10
unwilling to participate) resulting in the final 751
pregnant women. The mean age of pregnant
women was 28.56±5.51 years. The mean
gravidity and parity were 1.6±0.79 and 0.56±0.42
respectively. The pregnancies resulted in 380
boys (50.6%) and 371 girls (49.4%).
Assessing the pregnancy outcomes regarding
placental location revealed a significant
difference between sexes (p = 0.0001). However,
no significant difference was noted between
pregnancy outcomes regarding anterior or
posterior placental location (p = 0.290) (Table 1).
There was a significantly relationship between
maternal age groups (26-35 years old) and
placental location (p<0.05) (Table 2). The
relationship between frequency distribution of
pregnancy outcomes in primigravida mothers
and gravida are shown in Table 3. Relation
between frequency distribution of pregnancy
outcomes and right and left placental location in
nuliparus and primiparus mothers are shown in
Table 4.
Multivariate analysis assessed the relation
between placental location and the probability of
male and female birth using backward
conditional regression logistic (LR). After
controlling for maternal age, parity and gravidity,
no significant difference was observed between
left anterior and left posterior (reference group)
placental location and fetal sex (P=0.291). After
controlling for maternal age, parity and gravidity,
it was found that the chance of female birth was
significantly related to left posterior placental
location (p<0.0001) and the prevalence of left
anterior placenta (p=0.002) were significantly
higher than right anterior placenta (reference
group).
Whereas, the chance of female birth in left
posterior placenta was 2.4 fold higher than right
anterior placenta. (OR = 2.42, 95% CI: 1.54-
3.79). Furthermore, the chance of female birth in
left posterior placenta was 1.88 fold higher than
Mirbolouk et al.; JPRI, 27(5): 1-8, 2019; Article no.JPRI.48851
4
right posterior (reference group) placenta (OR =
1.88, 95% CI: 1.23-2.87). There was no
significant difference between right posterior
and right anterior (reference group) placental
location regarding the chance of female birth
(P=0.205).
4. DISCUSSION
The results of this study showed that the most
frequent pregnancy outcomes in right anterior
placenta were male and in left posterior placenta
were female. There was no significant difference
between sexes regarding anterior and posterior
placental location as well as right and left
placental position, whereas most of the fetuses in
right and left placental location were male and
female respectively.
To the best of our knowledge, the relationship
between fetal sex and anterior-posterior, right
left placental location has not been assessed
before.
A study on 5376 pregnant women revealed that
location of placenta in the first trimester of
pregnancy could predict of 97.97% of female
cases and 97.92% of male cases. They
concluded that there is a more tendency toward
right placement of placenta in male pregnancies
while the tendency is toward left placement in
female pregnancies [18]. In the current study, in
most female cases, the placenta was located
anteriorly, the placental position was located
posteriorly in male pregnancies.
Erdolu et al. [11] found that 62% of female
fetuses had an anterior placenta and 51.9% of
male fetuses had posterior placenta which was
similar to the results of our study. Similarly, the
results of a study by Jafari et al. [19] were also
in line with the findings of our study.
Hwida et al. reported opposite results compared
to the findings of our study. They found that most
placental positions among female and male
fetuses were anterior and posterior respectively
[20] But, in this study, results demonstrated no
significant difference between anterior- posterior
placenta between fetal sexes. This difference
between study findings might be due to
heterogeneous samples and the effect of
demographic factors.
Assessing the relation between right- left position
of placenta and fetal sexes:
Ismail et al. noted that the placental position was
on the right side among most male fetuses [15],
which was similar to the findings of our study.
The et al., however, assessed 227 pregnant
women and reported that 51% of male fetuses
had a right placenta while 57% of female fetuses
had a left placenta which was not significantly
different. They indicated that genital tubercle
ultrasound was a more effective tool for fetal sex
prediction [16]. The difference between the
findings of our study and The et al. might be due
to our sample size beingtoo small.
It seems that the association between fetal sex
and placental location could result from different
blood supplies in different sections of the uterus,
which depends on the distance between each
section and uterine artery. Increased distance
might decrease the blood supply, therefore;
blood supply in the central section of uterine
might be more appropriate than peripheral
section. It has been estimated that the lateral
placental location in fetuses with intrauterine
growth retardation were four fold higher than
anterior or posterior locations [21].
In addition, Kavraiskaya et al. noted that blood
supply to the right side of uterus was higher than
left side [22]. It seems that the difference in blood
supply might affect sex determination and each
sex might prefer different type of blood supply. A
previous study showed that endometrial
movement and electrical activity could affect
sperm transfer. The polarity of uterine wall
and sperm could be indicated as probable
causes for different implantation by different
sexes [21].
Although, no definite hypothesis for this
occurrence has yet been established, it is
thought that implantation in the right upper part of
uterine commonly occurs 4 days before
implantation in left upper quadrant, which could
be due to hormonal and temperature differences.
The imbalance in sexual hormones has been
confirmed previously, excessive estrogen may
affect male fetuses and can affect sexual
chromosomes. On the other hand, excessive
androgen can affect female fetuses. It can be
hypothesized that the right side of uterine may
allow male hormones to transfer more than the
left side. The right side may have a positive
polarity in comparison with the negative left
uterine side [15].
In this study, variables including maternal age,
gravidity and parity were assessed which were
not previously evaluated. The results of this
Mirbolouk et al.; JPRI, 27(5): 1-8, 2019; Article no.JPRI.48851
5
study showed that maternal age between 26 and
35 years old, first and second gravidity and first
parity were associated with the placental location
and fetal sexes. After adjustment for these
factors, the only predictive factor was the
placental location.
The limitations to this study include relatively a
small sample size. It is recommended that future
studies be performed on a larger population in a
multicenter study. Furthermore, this study was
the first study to assess three variables including
maternal age, number of pregnancies (gravidity)
and parity. It is recommended that future studies
should be conducted to assess the role of each
of these variables on fetal sex. This study did
not investigate abnormalities of uterus.
Considering the fact that different blood
transfusion exists in different uterine parts, it is
recommended that various hypotheses be
assessed in future studies. Additional placental
locations (lateral, fundal, etc.) could offer more
explanations. Geneticists use the X, Y
chromosome isolation technique for sex
determination that are costly and invasive while
past studies along with our study provide a low
cost and non-invasive method to help determine
the sex.
Table 1. The frequency distribution of pregnancy outcomes regarding the placental location
p-value Girls
N (%)
Boys
N (%)
Placental
location
0.0001 73(39.5) 112(60.5) Right Anterior Placental location
104(55.3) 84(44.7) Left anterior
109(45.6) 130(54.4) Right posterior
85(61.2) 54(38.8) Left posterior
0.290 178(47.5) 197(52.5) Anterior Placental location
193(51.3) 183(48.7) Posterior
0.0001 185(43.5) 240(56.5) Right Placental location
186(57.1) 140(42.9) Left
Table 2. The frequency distribution of pregnancy outcomes regarding the placental location in
maternal age groups
>36 years old
(n=69)
26-35 years old
(n=456)
21-25 years old
(n=189)
<20 years old )
(N=37)
Female
N(%)
Male
N(%)
Female
N(%)
Male
N(%)
Female
N(%)
Male
N(%)
Female
N(%)
Male
N(%)
8(22.2) 7(21.2) 40(17.7) 75(32.6) 22(24.2) 26(26.5) 3(16.7) 4(21.1) Right
anterior
13(36.1)
8(24.2) 60(26.5) 48(20.9) 23(25.3) 25(25.5) 8(44.4) 3(15.8) Left
anterior
9(25.0) 12(36.4)
71(31.4) 80(34.8) 25(27.5) 31(31.6) 4(22.2) 7(36.8) Right
posterior
6(16.7) 6(18.2) 55(24.3) 27(11.7) 21(23.1) 16(16.3) 3(16.7) 5(26.3) Left
posterior
0.669 0.0001 0.687 0.295 P -value
21(58.3)
15(45.5)
101(44.7)
124(53.9)
45(49.5) 51(52.0) 11(61.1)
7(36.8) Anterior
15(41.7)
18(54.5)
125(55.3)
106(46.1)
46(50.5) 47(48.0) 7(38.9) 12(63.2)
Posterior
0.285 0.049 0.722 0.140 P -value
17(47.2)
19(57.6)
113(50.0)
153(66.5)
48(52.7) 57(58.2) 7(38.9) 11(57.9)
Right
19(52.8)
14(42.4)
113(50.0)
77(33.5) 43(47.3) 41(41.8) 11(61.1)
8(42.1) Left
0.390 0.0001 0.454 0.248 P -value
Mirbolouk et al.; JPRI, 27(5): 1-8, 2019; Article no.JPRI.48851
6
Table 3. The frequency distribution of pregnancy outcomes regarding the placental location
and gravidity
≥3 gravida
(n=82)
Gravida 2
(n-266)
Primigravida
(n=403)
Female
N (%)
Male
N (%)
Female
N (%)
Male
N (%)
Female
N (%)
Male
N (%)
6(17.1) 12(25.5) 32(23.9) 40(30.3) 35(17.3) 60(29.9) Right
anterior
11(31.4) 9(19.1) 34(25.4) 30(22.7) 59(29.2) 45(22.4) Left
anterior
13(37.1) 17(36.2) 34(25.4) 48(36.4) 62(30.7) 65(32.3) Right
posterior
5(14.3) 9(19.1) 34(25.4) 14(10.6) 46(22.8) 31(15.4) Left
posterior
0.539 0.008 0.010 P -value
17(48.6) 21(44.7) 66(49.3) 70(53.0) 95(47.0) 106(52.7) anterior
18(51.4) 26(55.3) 68(50.7) 62(47.0) 107(53.0) 95(47.3) posterior
0.727 0.538 0.252 P -value
19(54.3) 27(57.4) 67(50.0) 88(66.7) 99(49.0) 125(62.2) Right
16(45.7) 20(42.6) 67(50.0) 44(33.3) 103(51.0) 76(37.8) Left
0.775 0.006 0.008 P -value
Table 4. The frequency distribution of pregnancy outcomes regarding the placental location
and parity
2 parity
(n=28)
Primipara
(n=256)
Nuliparity
Female
N (%)
Male
N (%)
Female
N (%)
Male
N (%)
Female
N (%)
Male
N (%)
2(16.7) 6(37.5) 29(23.2) 41(31.3) 42(17.9) 65(27.9) Right anterior
3(25.0) 4(25.0) 37(29.6) 28(21.4) 64(27.4) 52(22.3) Left anterior
5(41.7) 3(18.8) 31(24.8) 46(35.1) 73(31.2) 81(34.8) Right
posterior
2(16.7) 3(18.8) 28(22.4) 16(12.2) 55(23.5) 35(15.0) Left posterior
0.509 0.025 0.001 P -value
5(41.7) 10(62.5) 66(52.8) 69(52.7) 107(45.7) 118(50.6) anterior
7(58.3) 6(37.5) 59(47.2) 62(47.3) 127(54.3) 115(49.4) posterior
0.274 0.984 0.288 P -value
7(58.3) 9(56.3) 61(48.8) 85(64.9) 117(50.0) 146(62.7) Right
5(41.7) 7(43.8) 64(51.2) 46(35.1) 117(50.0) 87(37.3) Left
0.912 0.009 0.006 P -value
5. CONCLUSIONS
We here demonstrated that male and female
fetuses are more likely to have right anterior and
left posterior placentas, respectively. Although
this study was based on a small population, this
may provide a fundamental data for the future
study to associate fetal gender and the placental
location.
CONSENT
A written consent was obtained from each
participant.
ETHICAL APPROVAL
Ethical approval was obtained from the Ethics
Committee of the Guilan University of
Mirbolouk et al.; JPRI, 27(5): 1-8, 2019; Article no.JPRI.48851
7
Medical Sciences (Registration Number:
1393014414).
FUNDING / SUPPORT
Financial support was done with Vice-
chancellorships Research of Guilan University of
Medical Sciences.
ACKNOWLEDGEMENTS
The authors acknowledge with grateful
appreciation the support provided by the Vice-
chancellorships Research of Guilan University of
Medical Sciences. Also, this investigation was
based on a thesis submitted by Dr Mohammadi
(Guilan University of Medical Sciences in Iran).
COMPETING INTERESTS
Authors have declared that no competing
interests exist.
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... In our study, no significant correlation was found between placental localization and maternal age, but it was determined that the placenta was mostly in anterior localization in the group which is above 30 years of age. Mirbolouk et al. found a significant relationship between maternal age (26-35 years) and placental localization (17). In the study of Magann et al., no significant difference was found between maternal age and placental localization by following our study (18). ...
... In our study, we found that gender of the baby is not related to placental localization. While some studies indicate that placental localization may affect gender of the baby (3,17,21), Torricelli et al. stated that there is no significant relationship between the gender of the baby and placenta localization (22). In the studies which are indicating that placental localization is related to gender of the baby, researchers stated female fetuses have anterior placental localization and male fetuses have posterior placental localization (3,9). ...
... In the studies which are indicating that placental localization is related to gender of the baby, researchers stated female fetuses have anterior placental localization and male fetuses have posterior placental localization (3,9). Mirbolouk et al. found that right anterior located placenta could be seen in male fetuses, and left posterior located placenta in female fetuses (17). In conducted studies, we see that there is not enough evidence to support this information. ...
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Background: The relationship between placental localization and fetus is unclear. This study was aimed to determine the relationships between placental localization, ultrasound findings and pregnancy outcomes of the third trimester of pregnancies. Materials and Methods: Three-hundred and two women were included in the study. Maternal age, gravidity, parity, abortion and live birth numbers, types of previous births, gestational age, femur length (FL), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), placental localization (ante- rior/posterior/lateral/fundus), umbilical artery systolic/diastolic ratio (S/D), fetal presentation, type of deliv- ery, post-partum parameters of infant were obtained from archive records. Results: The placentas were located in the anterior, posterior, fundal and lateral uterine wall in 38.1%, 30.1%, 19.9%, and 11.9% of individuals, respectively. Measurements of the HC in the third trimester were differed according to the localization of the placenta, and the HC measurements were significantly higher if the pla- cental localization was anteriorly (p=0.045). There were no differences in other ultrasonographic measure- ments (S/D, BPD, AC ve FL), in the height, weight, and gender of the baby, gestational week at delivery, APGAR scores and type of delivery according to the placental localization (p>0.05). Conclusions: In this study, we found that placental localization did not affect pregnancy outcomes, type of delivery and gender of the baby in risk-free, spontaneous and single pregnancies in the third trimester. Also, we stated that the previous birth type did not give an idea about placental localization. We think that pla- centa implantations, except placental location anomaly and invasion anomaly, do not provide precise infor- mation about pregnancy outcomes and type of delivery.
... The total sample was consisted of 800 women. According to the results, left posterior placenta was associated with female neonates and the right anterior placenta with male neonates (18). A research undertaken by Behzadmehr R et al. did not found a significant correlation between neonatal gender and placental location. ...
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Background: Ultrasound imaging plays a crucial role in delivering high-quality obstetric care, serving purposes such as gender determination and assessing various parameters. Placenta is known to play a substantial part in fetal development and there is a keen interest in finding any association between placental location and neonatal gender but no consistent fallouts have been found.
... The total sample was consisted of 800 women. According to the results, left posterior placenta was associated with female neonates and the right anterior placenta with male neonates (18). A research undertaken by Behzadmehr R et al. did not found a significant correlation between neonatal gender and placental location. ...
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Full-text available
Background: Ultrasound imaging plays a crucial role in delivering high-quality obstetric care, serving purposes such as gender determination and assessing various parameters. Placenta is known to play a substantial part in fetal development and there is a keen interest in finding any association between placental location and neonatal gender but no consistent fallouts have been found.
... [2] Regarding the anterior and posterior placental location, our study shows that there is insignificant correlation between the location and gender with P = 0.789. This result is agreed with that obtained by Mirbolouk et al. [18] who found no significant association between anterior and posterior placenta and fetal outcome. However, Jafari et al. [13] found significant relation as 72.8% of girls had anterior placenta, and only 27.2% of males had anterior placenta. ...
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Background Ultrasound (US) is a highly feasible way to assess fetal health as well as detect the gender to satisfy parents’ curiosity and it is important in several hereditary and chromosomal diseases. Objectives The aim of this study was to determine the gender of the fetus during the first trimester by detecting the chorionic villi (placental) location by US and finding its relation with fetal gender. Materials and Methods The study was conducted on 67 women in April 2019–April 2020 on outpatient private clinic, ultrasound machine used DC N3 Pro, transabdominal approach by 5 MHz probe 3C5A measuring transverse and sagittal views of the gestational sac and localizing chorionic villi, another scan was done in the second trimester to identify the fetal gender by visualizing the genitalia. Results Of 67 pregnant women examined, 40 had male fetuses and 27 had female fetuses. Approximately 50% of males had right-sided placenta. And 50% of them had left sided placenta, 11 out of 27 examined females fetus had right sided placenta, 16/27 female had left sided chorionic villi, Chi square analysis done, P-value was 0.456. Conclusion The site of chorionic villi has an insignificant correlation with fetal gender difference.
... [ DOI:10.52547/iau.31.2.251 ] [ DOR: 20.1001.1.10235922.1400.31.2.8.8 ] [ Downloaded from tmuj.iautmu.ac.ir on 2022-11-24 ] ...
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Background: Superstition and traditional practices regarding pregnancy exist in various cultures around the world and are passed down from generation to generation. As a result of the literature review, it was observed that there weren't prospective and cross-sectional studies involving traditional practices and dietary preferences of pregnant women before and after determining the gender according to the gender of the baby they want. The purpose of this study was to determine dietary preferences, superstitions and traditional practices before and after determining the gender of the baby according to the desired gender of the baby among pregnant women.Methods: The research was a descriptive cross-sectional study and adopted the pretest-posttest research design. As the data collection tool, both investigators-designed questionnaire forms and the non-functional beliefs and practices scale (NFBPS) related to pregnancy to the same pregnant women were applied before and after the determination of baby gender in the first and second trimesters respectively.Results: The study found that 85% of the pregnant women thought that dietary preferences during pregnancy have an impact on the gender of the true baby. The results showed that superstitions and traditional practices were known and practiced by pregnant women at a young age, uneducated, living in the province and having a large family type (p<0.05).Conclusions: Health professionals, should pay attention to less educated, younger pregnant women to reinforce positive cultural health practices, discourage to them from using harmful ones superstition and traditional practice by providing non-critical scientific explanations.
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Fetal sex plays an important role in modifying the course and complications related to pregnancy and may also have an impact on maternal health and well-being both during and after pregnancy. The goal of this article is to review and summarize the findings from published research on physiologic and pathologic changes that may be affected by fetal sex and the effect of these changes on the maternal and obstetrical outcomes. This will help create awareness that fetal sex is not just a random chance event but an interactive process between the mother, the placenta, and the fetus. The reported effects of male sex on the course of pregnancy and delivery include higher incidence of preterm labor in singletons and twins, failure of progression in labor, true umbilical cord knots, cord prolapse, nuchal cord, higher cesarean section rate, higher heart rate variability with increased frequency, and duration of decelerations without acidemia and increased risk of gestational diabetes mellitus through the poor beta cells function. Similarly, female fetal sex has been reported to modify pregnancy and delivery outcomes including altered fetal cardiac hemodynamics, increased hypertensive diseases of pregnancy, higher vulnerability of developing type 2 DM after pregnancy possibly because of influences on increased maternal insulin resistance. Placental function is also influenced by fetal sex. Vitamin D metabolism in the placenta varies by fetal sex; and the placenta of a female fetus is more responsive to the relaxing action of magnesium sulfate. Male and female feto-placental units also vary in their responses to environmental toxin exposure. The association of fetal sex with stillbirths is controversial with many studies reporting higher risk of stillbirth in male fetuses; although some smaller and limited studies have reported more stillbirths with female fetus pregnancies. Maternal status such as BMI may in turn also affect the fetus and the placenta in a sex-specific manner. There is probably a sex-specific maternal–placental–fetal interaction that has significant biological implications of which the mechanisms may be genetic, epigenetic, or hormonal. Determination of fetal sex may therefore be an important consideration in management of pregnancy and childbirth.
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During a standard obstetrical sonogram, the assessment of placental location (PL) is often limited to a mere notional description without formulating any association to possible implications on pregnancy and childbirth. The aim of the study was to speculate if different sites of PL may have a role in influencing fetal presentation-(FP) at birth and if certain pregnancy-complications may be more closely associated with one rather than with another PL. We conducted an observational-prospective-cohort study on pregnant women referred to the Ob/Gyn Unit of Padua University for routine third-trimester ultrasound scan. For all eligible patients we evaluated the correlation between sites of PL and perinatal maternal/fetal outcomes. Non-cephalic presentation was found in 1.4% of anterior, 8.9% of posterior, 6.2% of fundal and 7.2% of lateral insertions. FP at the beginning of the third trimester as opposed to presentation at birth was concordant in 90.3% of anterior, 63.3% of posterior and 76.5% of lateral insertions. Considering only non-cephalic fetuses we observed a decreasing probability for spontaneous rotation in the following lies: 88% anterior-PL, 80% posterior-PL, 77% lateral-PL, and 70% fundal-PL. Patients with posterior-PL (significantly associated with previous-CS) had a significantly higher CS-rate (due to previous-CS and breech-presentation). Significant differences were found in terms of gestational-hypertension and fresh-placental-weight between different sites of PL. In conclusion our data showed that an understanding of the role that PL plays in influencing the incidence of certain maternal-fetal conditions may assist Clinicians in improving perinatal maternal/fetal outcomes.
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Background: Diabetes mellitus is a widespread disease. Its vascular complications can be characterized by arteriosclerosis formation in carotid arteries. Due to its delayed diagnosis resulting in more complications in Iran, it seems that screening diabetic patients is mandatory. Objectives: The aim of this study was to compare the intima-media thickness (IMT) of carotid artery in diabetic and non-diabetic patients. Patients and methods: This is a cross-sectional study, which included 80 participants (40 diabetics and 40 non-diabetics). By using ultrasound, bilateral IMTs of the distal carotid were measured and the data were analyzed using ANOVA and multivariate regression tests in SPSS 14. Results: The mean IMT was 0.97 in diabetic patients and 0.63 in non-diabetics (P < 0.001). Age and gender had significant positive effects on the increase of IMT (P < 0.05 and P < 0.005, respectively for age and gender). Past medical history of coronary heart disease (CHD) and cerebrovascular accident (CVA) in diabetes is associated significantly with an increase in IMT (P =0.019 and 0.027 respectively). Other confounding variables such as smoking, history of hypertension (HTN) and hyperlipoproteinemia (HLP) in diabetic patients showed no significant relationship with the increase of IMT. Conclusions: Although measuring the IMT of the carotid artery by sonography is a useful tool for screening diabetic patients, more studies are needed for determining how to use these measurements in promoting the patients outcomes.
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The purpose of this study was to evaluate the feasibility of three-dimensional freehand echocardiographic assessment of ventricular volumetry in healthy fetuses and in fetuses with congenital heart disease. The study was approved by the hospital institutional review board. After echocardiographic examination by conventional ultrasonographic equipment interfaced with a magnetic tracking system, three-dimensional cardiac data were collected prospectively in 57 fetuses. Ventricular volumes were determined from three-dimensional data sets, and 22 fetuses with congenital heart disease were compared with 29 healthy fetuses. A multiple regression analysis of covariance was performed to assess between-group differences. Gated three-dimensional volume data sets enabled assessment of ventricular volumes in 51 of the 57 fetuses. Both fetuses with and without congenital heart disease had exponential increases in cardiac volumes during gestation. In fetuses with congenital heart disease and a marked inequality of ventricular size but no heart failure, the combined end-diastolic and stroke volumes of both ventricles were found to be significantly reduced compared with controls with no disease and fetuses with other types of congenital heart disease. Three-dimensional imaging can provide estimates of ventricular volume changes in fetal hearts with abnormal ventricular morphology that cannot easily be performed by two-dimensional echocardiography, and it may provide insight into evolving congenital heart disease.
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The aim of this study is to examine the relationship between placental localisation, birth weight, and foetal sex. It also evaluates umbilical artery Doppler parameters and their relationship with placental localisation. This is a retrospective study of 500 healthy pregnant women who gave birth at our university. All women had undergone a detailed ultrasound and Doppler examination at 20-23 weeks. The ultrasonography results of the patients were examined retrospectively. Foetal biometry, birth weight, and umbilical artery Doppler parameters were recorded and compared according to placental localisation. Birth weight was significantly higher in foetuses with anteriorly located placenta. The incidence of female foetuses was higher (62%) in relation to anteriorly located placentas, whereas male incidence was higher (51.9%) in relation to posterior placentas. A comparison of Doppler parameters betiveen groups revealed significantly higher pulsatility index (PI) and resistance index (RI) values in posteriorly located placentas. Foetal sex might affect placental localisation. Doppler parameters and birth weight might also differ according to placental side. These factors should be taken into consideration during the evaluation of obstetric patients.