Placenta plays a key role in maintenance of milieu interior in the growing foetus by establishing a vital connection between the mother and foetus. Any change or deterioration in the placental function as seen in placental ageing or placental insufficiency, can indicate the outcome of pregnancy and if detected can help in timely appropriate intervention to save the life of baby as well as mother. Grade III placental changes if found early in pregnancy can indicate increased peri-natal morbidity and mortality more particularly in high risk pregnancies.150 cases (50  normal and 100 high risk)  cases were studied for a correlation between the placental grades and the foetal outcome. It is observed that there is a definite correlation between the grades of placenta and foetal outcome. In our study grade III placenta was seen mostly (35%) at 32-37weeks of gestation. A definite correlation is found between the advanced maturity of placenta and high risk pregnancies like PIH, Intra uterine growth retardation (IUGR) and sickle cell anaemia but a delayed maturity of placenta is seen in diabetes and Rh –ve pregnancies. Incidence of foetal distress was observed more with grade III placenta (51.4%) as compared to grade I and II placenta. Birth asphyxia was observed in 28.57% of high risk cases with grade III placenta. Low birth weight baby was seen in with grade III placenta in 50.25% cases. The results are consistent with result of other group. Detection of higher grades of placenta early in 3^rd trimester can alert the obstetrician for close observation regarding development of PIH, IUGR, foetal distress and foetal maturity as there is definite correlation of early maturation of placenta with foetal complications.

Key Words: placental grades, ultrasonography, high risk pregnancy, foetal outcome