Dr. Chapa’s OBGYN Clinical Pearls

TWOFER! (Quickie #4): A. Placental Grading, B. GBS discordant Results


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Podcast family, welcome to Quickie #4. This one will be fun: A. Medicine changes, and changes fast. I trained with and learned the Grannum grading placental system (grades 0-III based on ultrasound appearance). Is that still a thing? We recently found a “grade III placenta at 34 weeks” as an incidental finding. Is there specific management considerations for this? Listen in for details. B. What do we do when a patient has “two GBS results” in one pregnancy hat are discordant. Listen in for that as well!

1. Jaiman S, Romero R, Pacora P, et al. Disorders of Placental Villous Maturation Are Present in One-Third of Cases With Spontaneous Preterm Labor. Journal of Perinatal Medicine. 2021.

2. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2017. Sentilhes L, Sénat MV, Ancel PY, et al. Prevention of Spontaneous Preterm Birth: Guidelines for Clinical Practice From the French College of Gynaecologists and Obstetricians (CNGOF).

3. Brink LT, Roberts DJ, Wright CA, et al. Placental Pathology in Spontaneous and Iatrogenic Preterm Birth: Different Entities With Unique Pathologic Features. Placenta. 2022.

4. Chitlange SM, Hazari KT, Joshi JV, Shah RK, Mehta AC. Ultrasonographically Observed Preterm Grade III Placenta and Perinatal Outcome.International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics. 1990.

5. Mirza FG, Ghulmiyyah LM, Tamim H, et al. To Ignore or Not to Ignore Placental Calcifications on Prenatal Ultrasound: A Systematic Review and Meta-Analysis. The Journal of Maternal-Fetal & Neonatal Medicine : The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 2018.

6. Quinlan RW, Cruz AC, Buhi WC, Martin M. Changes in Placental Ultrasonic Appearance. II. Pathologic Significance of Grade III Placental Changes. American Journal of Obstetrics and Gynecology. 1982.

7. Karen M. Puopolo Group B Streptococcal Disease. https://orcid.org/0000-0002-5581-8825; Published February 25, 2026 N Engl J Med 2026;394:896-905ACOG 797



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