Placental grading was studied prospectively with real-time ultrasound in 654 consecutive pregnancies. the placental maturation was clearly demonstrated in both unselected and hypertensive pregnancies. No differences in placental grading were found between normotensive and hypertensive pregnancies. Fetal outcome was not associated with different placental grades and a grade III placenta was not predictive of an adverse outcome. the value of antenatal placental grading in unselective and hypertensive pregnancies could not be demonstrated.