Circumvallate placenta and abnormal cord insertion as risk factors for intrauterine growth restriction and preterm birth: a case report

Abstract

ObjectivesCircumvallate placenta is a rare abnormality of placental shape. Current data indicates that a circumvallate placenta can be a risk factor for severe adverse obstetric and neonatal outcomes such as antepartum bleeding, premature delivery, oligohydramnios, intrauterine growth restriction and placental abruption. An unusual insertion of the umbilical cord can cause a reduction of perfusion and can also lead to pregnancy complications. However, the clinical significance of these pathoanatomical findings often remains unclear.Case presentationWe report a case of a 22-year-old third gravida nullipara in 28+2 pregnancy weeks with a pathological cardiotocography (CTG) and a growth restricted fetus with oligohydramnios and pathological umbilical blood flow. Due to recurrent decelerations of fetal heart rate the baby was delivered via cesarean section. The examination of the placenta showed a circumvallate placenta and fixated umbilical cord mimicking a battledore insertion.ConclusionsIt can be concluded that circumvallate placenta may predispose to severe obstetric complications. Women with circumvallate placenta and abnormal cord insertion probably benefit from stringent follow ups in a specialized perinatal center. Histopathological examination of the placenta can be a diagnostic tool in women with recurrent obstetric complications.