Circumvallate Placenta: Associated Clinical Manifestations and Complications—A Retrospective Study

Taniguchi, Hanako; Aoki, Shigeru; Sakamaki, Kentaro; Kurasawa, Kentaro; Okuda, Masahiko; Takahashi, Tsuneo; Hirahara, Fumiki

doi:10.1155/2014/986230

Cited by 29 publications

(45 citation statements)

References 14 publications

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“…When the placental ring is flat or lacks the central depression, it is called a circummarginate placenta (17). Circumvallate placenta is reported to have an increased risk of chronic placental abruption, preterm delivery, small for gestational age (SGA) status, chronic lung disease (in the child), and neonatal intensive care admissions (18).…”

Section: Circumvallate Placentamentioning

confidence: 99%

Placental Imaging: Normal Appearance with Review of Pathologic Findings

et al. 2017

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The placenta plays a crucial role throughout pregnancy, and its importance may be overlooked during routine antenatal imaging evaluation. Detailed systematic assessment of the placenta at ultrasonography (US), the standard imaging examination during pregnancy, is important. Familiarity with the normal and abnormal imaging appearance of the placenta along with the multimodality and methodical approach for evaluation of its related abnormalities is necessary, so that radiologists can alert clinicians regarding appropriate prompt management decisions. This will potentially decrease fetal and maternal morbidity and mortality. This article reviews early placental formation and the expected imaging appearance of the placenta during pregnancy, as well as variations in its morphology. It also discusses various placental diseases and their potential clinical consequences. Placental pathologic conditions include abnormalities of placental size, cord insertion, placental and cord location, and placental adherence. Other conditions such as bleeding in and around the placenta, as well as trophoblastic and nontrophoblastic tumors of the placenta, are also discussed. US with Doppler imaging is the initial imaging modality of choice for placental evaluation. Magnetic resonance (MR) imaging is reserved for equivocal cases or when additional information is needed. Computed tomography (CT) has a limited role in evaluation of placental abnormalities because of the ionizing radiation exposure and the relatively limited assessment of the placenta; however, CT can provide important information in specific circumstances, particularly evaluation of trauma and staging of choriocarcinoma. This article also addresses recent techniques and updates in placental imaging, including elastography, diffusion-weighted MR imaging, and blood oxygen level-dependent (BOLD) MR imaging. These advanced imaging techniques may provide additional information in evaluation of abnormal placental adherence and new insights into placental pathophysiology in selected patients. Online supplemental material is available for this article. RSNA, 2017.

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Section: Circumvallate Placentamentioning

confidence: 99%

Placental Imaging: Normal Appearance with Review of Pathologic Findings

et al. 2017

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“…Unlike normally developed placenta, circumvallate placenta is a type of extrachorial placenta that results from the mismatch between the basal plate and the chorionic frondosum. Consequently, the chorion inserts inward from the usual placental margin at the basal plate-frondosum junction toward the umbilical cord, resulting in a raised annular margin (1,2,(13)(14)(15)(16).This placental edge, uncovered by a villous membrane, becomes an elevated membranous fold; it appears as an ILE at the placental margin when it is discovered tangentially at US (Fig 7) (1,16).…”

Section: Circumvallate Placentamentioning

confidence: 99%

“…Partial circumvallate placenta, in which the membrane is lifted along part of the placenta, is 10-20 times more common than complete circumvallate placenta and is considered to be clinically insignificant (3). Complete circumvallate placenta, in which the membrane is lifted along the entire placental circumference, is linked to a higher incidence of fetal growth restriction, placental abruption, preterm birth, and neonatal morbidity and mortality (3,15).…”

Section: Circumvallate Placentamentioning

confidence: 99%

“…Circumvallate placenta is seen during the early part of the second trimester but is less visible sonographically during the third trimester, because uterine enlargement causes stretching of the placenta (17,18). US findings of circumvallate placenta include an irregular lifted edge of the fetal placental attachment, within 3 cm of the placental edge, which traverses parallel to the surface of the placenta and attaches to another portion of the placenta, forming a placenta-to-placenta ILE (2,3,13,15,17). Fetal growth should be monitored with follow-up examinations when more than twothirds of the placental margin is involved (2).…”

Section: Circumvallate Placentamentioning

confidence: 99%

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Intrauterine Linear Echogenicities in the Gravid Uterus: What Radiologists Should Know

Jensen

Kennedy

et al. 2018

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Intrauterine linear echogenicity (ILE) is a common ultrasonographic finding in the gravid uterus and has variable causes and variable maternal and fetal outcomes. Correctly categorizing ILE during pregnancy is crucial for guiding surveillance and advanced imaging strategies. Common causes of ILE include membranes in multiple gestations, uterine synechiae with amniotic sheets, and uterine duplication anomalies. Less common causes include circumvallate placenta, chorioamniotic separation, and hemorrhage between membranes. Amniotic band syndrome is a rare but important diagnosis to consider, as it causes severe fetal defects. Imaging findings enable body stalk anomaly, a lethal defect, to be distinguished from amniotic bands, which although destructive are not necessarily lethal. This review describes the key imaging findings used to differentiate the various types of ILE in pregnancy, thus enabling accurate diagnosis and appropriate patient counseling. Online supplemental material is available for this article. RSNA, 2018.

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“…Different authors showed that circumvallate placenta is associated with vaginal bleeding, preterm rupture of the membranes, preterm delivery, and placental abruption, the need for emergency cesarean section and also for fetal and neonatal complications such as intrauterine growth restriction, neonatal death or admission to neonatal intensive care units. [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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

Dukatz

Henrich

Entezami³

et al. 2020

Case Reports in Perinatal Medicine

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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.

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Circumvallate Placenta: Associated Clinical Manifestations and Complications—A Retrospective Study

Cited by 29 publications

References 14 publications

Placental Imaging: Normal Appearance with Review of Pathologic Findings

Placental Imaging: Normal Appearance with Review of Pathologic Findings

Intrauterine Linear Echogenicities in the Gravid Uterus: What Radiologists Should Know

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

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