Early sonographic detection of a succenturiate placenta after IVF in a 42-year-old woman with multiple comorbidities

Abstract

We present a case of a 42-year-old woman with a pregnancy resulting from in vitro fertilisation and a medical history including two spontaneous abortions, hypercoagulable state and other comorbidities. At 13 4/7 weeks' gestation, during research ultrasonography, the patient was noted to have an anterior succenturiate placental lobe. Following an episode of vaginal bleeding at 21 6/7 weeks, she was diagnosed with a low-lying posterior placental lobe. Velamentous cord insertion, placenta previa and vasa previa were excluded at that time. After elective induction for advanced maternal age at 39 0/7 weeks, arrest of labour and chorioamnionitis resulted in a primary low transverse caesarean section and delivery of a healthy girl at 39 3/7 weeks. Gross examination of the placenta showed an irregular, singleton placenta with an attached succenturiate lobe and a marginally inserting umbilical cord. Both lobes were connected by two vessels.

Marginal umbilical cord insertions in a bipartite placenta responsible for placenta abruption: a case report

“…The antenatal diagnosis of bipartite placenta can be done by color Doppler obstetrical ultrasound. 6,7 In our case, it was not diagnosed antenatally given that Doppler color technique was not done. Differential diagnosis is that of a succenturiate lobe, defined as one or more accessory placenta lobes distinct from the body of the placenta.…”

Relationship between Abnormal Placenta and Obstetric Outcomes: A Meta-Analysis

“…A total of 963 studies were screened. Of these, 48 studies comprising 1625 pregnant women with abnormal placenta and 167,566 pregnant women without abnormal placentas met the inclusion criteria of the current systematic review for descriptive analysis [ 3 , 9 , 10 , 11 , 12 , 13 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ].…”

“…The metadata of the 48 eligible studies are shown in Supplementary Table S1 [ 3 , 9 , 10 , 11 , 12 , 13 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ]. The eligible studies were published between 1974 and 2022.…”

“…All studies were retrospective in nature, and none of them were randomized controlled studies. Of the included studies ( n = 48), 26 were case reports [ 3 , 25 , 27 , 29 , 32 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 47 , 48 , 49 , 50 , 51 , 53 , 56 , 57 , 58 , 63 , 64 , 65 ], 4 were case series [ 33 , 59 , 60 , 61 ], and the remaining 18 were original research articles [ 9 , 10 , 11 , 12 , 13 , 24 , 26 , 28 , 30 , 31 , 34 , 44 , 45 , 46 , 52 , 54 , 55 , 62 ]. The majority of the studies (approximately one-third) were from the United States of America ( n ...…”

“…Evidently, a similar rate of circumvallate placentas was observed between the experimental and control groups. The outcomes of succenturiate lobe placenta were mentioned in 20 studies (Supplementary Table S4) [9,13,24,27,28,30,31,35,37,40,41,43,44,46,47,49,51,60,61,63]. Of these (n = 20), 8 studies were original research articles [9,13,24,28,30,31,44,46], 2 were case series [60,61], and the remaining 10 were case reports [27,35,37,40,41,43,47,49,51,63].…”