Vaginal delivery through annular placenta – case report

Abstract

Annular placenta is an extremely rare morphological type of human placenta. It is commonly related to placental vessel abnormalities frequently causing antenatal and postnatal hemorrhage and operative delivery. Gravida 4 para 1 had an uneventful course of pregnancy and normal vaginal delivery followed by moderate postpartum hemorrhage. Hemorrhage was found to be local in origin but the placenta was annular in shape and the newborn was delivered through one of the openings. Annular placenta was not recognized before delivery. Its implantation site was in the lower uterine segment but high enough to allow the passage of the fetus through its annular defect and vaginal birth. To our knowledge, this is a first report of annular placenta ending in normal vaginal delivery.

Vacuum‐assisted vaginal delivery with annular placenta and vasa previa: A rare case report

“…In the present study, the authors used vacuum extraction due to parietal deflexion of the fetal head. The most remarkable thing about the present case and that of Živković et al 1 is that both deliveries were achieved vaginally, and both cases had no adverse effects…”

“…Annular or zonary placenta is a condition where instead of being located on one side of the uterus, the placenta eclipses and circumnavigates the uterus. 1,2 Vasa previa is a rare condition in which the umbilical blood vessels cross through the amniotic membranes, are unprotected by Wharton's jelly or placental tissue, and pass over the internal opening of the uterine cervix. 3 Annular placenta and vasa previa are extremely rare complications of pregnancy with high fetal morbidity and mortality rates.…”

“…1,2 Out of six articles, only two were fully available, and the remaining four articles were not only inaccessible, but were also published between 60 and 70 years ago. 1,2 To the best of our knowledge, this is the first study to report on a vaginal delivery with an annular placenta and vasa previa. The present case was unusual because annular placenta and vasa previa were not diagnosed before delivery through vaginal or ultrasound examination.…”

“…Furthermore, they are both associated with antepartum hemorrhage and cesarean delivery. [1][2][3] A 32-year-old woman (gravida 3, para 2) was admitted to our labor ward in the active stage of labor at 38 +4 weeks of pregnancy.…”

“…In the literature, six articles (three case reports and three other articles) were identified on the subject of annular placenta. 1,2 Out of six articles, only two were fully available, and the remaining four articles were not only inaccessible, but were also published between 60 and 70 years ago. 1,2 To the best of our knowledge, this is the first study to report on a vaginal delivery with an annular placenta and vasa previa.…”