Prenatal diagnosis of succenturiate lobe by ultrasonography and color Doppler imaging

Chihara, Hiromitsu; Otsubo, Yasuo; Ohta, Y.; Araki, Tsutomu

doi:10.1007/s004040050013

Cited by 22 publications

(19 citation statements)

References 7 publications

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“…Prenatal sonographic diagnosis of succenturiate (and bilobate) placenta, both similarly potential predisposing factors for vasa previa, have been reported. [126][127][128][129][130] Sonographic findings of these similar entities are rather straightforward and consist of the notation of placental tissue without continuity (occupying areas at a distance from each other) yet connected by fetal vasculature.…”

Section: Succenturiate Placentamentioning

confidence: 99%

Current Perspectives of Prenatal Sonography of Umbilical Cord Morphology

Sherer¹,

Al-Haddad²,

Cheng³

et al. 2021

IJWH

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The umbilical cord constitutes a continuation of the fetal cardiovascular system anatomically bridging between the placenta and the fetus. This structure, critical in human development, enables mobility of the developing fetus within the gestational sac in contrast to the placenta, which is anchored to the uterine wall. The umbilical cord is protected by unique, robust anatomical features, which include: length of the umbilical cord, Wharton's jelly, two umbilical arteries, coiling, and suspension in amniotic fluid. These features all contribute to protect and buffer this essential structure from potential detrimental twisting, shearing, torsion, and compression forces throughout gestation, and specifically during labor and delivery. The arterial components of the umbilical cord are further protected by the presence of Hyrtl's anastomosis between the two respective umbilical arteries. Abnormalities of the umbilical cord are uncommon yet include excessively long or short cords, hyper or hypocoiling, cysts, single umbilical artery, supernumerary vessels, rarely an absent umbilical cord, stricture, furcate and velamentous insertions (including vasa previa), umbilical vein and arterial thrombosis, umbilical artery aneurysm, hematomas, and tumors (including hemangioma angiomyxoma and teratoma). This commentary will address current perspectives of prenatal sonography of the umbilical cord, including structural anomalies and the potential impact of future imaging technologies.

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Section: Succenturiate Placentamentioning

confidence: 99%

Current Perspectives of Prenatal Sonography of Umbilical Cord Morphology

Sherer¹,

Al-Haddad²,

Cheng³

et al. 2021

IJWH

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“…Succenturiate lobes are easily diagnosed by ultrasound (fig 3A), especially using colour Doppler to demonstrate communicating chorionic vessels (fig 3B,C). 57 Colour Doppler may also allow identification of vasa praevia and velamentous cord insertion as vessels running across the cervical os and within the fetal membranes respectively 58 59. Abnormally invasive placentas (accreta, increta, percreta) may be diagnosed by prenatal sonography, although the sensitivity is low (<50%).…”

Section: Specific Entitiesmentioning

confidence: 99%

Correlation of placental pathology with prenatal ultrasound findings

Sebire

Sepúlveda²

2008

J Clin Pathol

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There have been recent major advances in obstetric ultrasound, regarding both improved technologies and sonographer expertise, which have resulted in changes in antenatal obstetric management. The placenta is routinely examined to some extent at the time of the second trimester fetal anomaly sonogram, timing of delivery in pregnancies complicated by intrauterine growth restriction is primarily dependent on Doppler sonographic assessment of umbilical and uterine artery blood flow, and an increasing number of specific placental lesions have been described. Many non-specialist diagnostic histopathologists may be unfamiliar with these obstetric advances, but they are an increasingly common indication for submission of placentas for histological examination. Since the aims of pathological examination of the placenta are to determine the pathological basis for the clinical findings and advance understanding of the pathophysiology of pregnancy complications, this review therefore provides an overview of the most common prenatal sonographic techniques and their clinical relevance to the diagnostic pathologist, primarily focusing on conditions with specific placental implications. These range from abnormalities of placental site and cord insertion, to obstetric complications such as antepartum haemorrhage, through sonographic placental parenchymal lesions such as subchorionic and intervillous thrombi, or chorioangiomata. In addition, the pathophysiological basis of abnormal maternal and fetal maternal Doppler indices and intrauterine growth restriction are now described, being associated with decidual vasculopathy and villous changes associated with reduced intervillous blood flow respectively. Finally, rare but characteristic, sonographic appearances of villous cystic or hydropic change, may be associated with intrinsic developmental placental abnormalities such as hydatidiform mole and placental mesenchymal dysplasia, which require histological examination for their specific diagnosis.

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“…In addition, there have been cases reported in the literature wherein the USG diagnosis of succenturiate placenta was mistaken as amniotic band syndrome owing to the interconnecting vessels between the two parts of the placenta 3 12. Using colour Doppler to visualise fetal blood flow is helpful in excluding the diagnosis of amniotic band syndrome 13. Efforts should be made not to confuse succenturiate placenta with a placenta covering two aspects of the uterine cavity and also with the appearance of the placenta during myometrial contraction 14.…”

Section: Discussionmentioning

confidence: 99%

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

Stelzl¹,

Yadav

Perley

et al. 2017

BMJ Case Reports

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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.

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Prenatal diagnosis of succenturiate lobe by ultrasonography and color Doppler imaging

Abstract: At 16 weeks' gestation, ultrasonography demonstrated a band-like structure in the amniotic cavity of a 27-year-old woman. Color Doppler imaging revealed blood flow in this band-like structure and a diagnosis of a placenta with succenturiate lobe rather than an amniotic band was made.

Cited by 22 publications

References 7 publications

Current Perspectives of Prenatal Sonography of Umbilical Cord Morphology

Current Perspectives of Prenatal Sonography of Umbilical Cord Morphology

Correlation of placental pathology with prenatal ultrasound findings

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

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