A circumvallate placenta is a form of extrachorial placenta
with a raised placental margin in an annular shape. Circumvallate placenta
often causes persistent vaginal bleeding beginning in the first trimester,
preterm premature rupture of membranes (PPROM), preterm delivery, and placental
abruption, thus being associated with poor pregnancy outcomes. A case of
circumvallate placenta is reported here, which led to preterm premature rupture
of membranes (PPROM) and leakage in a mother at 17 weeks of gestation. She was
the second gravida with a 10-year-old healthy daughter. The mother underwent
amniocentesis after the triple marker test showed an increased risk for trisomy
21. Difficulty in aspirating amniotic fluid was encountered due to the abnormal
placental structure, which was not known at the time of the invasive procedure.
The mother experienced leaking 7 days post-procedure, followed by miscarriage.
Autopsy examination revealed that the placenta was circumvallate, which not
only caused difficulty in aspirating the amniotic fluid but also could be the cause
of PPROM, a well-known complication of the circumvallate placenta. This is the
first case where difficulty in aspirating amniotic fluid was encountered. The
circumvallate placenta group shows poor pregnancy and delivery outcomes. The
circumvallate placenta may lead to vaginal bleeding during the second
trimester, PPROM, and preterm delivery. This study highlights that examining
the placenta is very important to identify the cause of events in certain
situations; circumvallate placenta or abnormal placenta can be suspected in
cases where hindrance is encountered (not able to aspirate amniotic fluid even
if the needle is visible in the amniotic sac) during amniocentesis.
Author (s) Details
Kumari Pritti
Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and
Research Centre, Ahmedabad, Gujarat, India.
Vineet Mishra
Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and
Research Centre, Ahmedabad, Gujarat, India.
Rohina Aggarwal
Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and
Research Centre, Ahmedabad, Gujarat, India.
Sumesh Choudhary
Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and
Research Centre, Ahmedabad, Gujarat, India.
Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v5/1769
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