Circumvallate placenta coexisting with a placenta succenturate lobe separation - A rare anomaly of the placenta: A Case report

Defective placenta formation and its blood vessels underpins some pregnancy disorders such as pre-eclampsia, intrauterine fetal growth restriction, retained products of placenta, vasa previa, etc. Circumvallate placenta is a rare form of extrachorial placenta with a raised placental margin in an annular shape. Succenturiate lobes of the placenta is the presence of one or more accessory placenta lobes resulting from focal areas of non-involution of the chorionic laeve. The patient described in this case report is a 34year old female who presented with recurrent vaginal bleeding at 34 week gestational age. Upon evaluation, a diagnosis of circumvallate placenta with marginal placenta bleeding coexisting with asuccenturate placenta lobewas made. She had a successful abdominal delivery. This report revealed that despite these coexisting placenta anomalies, the outcome to both the mother and her baby were favorable. This report will contribute significantly to our understanding of the anomalies associated with placenta. Succenturiate placenta and circumvallate placenta, or a combination of both, should be suspected in women with persistent vaginal bleeding in any trimester. Therefore, a history of bleeding and/or retained placenta fragments in previous pregnancies with bleeding in index pregnancy should raise a very high index of suspicion of placenta abnormalities until proven otherwise. Early presentation, accurate ultrasonographic/clinical diagnosis and urgent intervention remain the cornerstone for control and prevention of unfavorable pregnancy outcomesregarding placenta anomalies.