2. DEFINITION
“ Placental abnormalities refers to marked
variations including anatomical ,
physiological and abnormal
implantations of placenta that may lead to
serious placental-maternal fetal effects.”
3. BILOBED PLACENTA
• Also known as placenta bilobate, bipartite placenta,
placenta duplex.
• It is a placenta with two roughly equal-sized lobes
separated by a membrane.
• It occurs in 2% to 8% of placentas.
• The umbilical cord may insert in either lobe, in
velamentous fashion, or in between the lobes.
• No increased risk of fetal anomalies with this abnormality.
• Bilobed placentas can be associated with first-trimester
bleeding, polyhydramnios, abruption and retained
placenta.
• A placenta with more than two lobes is rare and is termed a
multilobate placenta.
6. SUCCENTURIATE PLACENTA
• It is a condition in which one or more accessory
lobes develop in the membranes apart from the
main placental body to which vessels of fetal origin
usually connect them.
• It is a smaller variant of a bilobed placenta.
• Advanced maternal age and in vitro fertilization are
risk factors for the succenturiate placenta.
• Ultrasound, particularly color Doppler, can be used
to identify this condition.
8. PLACENTA FENESTRATA
• It is a rare condition in which the central portion of
the discoid placenta is missing.
• Rarely, there may be an actual hole in the placenta,
but more often the defect involves the villous tissue,
and the chorionic plate remains intact.
• At delivery, this finding may cause concern for
retained placenta.
12. CIRCUMVALLATE PLACENTA
• It is an extrachorial placenta that is an annularly-shaped placenta
with raised edges composed of a double fold of chorion, amnion,
degenerated decidua, and fibrin deposits.
• In this condition, the chorionic plate is smaller than the basal
plate, resulting in hematoma retention in the placental margin.
• Circumvallate placenta is associated with poor pregnancy
outcomes due to increased risk of vaginal bleeding beginning in
the first trimester, premature rupture of the membranes (PROM),
preterm delivery, placental insufficiency, and placental abruption.
• The diagnosis is difficult to make during pregnancy and is
made most often on visual inspection of the placenta after
delivery.
14. PLACENTA MEMBRANACEA
• It is a rare placental abnormality where chorionic villi cover
fetal membranes either completely (diffuse placenta
membranacea) or partially (partial placenta membranacea),
and the placenta develops as a thin structure occupying the
entire periphery of the chorion.
• Clinically the abnormality can present with vaginal bleeding in
the second or third trimester which is often painless or during
labor.
• Other placenta abnormalities, such as placenta previa and
placenta accreta, can be associated with this condition.
• Ultrasound has been reported as a diagnostic tool for this
condition.
16. Battledore placenta (Marginal cord
insertion)
• It is a condition in which the umbilical cord is
inserted at or near the placental margin rather
than in the center.
• The cord can be inserted as close to 2 cm from
the edge of the placenta (velamentous cord
insertion).
• The incidence is 7% to 9% of singleton
pregnancies and 24% to 33% in twin pregnancies.
• Complications associated with battledore
placenta are preterm labor, fetal distress, and
intrauterine growth restriction.