Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Coexistent Circumvallate Placenta and Battledore Insertion of Umbilical Cord Resulting in Grave Obstetric Outcome: A Case Report

Authors
1 Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Meghalaya, India
2 Department of Obstet . and Gynecol . of Shahid Sadughi Medical Science of Yazd; Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Meghalaya, India
Abstract
Background: Various placental and cord abnormalities have been known to adversely affect the obstetric outcome. Circumvallate placenta and Battledore insertion of the umbilical cord are both rare and known to be associated with poor obstetric outcome individually. Case Presentation: In this case report, the woman presented at 8 months of gestation with preeclampsia with IUFD to North Easter Indira Gandhi Regional Institute of Health and Medical Science Shillong on 22/7/16 and delivered a macerated fetus vaginally. After delivery, examination revealed both a circumvallate placenta and Battledore insertion of umbilical cord. This might have attributed to preeclampsia and ultimately IUFD in this case as she had no other identifiable cause for IUFD. Conclusion: If such placental and cord abnormalities are suspected or diagnosed antenatally by ultrasonography, the pregnancy should be regarded as high risk. Such woman would require more stringent follow up in the antenatal period and continuous intrapartum monitoring to avoid any catastrophe and to achieve a favorable maternal and fetal outcome.
Keywords

  1. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 22nd ed. New York: McGraw Hill Professional; 2009. 1600 p.
  2. Benirschke K, Kaufmann P. Pathology of the human placenta. 3rd ed. New York: Springer; 2006. 870 p.
  3. Paalman RJ, Vander Veer CG, Rapids G. Circumvallate placenta. Am J Obstet Gynecol. 1953;65(3):491-7.
  4. Rolschau J. Circumvallate placenta and intrauterine growth retardation. Acta Obstet Gynecol Scand Suppl. 1978;72:11-4.
  5. Suzuki S. Clinical significance of pregnancies with circumvallate placenta. J Obstet Gynaecol Res. 2008;34(1):51-4.
  6. Taniguchi H, Aoki S, Sakamaki K, Kurasawa K, Okuda M, Takahashi T, et al. Circumvallate placenta: associated clinical manifestations and complications-a retrospective study. Obstet Gynecol Int. 2014;2014:986230.
  7. Liu CC, Pretorius DH, Scioscia AL, Hull AD. Sonographic prenatal diagnosis of marginal placental cord insertion: clinical importance. J Ultrasound Med. 2002;21(6):627-32.
  8. Ebbing C, Kiserud T, Johnsen SL, Albrechtsen S, Rasmussen S. Prevalence, risk factors and outcomes of velamentous and marginal cord insertions: a population-based study of 634,741 pregnancies. PLoS One. 2013;8(7):e70380.
  9. Tufail S, Nawaz S, Sadaf M, Sail SS. Association between battledore placenta and perinatal complications. J Rawal Med Coll. 2012;16(2):159-61.
  10. Reddy VM, Kumar SS, Reddy NS. Prevalence and pattern of abnormalities occurring in placenta and umbilical cord. Int J Med Res Health Sci. 2013;2(4):935-40.
  11. Holzman J, Zalud I, Bartholomew ML. Ultrasound of the placenta. Donald Sch J Ultrasound Obstet Gynaecol. 2007;1(4):47-60.
  12. Hasegawa J, Matsuoka R, Ichizuka K, Sekizawa A, Okai T. Ultrasound diagnosis and management of umbilical cord abnormalities. Taiwan J Obstet Gynecol. 2009;48(1):23-7.