Circumvallate placenta is an abnormality in the shape of the placenta. It can result in a lack of nutrients for the fetus.
In circumvallate placenta, the chorionic plate, which is the part of the placenta that’s on the fetal side, is too small. That causes the membranes to double back on the fetal side and around the edges.
The condition can be detected by ultrasound and is usually diagnosed around the 20th week of pregnancy. However, diagnosis during pregnancy can be difficult and the condition is often not detected until the placenta is examined following delivery.
Circumvallate placenta is extremely rare, occurring in around 1 to 7 percent of pregnancies.
There aren’t really any signs or symptoms of circumvallate placenta. The condition can cause a reduced supply of blood and nutrients to the fetus. This might cause your baby to grow at a slower rate than expected. However, there are many possible causes for delayed fetal growth, or growth retardation, including:
- chronic diseases in the mother, such as chronic kidney disease or diabetes
- chromosome abnormalities in the baby
- being pregnant with multiple babies at the same time
- infection in the mother
If your healthcare provider notices signs that your baby is not progressing as expected, they will run additional tests to determine an underlying cause, including an ultrasound and blood tests.
Circumvallate placenta increases your risk of certain pregnancy complications, including:
- Low birth weight. Restricted growth of the fetus is the most common complication of circumvallate placenta. It’s common for babies who have had a circumvallate placenta to have a low birth weight.
- Placental abruption. This is where the placenta separates from the uterine lining too soon. It causes significant bleeding that puts the mother at risk.
- Oligohydramnios. This condition is used to refer to a decreased amount of amniotic fluid. Amniotic fluid helps cushions the baby. It’s also important for fetal development, including lung, muscle, and bone development, and helps keep the umbilical cord from being compressed, which is important for providing nourishment and oxygen to the baby.
- Miscarriage and preterm birth. Circumvallate placenta can lead to death of the fetus if any of these complications are developed and are not treated promptly and appropriately.
Can you deliver vaginally if you have circumvallate placenta?
Circumvallate placenta is associated with an increased need for a cesarean section delivery (C-section). However, there is little evidence to support this. Since the condition is so rare, it’s difficult to gain quantifiable evidence. Any situation where the placenta begins to decline, or the baby is in distress, could lead to the need for an emergency C-section. However, it’s also possible for women with circumvallate placenta to carry to term and have vaginal deliveries.
A diagnosis of circumvallate placenta will mean that your doctors will want to monitor your baby far more closely to make sure they’re doing well. Your doctors will help you to create an individualized plan of care for you and your baby.
Circumvallate placenta is a variation of placental development. Researchers don’t know precisely what causes it, but it’s not caused by anything you did or didn’t do. Nothing can be done to prevent a circumvallate placenta from developing.
If you’ve been diagnosed with the condition, you should be extra vigilant about rest and a healthy diet to try and prevent intrauterine growth restriction.
There’s no way to repair the placenta. Instead, treatment for circumvallate placenta is aimed at managing the complications of the condition. Following are treatment plans your doctor may recommend for managing complications from circumvallate placenta:
If you develop placental abruption, you may be given IV fluids to help increase your blood pressure. If you lose a large amount of blood you may require a blood transfusion, which will also be given through an IV.
If your baby is not yet ready to be born you might be put on bed rest until they are.
If your blood loss is severe or your estimated due date is close, then immediate delivery of your baby might be suggested. If you or your baby’s life is at risk or your bleeding is heavy, your doctors may feel that an emergency C-section is necessary.
Intrauterine restricted growth
This complication is not so much treated, but managed. Your doctors will want to put in place a lot of extra monitoring to check on how your baby is developing. Doctors may see the need to deliver early. Mothers are advised to:
- eat a well-balanced, nutritious diet
- get plenty of rest
- adopt healthy lifestyle habits
- stop smoking or using tobacco products
This condition requires more frequent monitoring. A treatment called amnioinfusion places fluid in the amniotic sac to replace the lost fluid. This treatment may help to prevent underdeveloped lungs or compression of the cord at delivery, though more research is needed.
Delivery of the baby may be suggested, but in these cases, it’s always necessary to weigh the risks of inducing labor versus the risks of leaving the baby in utero.
If you go into premature labor, bed rest and possible admission to the hospital may be advised. IV fluids may be offered as well as medication to help relax your uterus and stop labor. Medication to help speed up the development of your baby’s lungs will also be offered.
Circumvallate placenta is associated with a higher risk of some pregnancy complications and, in some cases, can result in the loss of your baby. This condition is very rare and doesn’t always result in the loss of a pregnancy. Proper management and treatment of any complications that develop significantly improves outcomes.