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BMJ Case Reports 2017; doi:10.1136/bcr-2017-222189
  • Reminder of important clinical lesson
  • CASE REPORT

Early sonographic detection of a succenturiate placenta after IVF in a 42-year-old woman with multiple comorbidities

  1. Michelle Silasi1
  1. 1Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
  2. 2Abteilung für Gynäkologie & Geburtshilfe, Katholisches Marienkrankenhaus GmbH, Hamburg, Germany
  1. Correspondence to Dr Patrick W Stelzl, patrick.stelzl{at}yale.edu
  • Accepted 30 September 2017
  • Published 10 October 2017

Summary

We present a case of a 42-year-old woman with a pregnancy resulting from in vitro fertilisation and a medical history including two spontaneous abortions, hypercoagulable state and other comorbidities. At 13 4/7 weeks’ gestation, during research ultrasonography, the patient was noted to have an anterior succenturiate placental lobe. Following an episode of vaginal bleeding at 21 6/7 weeks, she was diagnosed with a low-lying posterior placental lobe. Velamentous cord insertion, placenta previa and vasa previa were excluded at that time. After elective induction for advanced maternal age at 39 0/7 weeks, arrest of labour and chorioamnionitis resulted in a primary low transverse caesarean section and delivery of a healthy girl at 39 3/7 weeks. Gross examination of the placenta showed an irregular, singleton placenta with an attached succenturiate lobe and a marginally inserting umbilical cord. Both lobes were connected by two vessels.

Footnotes

  • Contributors All authors certify that they have participated sufficiently in the work and to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript. Conception and design of study: PWS, LP, MS. Acquisition of data: PWS, LP. Interpretation of data: PWS, GY. Drafting the manuscript: GY, PWS. Revising the manuscript critically for important intellectual content: PWS, GY, LP, MS. Approval of the version of the manuscript to be published: PWS, LP, MS, GY.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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