A smooth and healthy pregnancy, free from worrisome complications, is something every expecting mother hopes for. However, at times, unexpected health issues may arise during pregnancy that require additional care and monitoring. One such concern involves the placenta, the organ that nourishes and supports the baby in the womb. While many pregnancies progress normally, some may face placental abnormalities during pregnancy. One of these rare but important conditions is called circumvallate placenta.
Understanding what it means and how it might affect the pregnancy can help parents feel more informed and prepared.
The placenta is a temporary but essential organ that forms seven to ten days after the successful conception and fertilisation of the egg and sperm. The placental tissue comprises blood vessels that serve the dual purpose of carrying vital nutrients and oxygen to the fetus while simultaneously removing harmful gases like carbon dioxide and other wastes. Production of important hormones like estrogen, progesterone and lactogen is yet another function of the placenta. Apart from this, the placenta helps protect the baby by passing maternal immunity to it, thus allowing it to grow strong and healthy.
A normal placenta looks like a disc, approximately ten inches long and about one inch thick in the middle. The maternal side that is connected to the uterus, facing the uterine wall, is a deep reddish blue, while the fetal side, the side nearest to the fetus, is typically grey. The placenta could be found in various locations within the uterus:
● Fundal position, which is at the top of the uterus.
● Anterior position, whereby the placenta is found on the front wall of the uterus, near the abdomen.
● The posterior position is at the back of the uterus, near the spine.
● Lateral position, which means the placenta is growing on either the left or right wall of the uterus.
Under normal circumstances, the placenta will be expelled from the mother’s body after the baby is delivered.
There are different types of placentas in pregnancy. A circumvallate placenta is an abnormally shaped placenta. It happens when the fetal membranes (amnion and chorion) fold back around the edges because the chorionic plate is too small. It is not known why this condition occurs.
Let’s take a quick look at normal placenta vs. circumvallate placenta. The key difference between the two is in the shape. In a normal placenta, the fetal side will align perfectly with the maternal side. However, in a circumvallate placenta, the shape will be abnormal, and it will look unbalanced or lopsided. The fetal side will be smaller than the maternal side, as the edges have curled up and folded towards the fetal side.
Despite being a rare condition, the formation of a circumvallate placenta poses significant risks and complications during pregnancy. These include:
A placental abruption occurs when the placenta gets detached from the lining of the uterus too early. This is a very serious complication, as it could cause excessive bleeding and may even endanger the fetus.
As the fetal side is smaller, this results in the reduction of the supply of blood and nutrients to the fetus. Consequently, babies end up having lower than normal birth weight.
Severe cases of circumvallate placenta could be fatal to the fetus. It could result in miscarriages or preterm delivery.
Circumvallate placenta could lead to oligohydramnios, a condition where the amount of amniotic fluid that cushions the baby in the uterus is less than usual. An optimal level of amniotic fluid is essential for the overall growth of the baby, and it prevents the compression of the umbilical cord.
Complications arising from severe cases of circumvallate placenta might cause fetal distress. In such situations, the baby might have to be delivered via emergency C-section.
Complications like low birth weight, premature birth or emergency C-sections may necessitate the need for the baby to be admitted into the neonatal intensive care unit until health improvement is noted. This could be distressing to new mothers who may become overwhelmed by seeing their newborn in intensive care and being separated so soon after birth.
A circumvallate placenta may not always have notable symptoms. Here are a few signs that could indicate the presence of this condition:
● Slow fetal growth is an indicator of severe health issues like circumvallate placenta. If the baby has failed to achieve standard growth milestones, then it would be wise to get a thorough examination to rule out the presence of circumvallate placenta.
● Persistent vaginal bleeding during the first trimester is yet another sign of circumvallate placenta.
● Premature rupture of membranes (PROM) is a critical issue that occurs when the amniotic sac ruptures prematurely. Circumvallate placenta could be the cause behind this.
More often than not, the presence of a circumvallate placenta is left undiagnosed due to the absence of any severe signs or symptoms. In fact, in most cases, the abnormality in the placenta is noticed after the child has been delivered.
However, in cases where severe symptoms are present, diagnosis is often made via ultrasound scans.
If a circumvallate placenta has been detected, the doctor will recommend additional care and monitoring to ensure the health and well-being of the expectant mother and her baby. In case of severe complications, the doctor may recommend early delivery of the baby, typically via C-section and not vaginally.
As such, circumvallate placenta is not treatable. The doctor will usually treat any complications from such placental abnormalities.
It is not possible to take preventive measures against circumvallate placenta since the exact causes behind the occurrence are still unknown. However, general preventive steps such as avoiding alcohol and tobacco, getting adequate rest, reducing stress, etc., might help in preventing this condition.
While a circumvallate placenta can lead to a few complications, many babies will still grow well with the proper care. Regular checkups, a healthy lifestyle, and early support can make a big difference. With proper medical attention, most mothers have positive birth experiences and healthy, happy babies.
