Circumvallate Placenta and Restricted Fetal Growth

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The most important part of prenatal care is to make sure the fetus is growing and developing properly. During routine ultrasounds, the doctor may find that the placenta and its membranes are not growing properly, a condition called circumvallate placenta. This condition can result in low birth weight, preterm labor and delivery, and intrauterine growth restriction. Diagnoses of circumvallate placenta and intrauterine growth restriction early in pregnancy are important to ensure proper care and monitoring of the baby. It is important to have regular routine ultrasounds and checkups.

Significance

  • Circumvallate placenta is when the bag of membranes are behind the placenta, limiting the effectiveness of the placenta. The bag of membranes, known as a ring, limits the expansion of the fetal blood vessels. Pregnant women diagnosed with circumvallate placenta have a placenta that is curving inward. The curving of the placenta can cause stress to the fetus, growth restriction and sometimes detachment of the placenta resulting in emergency delivery.

    Intrauterine growth restriction is a condition where a fetus is unable to grow to its genetically determined size. IUGR refers to a fetus that is expected to be at the 10th percentile or lower when born. When a woman is diagnosed with a circumvallate placenta, this correlates directly to a fetus with IUGR. To ensure the safety and proper growth of an unborn baby, it's important to discuss family history and schedule regular exams.

Identification

  • Circumvallate placenta is identified as a thick, round white and opaque ring of membranes around the placenta. As a woman reaches her third trimester in pregnancy, the white ring can begin to cover the fetal side of the placenta. To an untrained eye, circumvallate placenta looks like a plastic white bag forming around the placenta coming up from underneath.

Function

  • The placenta is an organ within a woman's body that connects the developing fetus to the uterine wall. The placenta allows the waste of the fetus to be disposed through the mother's kidneys. When a woman is diagnosed with circumvallate placenta, the placenta is unable to provide the fetus with the appropriate amount of oxygen and food.

Warning

  • Pregnant women who experience circumvallate placenta are at a very high risk to deliver a premature baby or miscarriage. When circumvallate placentas continue to curve and curl throughout most of the pregnancy there is a chance that the placenta will detach and the baby will need to be delivered immediately by Caesarean section. If the placenta detaches before 25 weeks of gestation, there is a significant chance of miscarriage. Once a woman is diagnosed with circumvallate placenta, it's essential to have ultrasounds and fetal stress tests at least once a month.

Prevention/Solution

  • Diet is important, and a patient with a fetus diagnosed with growth restriction should eat a healthy diet. While the placenta may only release small portions of nutrients, it's important that what is released is healthy. While there are no treatments for circumvallate placenta, most women do carry their fetus to a healthy gestational age and deliver healthy babies. Women who have circumvallate placenta should have monthly ultrasounds and will be treated as high-risk pregnancy patients to ensure the fetus and placenta are closely monitored. To help with the baby's growth and development, prenatal vitamins are essential for the mother-to-be and should be taken twice a day.

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