Circumvallate placenta
Citation, DOI, disclosures and article data
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.
View Arlene Campos's current disclosures- Placenta extrachorialis
Circumvallate placenta refers to a variation in placental morphology in which, as a result of a small chorionic plate, the amnion and chorion fetal membranes ‘double back’ around the edge of the placenta.
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Epidemiology
The prevalence is estimated to be around 1-7% 3.
Pathology
There is an inward insertion of membranes from the edge towards the center of the placenta (from deep implantation of the placenta into the decidua). Because of this excessive implantation, the placenta covers more than half of the fetal sac. The placenta reduces this excessive covering to the normal one-fourth by separating from the uterine wall, with the resultant back folding of the placenta and fetal membranes towards the chorionic surface.
This can be accompanied by tethering of membranes, frequently in association with a marginal infarction, hemorrhage, or fibrin deposition.
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Radiographic features
Ultrasound
May show a peripheral rim of chorionic tissue appearing as an echodense ridge (placental shelf) 2,6.
On 3D ultrasound, it has an appearance similar to a tire (the "tire sign").
Treatment and prognosis
Recognized complications include 1,4:
higher incidence of placental abruption
increased risk of IUGR
Differential diagnosis
For a raised placental edge on ultrasound:
amniotic shelf (amniotic sheet)
part of an amniotic band close to the placenta
References
- 1. Harris R, Wells W, Black W et al. Accuracy of Prenatal Sonography for Detecting Circumvallate Placenta. AJR Am J Roentgenol. 1997;168(6):1603-8. doi:10.2214/ajr.168.6.9168736 - Pubmed
- 2. Sebire NJ, Sepulveda W. Correlation of placental pathology with prenatal ultrasound findings. J. Clin. Pathol. 2008;61 (12): 1276-84. doi:10.1136/jcp.2008.055251 - Pubmed citation
- 3. Harris RD, Barth RA. Sonography of the gravid uterus and placenta: current concepts. AJR Am J Roentgenol. 1993;160 (3): 455-65. AJR Am J Roentgenol (abstract) - Pubmed citation
- 4. Suzuki S. Clinical Significance of Pregnancies with Circumvallate Placenta. J Obstet Gynaecol Res. 2008;34(1):51-4. doi:10.1111/j.1447-0756.2007.00682.x - Pubmed
- 5. Elsayes KM, Trout AT, Friedkin AM et-al. Imaging of the placenta: a multimodality pictorial review. Radiographics. 29 (5): 1371-91. doi:10.1148/rg.295085242 - Pubmed citation
- 6. Shen O, Golomb E, Lavie O et-al. Placental shelf - a common, typically transient and benign finding on early second-trimester sonography. Ultrasound Obstet Gynecol. 2007;29 (2): 192-4. doi:10.1002/uog.3860 - Pubmed citation
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