Succenturiate lobe
Citation, DOI & article data
- Succenturiate lobes
- Succenturiate lobe of placenta
- Accessory placental lobe
- Accessory placental lobes
A succenturiate lobe is a variation in placental morphology and refers to a smaller accessory placental lobe that is separate to the main disc of the placenta. There can be more than one succenturiate lobe.
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Epidemiology
The estimated incidence is ~2 per 1000 pregnancies. Some authors suggest frequency of maternal age > 35 years and history of using in vitro fertilization having higher prevalences of succenturiate lobes 8.
Radiographic features
Antenatal ultrasound
Seen as a smaller separate lobe of similar echotexture to the main placental disc. It is important to establish the location of any connecting vessels, and in particular to look for any vascular connection crossing the internal os (i.e. vasa previa).
Complications
- increased incidence of type II vasa previa
- increased incidence of postpartum hemorrhage due to retained placental tissue 5
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History and etymology
The term "succenturiate" derives from the Latin word "succenturio" meaning "to substitute".
Differential diagnosis
If more than one lobe of the placenta is confidently seen in an antenatal scan consider
- bilobed placenta: two lobes are usually of similar size
- twin pregnancy with two placentas
For a focal area of increased thickening on ultrasound also consider
- focal myometrial contraction
- isoechoic hematoma from a placental abruption
References
- 1. Chihara H, Otsubo Y, Ohta Y et-al. Prenatal diagnosis of succenturiate lobe by ultrasonography and color Doppler imaging. Arch. Gynecol. Obstet. 2000;263 (3): 137-8. Arch. Gynecol. Obstet. (link) - Pubmed citation
- 2. Marino T. Ultrasound abnormalities of the amniotic fluid, membranes, umbilical cord, and placenta. Obstet. Gynecol. Clin. North Am. 2004;31 (1): 177-200. doi:10.1016/S0889-8545(03)00125-6 - Pubmed citation
- 3. Fadl S, Moshiri M, Fligner CL, Katz DS, Dighe M. Placental Imaging: Normal Appearance with Review of Pathologic Findings. Radiographics : a review publication of the Radiological Society of North America, Inc. 37 (3): 979-998. doi:10.1148/rg.2017160155 - Pubmed
- 4. Spirt BA, Kagan EH, Gordon LP et-al. Antepartum diagnosis of a succenturiate lobe: sonographic and pathologic correlation. J Clin Ultrasound. 1981;9 (3): 139-40. - Pubmed citation
- 5. Nelson LH, Fishburne JI, Stearns BR. Ultrasonographic description of succenturiate placenta. Obstet Gynecol. 1977;49 (1 suppl): 79-80. - Pubmed citation
- 6. Spirt BA, Gordon LP, Kagan EH. The placenta: sonographic-pathologic correlations. Semin Roentgenol. 1982;17 (3): 219-30. - Pubmed citation
- 7. Kimberly M. Rathbun, Jason P. Hildebrand. Placenta Abnormalities. (2019) Pubmed
- 8. Suzuki S, Igarashi M. Clinical significance of pregnancies with succenturiate lobes of placenta. (2008) Archives of gynecology and obstetrics. 277 (4): 299-301. doi:10.1007/s00404-007-0482-6 - Pubmed
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