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Blood Flow Velocimetry in the
Diagnosis of Succenturiate Placenta
Succenturiate placenta is defined as the presence
of 1 or more accessory lobes connected to the body
of the placenta by blood vessels. The condition
occurs in 3–6% of pregnancies.1 Succenturiate
placenta may be suspected on prenatal sonograms when a discrete lobe separated from the
body of the placenta is demonstrated.
We recently encountered a case suspicious for
succenturiate placenta at 21 weeks of gestation.
An isolated placental lobe was observed connected to the main mass of the placenta by a
band. Because the band was believed to represent
blood vessels, we tried to obtain Doppler signals
using duplex Doppler equipment. Clear arterial
flow velocity waveforms were demonstrated (Figure 1), thus proving the vascular nature of the
band connecting the lobes of the placenta.
Doppler imaging enables visualization of vascular channels within the placenta or traversing
the membranes. Cases of Doppler identification of
vasa praevia immediately prior to labor have
been reported.2,3 Our case is similar to that reported by Clerici et al4 in which second-trimester
sonograms coupled with Doppler studies clearly
identified vasa praevia in an asymptomatic patient.
Because retention of a succenturiate lobe at delivery may result in postpartum hemorrhage and
infection and because, rarely, rupture of the connecting vessels may occur during delivery, early
diagnosis of succenturiate placenta is important.
We therefore recommend blood flow velocimetry
as an adjunct to routine prenatal sonography in
the early detection of this pregnancy complication.
© 1998 John Wiley & Sons, Inc.
VOL. 26, NO. 1, JANUARY 1998
CCC 0091-2751/98/010055-01
FIGURE 1. Duplex sonogram obtained with the gate placed on the
vascular band shows arterial flow velocity waveforms.
I. Meizner, MD
R. Mashiach, MD
Y. Shalev, MD
Z. Ben-Rafael, MD
Rabin Medical Center–Beilinson Campus
Petah-Tikva 49100, Israel
1. Fox H: Pathology of the Placenta. Philadelphia, WB
Saunders, 1978.
2. Mayer WJ, Blumenthal L, Cadkin A, et al: Vasa
previa: prenatal diagnosis with transvaginal color
Doppler flow imaging. Am J Obstet Gynecol 1993;
3. Hsieh F, Chen HF, Ko TM, et al: Antenatal diagnosis of vasa previa by color-flow mapping. J Ultrasound Med 1991;10:397.
4. Clerici G, Burnelli L, Lauro V, et al: Prenatal diagnosis of vasa previa presenting as amniotic band. A
not so innocent amniotic band. Ultrasound Obstet
Gynecol 1993;7:61.
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