QuestionI'm 17 weeks and 5 days pregnant and been diagnosed with both circumvallete placenta and low line placenta. I can't find anything online on having both diagnoses at the same time. What are my chances of having a normal full term birth? I know that the low line placenta could be improved and time will tell but does circumvallete placenta go back to becoming a normal placenta again? I was told that circumvallete placenta is rare but I can't find any statistics on it. My Prenatal doctor said to take it easy but what does that mean? What are my restrictions? I've also read that there is a chance of fetal abnormality. Can you be more specific of what kind of abnormality that is and what is the statistics?
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AnswerHi,
First, 17 weeks is slightly early to have a diagnosed circumvallate placenta. Ultrasounds and sonographers are becoming much more advanced in diagnostics, however I would almost wonder if this is simply a low-lying placenta which is over the cervix. In that scenario, there is a good possibility that the placenta will move up and around - and out of the way - as the uterus grows.
Actual circumvallate placenta is associated with an increased risk of prematurity, prenatal bleeding, placental abruption, multiparity (multiple births), and early fluid loss. The placenta's characteristics are a thick ring of membranes on the fetal surface and typically the edges are elevated or curled up rather than firmly attached to the uterine surface. This is what poses the increased risk for an abruption and also limits the expansion of blood vessels. This can limit the nutritional supply to the fetus (there is a smaller surface area of placenta attached to the uterine wall).
Circumvallate placenta occurs in 1-2% of pregnancies. Also, it is generally concluded that placentae with more than 50% circumvallation are associated with prematurity and under-weight, as well as a placenta with fewer cells than normal. So, simply put, the grade or severity of the circumvallance will have quite a bit to do with the risks.
The encouraging news is that they have already noted the potential diagnosis for you. That means they will be watching for signs and so will you. You and your doctors will be more vigilant in the care and watchfulness of your pregnancy and this can only be a positive for the outcome. More often than not, it is when this goes undiagnosed (which happens because it is often diagnosed AFTER delivery upon physical examination of the placenta) and doctors are caught unaware, that the poorer outcomes occur.
As far as the situation of a low-lying placenta - if the edge of the placenta is within 2 centimeters of the cervix but not bordering it, it's called a low-lying placenta. Normally, as the uterus grows and expands, the placenta tends to inch its way upward and away from the cervix. As your pregnancy progresses, your placenta is likely to "migrate" farther from your cervix and no longer be a problem. (Since the placenta is implanted in the uterus, it doesn't actually move, but it can end up farther from your cervix as your uterus expands. Also, since the placenta itself grows, it's likely to grow toward the richer blood supply in the upper part of the uterus.) As the uterus does grow and the placenta does start to inch around, it will be much easier to visualize whether it actually is BOTH conditions that you have or just the low-lying placenta. If it is both, again - you have the advantage of knowing about it early and watching for signs of a problem.
Right now, you really just need to note any cramping and/or vaginal bleeding. If that were to begin, you should let your doctor know right away. As long as the blood supply is maintained between mom and baby, there is every chance if a healthy delivery!
I hope this has helped you and answered your question. I wish you well.
Brenda
