Readout - Circumvallate vs. Synechium
Take Home Points
how to differentiate circumvallate from synechium
- Location at edge of placenta is certainly helpful, but not definitive
- Placenta can grow and "bump up" against a synechium as well.
- Look at contralateral edge of placenta for similar finding, if present confirms circumvallate
- Also not 100% because you can have a partial circumvallate placenta as well.
circumvallate placenta complications
- Reports of increase risk of bleeding, small for dates pregnancy or early delivery
- However, in our experience, these are more "smoke than fire" and outcome is typically excellent
Placenta previa terminology
- "Old terminology"
- Marginal: Placenta inserts on cervical stroma but not covering internal os
- Complete: Placenta covers the internal os
- "New terminology" from article referenced below
- Low lying: Placental edge is < 2 cm from the internal os, but not covering (follow-up at 32 weeks)
- Previa: Placental edge covers the internal cervical os
- Both follow up at 32 weeks: If still < 2 cm from the internal cervical os (low-lying) or covering the os, follow-up transvaginal scan is recommended at 36 weeks.
- Fetal Imaging Executive Summary of a Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound Fetal Imaging Workshop Uma M. Reddy, MD, MPH, Alfred Z. Abuhamad, MD, Deborah Levine, MD, and George R. Saade, MD, for the Fetal Imaging Workshop Invited Participants* Obstetrics and Gynecology VOL. 123, NO. 5, MAY 2014