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Case Report
A true accessory placental lobe: Two case reports of a novel morphological placental anomaly, distinct from succenturiate and bilobed placenta
1 Medical Student, Creighton School of Medicine, Omaha, NE, United States of America
2 Assistant Professor, Creighton School of Medicine, Omaha, NE, United States of America
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Erin Whiteford
2929 California Plaza, Appt 6228, Omaha, NE 68131,
United States of America
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Article ID: 100094Z08EW2021
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Whiteford E, Kinnan A. A true accessory placental lobe: Two case reports of a novel morphological placental anomaly, distinct from succenturiate and bilobed placenta. J Case Rep Images Obstet Gynecol 2021;7:100094Z08EW2021.ABSTRACT
Introduction: The placenta is a complex organ, originating from both fetal and maternal tissues. Morphological placental anomalies are rare but can result in significant morbidity and mortality for both the fetus and mother. The use of ultrasound imaging to detect these anomalies has led to improved outcomes; however, the use of ultrasound technology for non-medical purposes, such as “keepsake” imaging has proved more controversial.
Case Series: These two cases demonstrate a novel morphological placental anomaly, distinct from bilobed and succenturiate placenta. Guidance is provided on the diagnosis and management of a true accessory placental lobe through case reports of a 24 year old in her second pregnancy with a normal fetal anatomic survey (FAS) and history of retained placenta in her first pregnancy and a 37 year old in her third pregnancy also with a normal FAS.
Conclusion: We identified a unique variant of succenturiate placenta, described here as a true accessory placental lobe. Although these particular cases resulted in no acute complications, we argue that the potential risks for placental retention, hemorrhage, postpartum infection, and vasa previa are significant. Thus, we emphasize the importance of thorough antenatal ultrasound examination of the placenta, to ensure the safety of both the infant and mother at delivery. This could occur during the recommended ultrasound for FAS around 20 weeks gestation. Although the non-medical use of ultrasound in one of the two presented cases ultimately resulted in closer follow-up and precautions during delivery, we conclude that the regular use of ultrasound for “keepsake” imaging lacks sufficient evidence of benefit when weighed against the potential harms. However, if an ultrasound is done in the third trimester, regardless of the reason, we recommend thorough placental examination by a trained technician.
Keywords: Accessory lobe, Obstetric ultrasound, Placenta, Placenta anomaly, Succenturiate placenta
SUPPORTING INFORMATION
Author Contributions
Erin Whiteford - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Andrea Kinnan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Erin Whiteford et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
