Succenturiate Placental Lobe Abruption: a placental pathology complicating a dangerous delivery

Abstract

The development of a placenta is a complex process that occurs without a clinically significant issue in most pregnancies. At times, however, the process develops in a way that isolates an island of placental tissue away from the main body, connected only by unprotected vasculature within the amniotic membranes. The vessels of this succenturiate lobe of the placenta are vulnerable both to compression or laceration, threatening the antepartum period with poor weight gain or the peripartum period with fetal distress, hemorrhage or retained products of conception. A majority of the time, this pathology is undiagnosed until recognized innocuously following delivery of the placenta. A placental abruption is a premature separation of the placenta from the uterus that can result in painful bleeding and fetal distress. This increased distress of mother or baby from continued blood loss usually necessitates delivery either vaginally, if stability is maintained, or by cesarean if it isn’t. The amount of distress correlates to where and how much of the placenta is affected. While succenturiate lobes of the placenta and placental abruptions are not routinely associated with each other, the abruption of only the succenturiate lobe of the placenta in this instance minimized the severity to the fetus, by allowing the main body of the placenta to remain intact. As the bleeding coagulated at the lobe, maternal well-being was maintained allowing enough time to complete a vaginal delivery

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