circumvallate placenta, placental abruption and acute chorioamnionitis separately are associated with unfavourable clinical outcomes. We aimed to determine the prevalence and define whether an association exists between the three abnormalities.
16,042 placenta pathology reports between 1997 and 2020 from a tertiary care centre in the Netherlands were retrospectively analysed. For the statistical analysis, the chi-square test and bootstrapping were used to evaluate an association.
In our cohort the prevalence of circumvallate placenta is 2.2 %, placental abruption cases 4.0 % and acute chorioamnionitis 20.6 %. We observed a statistically significant association between all three placental abnormalities: circumvallate placenta, placental abruption and acute chorioamnionitis. In addition, there was also an association between circumvallate placenta and acute chorioamnionitis.
Our results show that combined presence of circumvallate placenta, placental abruption and acute chorioamnionitis are associated in preterm birth (p = 0.001). A remarkable finding is that the combination of all three abnormalities (circumvallate placenta, placental abruption and acute chorioamnionitis) was not observed in term pregnancies >37 weeks.

The placenta has several crucial physiological functions that help maintain a normal pregnancy. Although approximately 2-4% of pregnancies are complicated by abnormal placentas, obstetric outcomes remain understudied. This study aimed to determine the outcomes and prevalence of patients with abnormal placentas by conducting a systematic review of 48 studies published between 1974 and 2022. The cumulative prevalence of circumvallate placenta, succenturiate placenta, multilobed placenta, and placenta membranacea were 1.2%, 1.0%, 0.2%, and 0.004%, respectively. Pregnancies with a circumvallate placenta were associated with an increased rate of emergent cesarean delivery, preterm birth (PTB), and placental abruption compared to those without a circumvallate placenta. The succenturiate lobe of the placenta was associated with a higher rate of emergent cesarean delivery, whereas comparative results were observed in terms of PTB, placental abruption, and placenta previa in comparison to those without a succenturiate lobe of the placenta. A comparator study that examined the outcomes of multilobed placentas found that this data is usually unavailable. Patient-level analysis (n = 15) showed high-rates of abortion (40%), placenta accreta spectrum (40%), and a low term delivery rate (13.3%) in women with placenta membranacea. Although the current evidence is insufficient to draw a robust conclusion, abnormal placentas should be recognized as a high-risk factor for adverse outcomes during pregnancy.

Pregnant polycystic ovary syndrome (PCOS) patients are at increased risk for myriad obstetric complications, with the placenta thought to play a key role in their development. We aimed to evaluate placental histopathology patterns in placentas of women with PCOS who underwent in-vitro-fertilization (IVF).
This retrospective study utilized full gross and histopathologic assessment of placentas of all women who had IVF treatment and delivered at the Royal Victoria Hospital from 2009 to 2017, regardless of complications or mode of delivery. Pathologic findings included anatomic, inflammation, villous maturation, and vascular mal-perfusion features. Placentas of PCOS women were compared to those of ovulatory controls. Multivariate logistic regression was used to adjust results for confounding factors potentially associated with significant placental and perinatal characteristics.
Women with PCOS (n = 47) were more likely to develop gestational diabetes mellitus compared to ovulatory controls (n = 1121) (38.3% vs. 9.8%, p < 0.001). Placentas from PCOS women were more likely circumvallate placentas (aOR 8.3, 95%CI 1.9-37.3) and more likely to have a hypercoiled umbilical cord (aOR 6.8 95%CI 1.3-36.8) and villitis of unknown etiology (aOR 6.1, 95%CI 1.5-25.6). There was an increased likelihood of chorangiosis (aOR 2.7, 95% CI 1.3-5.8), evidence of fetal vascular malperfusion based on one criteria (aOR 2.7, 95%CI 1.1-7.4), or more than one criteria (aOR 6.4, 95%CI 1.6-25.9), more nucleated fetal red blood cells (aOR 5.2, 95%CI 1.1-24.5), and a higher likelihood of chorangiomas (aOR 9.4, 95%CI 1.6-55.1) in placentas from PCOS women than in controls.
IVF pregnancies\' placental histopathological characteristics are significantly impacted by an underlying diagnosis of PCOS, including important anatomic changes and vascular placental abnormalities.

Longitudinal investigations using ultrasound during pregnancy can be used to clarify the mechanisms and pathophysiology of abnormal fetal and placental development. In this report, we presented a case of a true knot that appeared to develop into a hypercoiled cord and circumvallate placenta, which we found through longitudinal ultrasound investigations during pregnancy. In the present case, ultrasonography proved that the true knot had existed at least 16 weeks of gestation. The true knot was presumed to develop into a hypercoiled cord based on the hypothesis of differential umbilical vascular growth rates.

UNASSIGNED: Various placental and cord abnormalities have been known to adversely affect the obstetric outcome. Circumvallate placenta and Battledore insertion of the umbilical cord are both rare and known to be associated with poor obstetric outcome individually.
UNASSIGNED: In this case report, the woman presented at 8 months of gestation with preeclampsia with IUFD to North Easter Indira Gandhi Regional Institute of Health and Medical Science Shillong on 22/7/16 and delivered a macerated fetus vaginally. After delivery, examination revealed both a circumvallate placenta and Battledore insertion of umbilical cord. This might have attributed to preeclampsia and ultimately IUFD in this case as she had no other identifiable cause for IUFD.
UNASSIGNED: If such placental and cord abnormalities are suspected or diagnosed antenatally by ultrasonography, the pregnancy should be regarded as high risk. Such woman would require more stringent follow up in the antenatal period and continuous intrapartum monitoring to avoid any catastrophe and to achieve a favorable maternal and fetal outcome.

OBJECTIVE: Prenatal recognition of circumvallate placenta is important because the condition may lead to some serious perinatal complications.
METHODS: The possibility of antenatal ultrasonographic screening for circumvallate placenta was examined by measuring the thickness of the placenta at the thickest point. The study group consisted of 722 unselected patients with uncomplicated singleton pregnancies seen for routine ultrasonographic examination between 18 and 21 weeks\' gestation. Data were collected from 11 deliveries complicated by completely circumvallate placenta and from 711 unaffected controls.
RESULTS: The average thickness of the placenta was 2.22 ± 0.36 cm in the control subjects, whereas it was 2.74 ± 0.53 cm (P = 0.01 versus control) for circumvallate placentas. When a placental thickness greater than 3.0 cm was demonstrated, 19.4% (6/31) had a circumvallate placenta at delivery (P < 0.01).
CONCLUSIONS: The current results suggest that measurement of placental thickness is useful for screening for circumvallate placenta.