Bilobed placenta
Citation, DOI & article data
- Bipartite placenta
- Bilobate placenta
- Duplex placenta
- Placentae bilobata
A bilobed placenta also referred to as bipartite placenta, is a variation in placental morphology and refers to a placenta separated into two near equal-sized lobes. If more than two lobes are present, it is termed a trilobed, four-lobed and so on. If the second lobe is smaller than the main lobe (with the umbilical cord insertion), then the smaller lobe is termed a succenturiate lobe.
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Epidemiology
The estimated incidence is at up to ~4% of pregnancies.
Pathology
It is thought to result from localized placental atrophy as a result of poor dedicualisation or vascularization of a part of the uterus (dynamic placentation theory) 5.
Associations
Radiographic features
Antenatal ultrasound
May be sonographically seen as two separate placental discs of nearly equal size. The cord usually attaches to a thin connecting rim of chorionic tissue which bridges the two lobes. Less commonly the cord may insert into one of the lobes.
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Complications
- it carries an increased incidence of type II vasa previa
- it may increase the incidence of postpartum hemorrhage due to retained placental tissue
Differential diagnosis
If more than one lobe of the placenta is seen in an antenatal scan consider:
- succenturiate lobe: accessory lobe(s) smaller in size than the main lobe
- twin pregnancy with two placentas
References
- 1. Fadl S, Moshiri M, Fligner CL, Katz DS, Dighe M. Placental Imaging: Normal Appearance with Review of Pathologic Findings. Radiographics : a review publication of the Radiological Society of North America, Inc. 37 (3): 979-998. doi:10.1148/rg.2017160155 - Pubmed
- 2. Kikuchi A, Uemura R, Serikawa T et-al. Clinical significances of magnetic resonance imaging in prenatal diagnosis of vasa previa in a woman with bilobed placentas. J. Obstet. Gynaecol. Res. 2011;37 (1): 75-8. doi:10.1111/j.1447-0756.2010.01308.x - Pubmed citation
- 3. Benirschke K, Kaufmann P. Pathology of the human placenta. Springer Verlag. (2000) ISBN:0387988947. Read it at Google Books - Find it at Amazon
- 4. Fujikura T, Benson RC, Driscoll SG. The bipartite placenta and its clinical features. Am. J. Obstet. Gynecol. 1970;107 (7): 1013-7. - Pubmed citation
- 5. Baergen RN, Benirschke K(. Manual of Pathology of the Human Placenta. Springer Verlag. (2010) ISBN:1441974938. Read it at Google Books - Find it at Amazon
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