COMPLICATIONS OF CIRCUMVALLATE PLACENTA

1. No complications (1).
2. Prematurity (2,3).
3. Abruptio placenta (2,4).
4. Antepartum hemorrhage (2,3,5,6).

According to Scott (5), occult hemorrhage occurs at the edge of the chorionic plate due to weakness of the encapsulating wall of the intervillous space. The hemorrhage then travels circumferentially forming a ring clot within the membranous fold. The clot contracts as fibrin forms leading to further separation and more severe bleeding. This maternal blood may then travel between the chorionic membrane and the extrachorial placental tissue, dissecting between the membrane and uterine wall towards the cervix. Unlike placental abruption, the bleeding is painless and does not result in placental abruption.

Purely maternal intra-amniotic hemorrhage is unusual, but may occur if maternal blood dissects between the chorion and decidua and ruptures through the amniotic membrane. If hemorrhage is massive and acute, dislodgement of the fetal (chorionic) vessels may result in their rupture resulting in fetal bleeding as well.

REFERENCES

1. Wentworth P. Circumvallate and circummarginate placenta: Their incidence and clinical significance. Am J Obstet Gynecol 1968;102:44.
2. Benson RC, Fujikura T. Circumvallate and circummarginate placenta. Unimportant clinical entities. Obstet Gynecol 1969;34:799.
3. Wilson D, Paalman RJ. Clinical significance of circumvallate placenta. Obstet Gynecol 1967;29:774.
4. Naftolin F, Khdur G, Benirschke K et.al. The syndrome of chronic abruptio placenta, hydrorrhea, and circumvallate placenta. Am J Obstet Gynecol 1973;116:347.
5. Scott JS. Placenta extrachorialis: A factor in ante-partum hemorrhage. J Obstet Gynecol Br Emp 1960;67:904.
6. Cutillo DP, Swayne LC, Schwartz JR et.al. Intra-amniotic hemorrhage secondary to placenta circumvallate. J Ultrasound Med 1989;8:399-401.