succenturiate placenta

[Tattoomom]

I found out during an ultrasound yesterday that I have a "baby placenta" as well as my regular placenta. My OB didn't seem overly concerned and I didn't ask many questions but now that I've googled it, I'm worried.

My last pregnancy had a surprise velamentous inserted cord that was not discovered until delivery despite ultrasound. Supposedly they are hard to detect?

And now, again, despite numerous ultrasounds this pregnancy, I just learned yesterday at 36 weeks, I have this weird placenta problem.

What is this? What are the risks?

As it is, I've been worried about delivery because this baby is measuring bigger than my previous 2 and I had a hard time birthing them vaginally due to a small pelvis (big episiotimies, forceps, etc...)

NOW I'm REALLY WORRIED about a vaginal birth with the strange placenta. And even more worried that I have another velamentous inserted cord that he hasn't detected since reading online says the 2 problems can be linked.

Help! Anyone have experience with these issues?

I'm already 2cm. dilated and 50% effaced.

[Earthylady]

Where you able to change positions in your last births? The lithotomy ( on your back ) position is the absolute worst to birth in! The best is usually squat, or hands and knees, perhaps even on a birthing chair. In lithotomy, you are defying gravity as well as not doing anything proactive to help spread open the hips. It's a convenient position for doctors, and often necessarily if you've had an epi, but there are so many other ways to give birth that can actually work with your body to open up and let the baby out.

I've never heard of the placenta thing you said, but I hope you find out more info about it soon.

Mandy

[Charmie981]

The placenta and cord insertion can be a problem, but only if one of two things happens: a) there's a cord vessel traversing the cervix and baby's presenting part puts pressure on it (called a vasa previa) and b) you membranes rupture or are artificially ruptured and cause one of the vessels that traverses the uterus to break.

In all honesty, this is a case where I might consider a scheduled section, unless I knew the position of the cord vessels in the membrane and in relation to baby. I believe they can do an infared sonogram to track the blood flow through the uterus and determine if there's any concern about a vasa previa.

[Tattoomom]

Charmie,

Thank you so much for replying. My dilemma is that I don't know if this cord is velamentous or not. My OB said he thinks it's inserted on the side but not sure about velamentous. My last pregnancy had the velamentous that wasn't discovered until delivery, and thankfully wasn't vasa previa.

I'm so confused as to what to do. I'm mainly scared that I could go into labor at any time and encounter a problem. I'd like to figure this out and have the c-section scheduled if that's what needs to be done to be on the safe side, sooner than later.

Of course, it's a 3 day weekend and nothing can be done before next Tuesday.

If my OB is right and it's not a velamentous cord, is having a succenturiate placenta dangerous at all? What causes that to happen?

[Charmie981]

Originally Posted by Tattoomom

If my OB is right and it's not a velamentous cord, is having a succenturiate placenta dangerous at all? What causes that to happen?

A succenturiate placenta can have the same issues as a velamentous insertion because it can have vessels that traverse the membrane between the little placenta and the big placenta. If those vessels are in baby's path or your water breaks over them, then you can have the same problems as are possible with the velamnetous insertion.

Here are some pictures that show a succenturiate placenta with and without a large blood supply to it: http://www.thefetus.net/page.php?id=1183. If the succneturiate lobe is placed close to the placenta, there's less likely to be a problem, but if they are on opposite sides of the uterus, there could be inches of vessels exposed in the membranes, which would pose more of a potential problem.

This is probably one of those cases of knowing too much, ya know? Chances are very good that this won't be a problem at all, but I can see where knowing about it would make you want to *do something* to make SURE everything will be okay...and I'm not sure you *can* do anything.

[Kellie_MO4]

I had a velamentous inserted cord (I guess...Had to actually look it up, but yep, the Cord was 1/2 on the placenta, with 1/2 the blood vessels going all the way around the amniotic sac.. the midwife was *very* suprised, since she had never actually seen one before) but I was told that just because it happens once doesn't mean it will happen again, or put you at higher risk for it happening again.. just one of those things that can sometimes happen... Not sure on the placenta thing, really don't know much about what you have going on.. but I hope it works out whatever way is best for you and babe!

[Tattoomom]

I am so depressed over this.

I went from being so excited about being 2cm. and the possibility of spontaneous labor (my other 2 births were induced) to terrified that I'll go into labor and something go wrong.

Here comes the "why me's" and "what if's"

Why does my body make strange cords/placentas?!

What if my water breaks or is artificially ruptured and it breaks a membrane? Will the baby bleed out?

Should I trust my OB and just wait and see if I go into labor? The plan was if I hadn't went into labor on my own by 38 1/2 weeks, he would induce me, since the baby is looking big and I have a tiny pelvis.

Should I just elect a scheduled c-section?

A section scares me but what are my risks with this type of placenta to deliver vaginally?

This whole situation has made me so frazzled.... help!

[Charmie981]

the concern is that the baby can bleed out, yes. I think you need more answers to make an educated decision...is there an exposed vessel and if there is, where is it? I've read that a transvaginal ultrasound can be helpful in determining that.

Honestly, if your OB isn't concerned, I would probably ask if he can get you the answers to these questions and then take comfort in the fact that he's not worried about it. It's his job to think through every possibility and act on the WORST of those possibilities, so if he's not wanting you to schedule a c-section, then I wouldn't want to do that either, KWIM?

[Tattoomom]

Thank you Charlotte!

[Tattoomom]

Update-

I went to my OB yesterday and it was an awful experience. When I voiced my concerns about the placenta and cord, I got the whole "you worry too much speech." He did another ultrasound to look again but not before making me feel 2 inches tall first. I was in tears. I know I'm pregnant and hormonal and that probably made me take his criticism so seriously but either way, I wish things had been different. Before the ultrasound was set up, I felt like leaving but then I knew I'd still wonder about the succenturiate placenta etc... so I stuck it out and just had a lump in my throat the whole time.

He said the extra placenta is located next to my regular placenta and when he looked at the cord, he "thinks he can see the insertion, and it doesn't appear velamentous but it's very hard to tell on ultrasound."

He sees no need in a scheduled section at this time, so I just have to have faith in his judgement.

I left there feeling like I must be the most annoying patient for him to have given me the 10 minute lecture he felt need to give. I'm so sad.

Now more than ever, I'm just ready for this baby to come so my weekly visits there can be over!

[joshs_girl]

Tricia - I'm sorry he's so dismissive of your concerns but at least you know a bit more that everything is okay. Wishing you peace - how much longer do you have now?

[Tattoomom]

Aww, thanks for the hugs! I'm 37 weeks.

My other 2 children were born at 38 and 37 weeks. I know that doesn't mean anything, but I'm hoping this one will follow suit!