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#1
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succenturiate placenta (accessory lobe)
I mentioned this in an earlier post but got no answers (maybe b/c no one has
any to give) but thought I'd give it another try with it's own subject line. I have an anterior placenta with a posterior accessory lobe. My midwife looked concerned at the report and asked what I had been told at the u/s. I said that my understanding was that we'd just have to make sure all of the placenta comes out. The midwife confirmed this and said that it was likely the lobe would have to manually removed. No further discussion of risks, etc. so I figured that was that. Then, I went and did some research on the internet (way to scare myself!) and found that a succenturiate placenta can cause vasa previa, or hemorrhage of the umbilical cord, which if it happens all the way is usually fatal to the baby. What I can't find is information about how high the risk really is (ie did my risk of vasa previa go from 1 in a million to 1 in half a million or are we talking realistic risks?). Also, is a pregnancy with succenturiate placenta managed differently? Should I be asking about other testing, be more conservative in decision making, etc. Obviously I'll be talking to my midwife at my next appt in 10ish days, but wanted to be armed with more info if possible. So, anyone been told they have an accessory lobe of the placenta before birth, and if so what was recommended, how were things done differently, etc.? Thanks! Amy |
#2
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succenturiate placenta (accessory lobe)
V. wrote:
I mentioned this in an earlier post but got no answers (maybe b/c no one has any to give) but thought I'd give it another try with it's own subject line. I have an anterior placenta with a posterior accessory lobe. Sorry, I don't know squat. A little searching turned up the following: http://tinyurl.com/cpfhp http://tinyurl.com/88rsn http://tinyurl.com/bgwel It seems to me that what matters here is the precise geometry involved. It looks like there are ultrasonography techniques that should be able to detect a likely vasa previa with some degree of accuracy (though likely not perfect). What reassurance have they given you that they have checked adequately for vasa previa and come to the conclusion that it's not likely to be an issue in your case? Best wishes, Ericka |
#3
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succenturiate placenta (accessory lobe)
I saw your original post, but have no answers for you. I would say this --
your midwife didn't sound overly concerned about it, so I wouldn't be either. At least don't jump the gun. Ask your questions, but listen to her answers. She isn't going to risk you or the baby. Good luck. -- Jamie Earth Angels: Taylor Marlys, 1/3/03 -- My Big Girl, who started preschool, and loved it! Addison Grace, 9/30/04 -- My Little Walker, who wants nothing more than to go explore the world! Check out the family! -- www.MyFamily.com, User ID: Clarkguest1, Password: Guest Become a member for free - go to Add Member to set up your own User ID and Password "V." wrote in message ... I mentioned this in an earlier post but got no answers (maybe b/c no one has any to give) but thought I'd give it another try with it's own subject line. I have an anterior placenta with a posterior accessory lobe. My midwife looked concerned at the report and asked what I had been told at the u/s. I said that my understanding was that we'd just have to make sure all of the placenta comes out. The midwife confirmed this and said that it was likely the lobe would have to manually removed. No further discussion of risks, etc. so I figured that was that. Then, I went and did some research on the internet (way to scare myself!) and found that a succenturiate placenta can cause vasa previa, or hemorrhage of the umbilical cord, which if it happens all the way is usually fatal to the baby. What I can't find is information about how high the risk really is (ie did my risk of vasa previa go from 1 in a million to 1 in half a million or are we talking realistic risks?). Also, is a pregnancy with succenturiate placenta managed differently? Should I be asking about other testing, be more conservative in decision making, etc. Obviously I'll be talking to my midwife at my next appt in 10ish days, but wanted to be armed with more info if possible. So, anyone been told they have an accessory lobe of the placenta before birth, and if so what was recommended, how were things done differently, etc.? Thanks! Amy |
#4
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succenturiate placenta (accessory lobe)
V. wrote:
I mentioned this in an earlier post but got no answers (maybe b/c no one has any to give) but thought I'd give it another try with it's own subject line. I have an anterior placenta with a posterior accessory lobe. My midwife looked concerned at the report and asked what I had been told at the u/s. I said that my understanding was that we'd just have to make sure all of the placenta comes out. The midwife confirmed this and said that it was likely the lobe would have to manually removed. No further discussion of risks, etc. so I figured that was that. Then, I went and did some research on the internet (way to scare myself!) and found that a succenturiate placenta can cause vasa previa, or hemorrhage of the umbilical cord, which if it happens all the way is usually fatal to the baby. What I can't find is information about how high the risk really is (ie did my risk of vasa previa go from 1 in a million to 1 in half a million or are we talking realistic risks?). Also, is a pregnancy with succenturiate placenta managed differently? Should I be asking about other testing, be more conservative in decision making, etc. Obviously I'll be talking to my midwife at my next appt in 10ish days, but wanted to be armed with more info if possible. So, anyone been told they have an accessory lobe of the placenta before birth, and if so what was recommended, how were things done differently, etc.? Thanks! Amy Succenturiate lobe of the placenta is when a vessel goes away from the placenta to form a separate lobe. All the joins the lobe is a blood vessel. This only becomes vasa praevia if the vessel is right down low infront of baby's head. In this case, you must have a c/s AFAIK. If your membranes rupture right where the vessel is, in some cases the tear might go into the vessel and you would haemorrhage. It isn't the actual umbilical cord though. An ultrasound should be able to detect where the 2 lobes of placenta are exactly, and where the vessel is that joins them. If the vessel is not infront of the baby's head, your risk of haemorrhage isn't anywhere near as high, and you can definitely have a normal birth. The best way to avoid leaving the lobe behind though, is to have a physiological 3rd stage, and have no one tugging on your cord to remove the placenta... let it all come out gently and in its own time. If someone tugs on the cord after giving the oxytocic they might only get the main bit of placenta out if the lobe hasn't detached yet. I strongly advise you to speak to your midwife about that issue, after you confirm that you don't have vasa praevia. How many weeks pregnant are you? If your midwife isn't worried, maybe she knows that there is no vasa praevia. When we midwives check the placenta after birth, we always check to make sure there is no vessel leading away from the placenta to 'nothing'. That indicates a succenturiate lobe still insitu. So it can definitely happen to people without an u/s picking it up! Good luck, and talk to someone about 1) Vasa Praevia and 2)Normal 3rd Stage. Jo (Mum to Will and a Midwife on maternity leave) |
#5
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succenturiate placenta (accessory lobe)
"Jo" wrote in message ... V. wrote: I mentioned this in an earlier post but got no answers (maybe b/c no one has any to give) but thought I'd give it another try with it's own subject line. I have an anterior placenta with a posterior accessory lobe. My midwife looked concerned at the report and asked what I had been told at the u/s. I said that my understanding was that we'd just have to make sure all of the placenta comes out. The midwife confirmed this and said that it was likely the lobe would have to manually removed. No further discussion of risks, etc. so I figured that was that. Then, I went and did some research on the internet (way to scare myself!) and found that a succenturiate placenta can cause vasa previa, or hemorrhage of the umbilical cord, which if it happens all the way is usually fatal to the baby. What I can't find is information about how high the risk really is (ie did my risk of vasa previa go from 1 in a million to 1 in half a million or are we talking realistic risks?). Also, is a pregnancy with succenturiate placenta managed differently? Should I be asking about other testing, be more conservative in decision making, etc. Obviously I'll be talking to my midwife at my next appt in 10ish days, but wanted to be armed with more info if possible. So, anyone been told they have an accessory lobe of the placenta before birth, and if so what was recommended, how were things done differently, etc.? Thanks! Amy Succenturiate lobe of the placenta is when a vessel goes away from the placenta to form a separate lobe. All the joins the lobe is a blood vessel. This only becomes vasa praevia if the vessel is right down low infront of baby's head. In this case, you must have a c/s AFAIK. If your membranes rupture right where the vessel is, in some cases the tear might go into the vessel and you would haemorrhage. It isn't the actual umbilical cord though. An ultrasound should be able to detect where the 2 lobes of placenta are exactly, and where the vessel is that joins them. If the vessel is not infront of the baby's head, your risk of haemorrhage isn't anywhere near as high, and you can definitely have a normal birth. The best way to avoid leaving the lobe behind though, is to have a physiological 3rd stage, and have no one tugging on your cord to remove the placenta... let it all come out gently and in its own time. If someone tugs on the cord after giving the oxytocic they might only get the main bit of placenta out if the lobe hasn't detached yet. I strongly advise you to speak to your midwife about that issue, after you confirm that you don't have vasa praevia. How many weeks pregnant are you? If your midwife isn't worried, maybe she knows that there is no vasa praevia. When we midwives check the placenta after birth, we always check to make sure there is no vessel leading away from the placenta to 'nothing'. That indicates a succenturiate lobe still insitu. So it can definitely happen to people without an u/s picking it up! Good luck, and talk to someone about 1) Vasa Praevia and 2)Normal 3rd Stage. Jo (Mum to Will and a Midwife on maternity leave) Jo, thank you so much! I must have misunderstood the stuff about vasa previa, thinking that it had something to do with the umbilical cord (it did occur to me last night that what I was thinking of sounded just like prolapsed cord, so why would it have a different name?) I will need to ask my midwife about it at my next visit (I'm 33.5 wks and have a 35 wk scheduled visit), but I do remember the u/s doing a color doppler during the u/s, I just assumed it was related to checking for placenta previa/abruption which was the reason I was there. Before the color doppler, I remember the u/s tech saying she couldn't tell if the lobe was connected to the main placenta, so know I think that must have been what she was looking for. I'll check this all out with my midwife next week, but I feel so much better! Thanks! Amy |
#6
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succenturiate placenta (accessory lobe)
"Ericka Kammerer" wrote in message ... V. wrote: I mentioned this in an earlier post but got no answers (maybe b/c no one has any to give) but thought I'd give it another try with it's own subject line. I have an anterior placenta with a posterior accessory lobe. Sorry, I don't know squat. A little searching turned up the following: http://tinyurl.com/cpfhp http://tinyurl.com/88rsn http://tinyurl.com/bgwel It seems to me that what matters here is the precise geometry involved. It looks like there are ultrasonography techniques that should be able to detect a likely vasa previa with some degree of accuracy (though likely not perfect). What reassurance have they given you that they have checked adequately for vasa previa and come to the conclusion that it's not likely to be an issue in your case? Best wishes, Ericka I'll need to talk to my midwife about it at my next visit. After reading those abstracts and Jo's post I'm thinking that it's already been ruled out, so they didn't bother getting me worried about it. I did that all on my own! (a little knowledge is a dangerous thing and all that!) Thanks for the help Ericka, I knew I could count on you! Amy |
#7
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succenturiate placenta (accessory lobe)
Thanks Jamie, of course you're right. I'm just one of those people that
reads a little info, understands a little bit of it, and goes into worry-land! I could never go to medical school, I'd be the worst hypochondriac! I've only had two visits with this midwife, so while I trust her in theory and like her a lot so far, I just don't have that implicit "she'll take care of me" feeling yet. Due to all my switching of providers I think I've taken the concept of "patient-directed health care" a little too seriously! Thanks again, Amy |
#8
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succenturiate placenta (accessory lobe)
V. wrote:
Jo, thank you so much! I must have misunderstood the stuff about vasa previa, thinking that it had something to do with the umbilical cord (it did occur to me last night that what I was thinking of sounded just like prolapsed cord, so why would it have a different name?) I will need to ask my midwife about it at my next visit (I'm 33.5 wks and have a 35 wk scheduled visit), but I do remember the u/s doing a color doppler during the u/s, I just assumed it was related to checking for placenta previa/abruption which was the reason I was there. Before the color doppler, I remember the u/s tech saying she couldn't tell if the lobe was connected to the main placenta, so know I think that must have been what she was looking for. I'll check this all out with my midwife next week, but I feel so much better! Thanks! Amy Glad to have helped, Amy All the best Jo |
#9
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succenturiate placenta (accessory lobe)
Elfanie writes:
: here is a picture I took at a birth of this...you can see where the : doctor's hand is inserted - where the membranes had ruptured - and you : can see the vessels connecting the two placental plates. If those : vessels had gone over the opening...that would have been scary. (it : was close enough as it was!) Picture? What picture? There is no URL, and my newsreader does not support attachments. Can you try again. Email if necessary. Thanks, Larry |
#10
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succenturiate placenta (accessory lobe)
wrote in message ... Elfanie writes: : here is a picture I took at a birth of this...you can see where the : doctor's hand is inserted - where the membranes had ruptured - and you : can see the vessels connecting the two placental plates. If those : vessels had gone over the opening...that would have been scary. (it : was close enough as it was!) Picture? What picture? There is no URL, and my newsreader does not support attachments. Can you try again. Email if necessary. Thanks, Larry LOL, you're a braver man than me Larry....anytime the words "hand is inserted", "membranes" and "ruptured" are used to describe a photo, I'm pretty sure I don't want to see it! Thanks Stephanie, the explanation did help.(without pictures and all!) I'm feeling much more reassured since I recall the u/s tech checking very carefully to make sure nothing was over the cervix. Since I was there to rule out placenta previa due to bleeding, I thought that was the reason. Now I'm thinking it was also because of the accessory lobe. Amy Amy |
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