Vadlamudi G, Goyert G, and Shaman M. Growth outcomes associated with prenatal diagnosis of partial and complete circumvallate placenta. Am J Obstet Gynecol 2022; 226(1):S632.
Am J Obstet Gynecol
Objective: Prior studies have shown higher rates of fetal growth restriction associated with circumvallate placenta based on placental pathology. However, none have assessed growth outcomes associated with sonographic diagnosis alone. The objective of this study is to assess the accuracy of ultrasound diagnosis of circumvallate placenta and to compare the association of partial and complete circumvallate placenta on ultrasound with fetal growth restriction (FGR) and small for gestational age (SGA) birthweight.
Study Design: Patients with the sonographic diagnosis of circumvallate placenta (partial or complete) were identified. Confirmation of circumvallate placenta was noted if pathologic examination of the placenta was performed. Findings of antenatal FGR and neonatal SGA were recorded.
Results: Placental pathology was available for 117 of 222 cases of sonographically diagnosed circumvallate placenta; 25 were confirmed to be circumvallate (21.4%). In patients with circumvallate placenta diagnosed on ultrasound, FGR was identified in 9.5% and SGA in 10.8%. FGR and SGA occurred in 7.3 and 8.0% in patients with partial circumvallate placenta, and in 10.6% and 17.0% of patients with complete circumvallate placenta, respectively. None of these values were significantly different from the baseline population rate of 10%. In cases of circumvallate placenta confirmed on pathology, FGR and SGA occurred in 12.0%.
Conclusion: The accuracy of sonographic diagnosis of circumvallate placenta remains poor. Strategies to improve sonographic diagnosis of circumvallate placenta are needed. Patients with circumvallate placenta identified on ultrasound did not have higher rates of FGR or SGA than the general population, even when partial and complete circumvallate placenta were evaluated separately. This information can be used to guide counseling for patients with circumvallate placenta identified on prenatal ultrasound and to re-evaluate recommendations for antenatal surveillance.