Vasa previa with bilobate placenta

Fabrice Cuillier

Service de Gynécologie-Obstétrique, HÎpital Félix Guyon, Saint-Denis de La Réunion, France.


Case report

A 36 year-old healthy woman (G4P3, one C-section), was referred to our unit for routine ultrasound examination at 32 weeks of gestation. The examination of the fetus was normal.
Examination of the placenta and umbilical cord revealed a bilobate placenta with a velamentous cord insertion across the cervical os.

Another ultrasound examination at 34 weeks of gestation, confirmed the bilobate placenta on the anterior and posterior uterine wall and the velamentous insertion of the cord, suggestive of associated vasa previa.

Patient delivered via C-section at 37 weeks of gestation. The pathologic examination of the placenta confirmed our prenatal ultrasound diagnosis of vasa previa with bilobate placenta and velamentous cord insertion. 


Images 1,2: 2D and color doppler images show the lower uterine segment. Placental vessels near the internal cervical os.

1A-Riv_Pri_-36SA
1B-Riv_Pri_-36SA


Images 3,4
: 2D color doppler image showing the cord vessels across the cervical os. The frequency differentiates the placental vessels from maternal uterine vessels.

2A-Riv_Pri_-32SA
2B-Riv_Pri_-32SA


Images 5,6
: gross specimen images  show vasa previa and bilobated placenta. 

3A-Riv_Pri_-PN
3B-Riv_Pri_-PN


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