Moral-Moral Carmen Maria, Porras-Caballero Lorena, Blasco-Alonso Marta, Cuenca-Marín Celia, Monis-Rodriguez Susana, Gonzalez-Mesa Ernesto, Narbona-Arias Isidoro, Jimenez-Lopez Jesus S
Obstetrics and Gynecology Department, Hospital Materno-Infantil, Hospital Regional Universitario Málaga, Avenue Arroyo de los Ángeles S/N, 29011 Málaga, Spain.
Department of Surgical Specialties, University of Malaga, 29010 Málaga, Spain.
Diagnostics (Basel). 2025 May 26;15(11):1329. doi: 10.3390/diagnostics15111329.
Succenturiate placenta is a rare anatomical variant characterized by one or more accessory lobes connected to the main placental mass by fetal vessels. While frequently asymptomatic, this condition can lead to serious maternal-fetal complications if not diagnosed prenatally. Early detection through advanced ultrasonographic techniques plays a critical role in guiding obstetric management and reducing adverse outcomes. To describe and analyze the prenatal diagnosis, sonographic characteristics, clinical management, and maternal-fetal outcomes of succenturiate placenta cases diagnosed over a ten-year period at a tertiary care center. We conducted a retrospective observational study of nine pregnancies diagnosed with succenturiate placenta between 2014 and 2024. Data collected included maternal demographics, ultrasound findings, type of cord insertion, presence of associated anomalies such as velamentous cord insertion or vasa previa, vaginal or cesarean delivery, complications, and neonatal outcomes. Ultrasound evaluation was scored based on a four-point checklist assessing key diagnostic steps. Five of the nine cases (55.6%) presented isolated succenturiate placenta, while four (44.4%) were associated with velamentous cord insertion. No cases of vasa previa were identified. Obstetric outcomes included three vaginal deliveries (33.3%), two instrumental (22.2%), and four cesarean sections (44.4%), one of which was emergent due to fetal distress. Complications occurred in 44.4% of cases, with intrapartum bradycardia being the most common. One neonatal death was reported due to placental abruption. The quality of the ultrasound diagnosis was high in most cases, though transvaginal scanning was inconsistently applied. Prenatal identification of succenturiate placenta via detailed ultrasound, including color Doppler and targeted assessment of cord insertion, is essential to minimize risks associated with this condition. Standardized diagnostic protocols can improve detection rates and enable timely clinical decisions, ultimately improving maternal and neonatal outcomes.
副胎盘是一种罕见的解剖变异，其特征是一个或多个副叶通过胎儿血管与主胎盘相连。虽然通常无症状，但如果产前未诊断出来，这种情况可能会导致严重的母婴并发症。通过先进的超声技术进行早期检测在指导产科管理和减少不良结局方面起着关键作用。描述和分析在一家三级医疗中心十年间诊断出的副胎盘病例的产前诊断、超声特征、临床管理及母婴结局。我们对2014年至2024年间诊断为副胎盘的9例妊娠进行了回顾性观察研究。收集的数据包括产妇人口统计学资料、超声检查结果、脐带插入类型、是否存在如帆状脐带插入或前置血管等相关异常、阴道分娩或剖宫产、并发症及新生儿结局。超声评估基于一份评估关键诊断步骤的四点检查表进行评分。9例病例中有5例（55.6%）表现为孤立性副胎盘，4例（44.4%）与帆状脐带插入有关。未发现前置血管病例。产科结局包括3例阴道分娩（33.3%）、2例器械助产（22.2%）和4例剖宫产（44.4%），其中1例因胎儿窘迫而急诊剖宫产。44.4%的病例发生了并发症，产时心动过缓最为常见。报告1例因胎盘早剥导致的新生儿死亡。大多数病例的超声诊断质量较高，不过经阴道扫描的应用并不一致。通过详细超声检查，包括彩色多普勒和对脐带插入的靶向评估，产前识别副胎盘对于将与这种情况相关的风险降至最低至关重要。标准化的诊断方案可以提高检测率并促成及时的临床决策，最终改善母婴结局。
