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Vasa previa with bilobate placenta

Fabrice Cuillier, MD

Article Published: Dec 14, 2010    Article Revised: Feb 9, 2016

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

Case report

A 30-year-old G2P1 healthy woman was referred to our unit for an ultrasound examination at 31 weeks of gestation. The ultrasound examination of the fetus was normal. Examination of the placenta and umbilical cord showed a bilobate placenta with a velamentous cord insertion.

On the ultrasound examination at 34 weeks of gestation, we saw a bilobate placenta on the anterior and posterior uterine wall. Between these two, we confirmed a vasa previa, the placental vessels traversed the lower uterine segment and the internal cervical os.

The patient delivered via scheduled cesarean section at 37 weeks. The examination of the placenta confirmed our antenatal diagnosis of the bilobate placenta with vasa previa.

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Image 1: Ultrasound performed at 31 weeks gestation shows a bilobate placenta.
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Image 2: Ultrasound performed at 31 weeks gestation shows a velamentous cord insertion.
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Image 3: Ultrasound obtained at 34 weeks shows vasa previa traversing the internal cervical os.
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Image 4: Ultrasound obtained at 34 weeks shows vasa previa traversing the internal cervical os.
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Image 5: Ultrasound obtained at 34 weeks shows vasa previa traversing the internal cervical os (arrow).
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Image 6: Ultrasound obtained at 34 weeks shows vasa previa traversing the internal cervical os.
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Image 7: 2D color doppler image showing the cord vessels across the cervical os. The frequency differentiates the placental vessels from maternal uterine vessels.
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Image 8: 2D color doppler image showing the cord vessels across the cervical os. The frequency differentiates the placental vessels from maternal uterine vessels.
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Image 9: 2D color doppler images show the lower uterine segment. Placental vessels near the internal cervical os.
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Image 10: 2D color doppler images show the lower uterine segment. Placental vessels near the internal cervical os.
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Image 11: 3D images of the vasa previa.
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Image 12: 3D images of the vasa previa.
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Image 13: Gross pathology images of the bilobate placenta with vasa previa running between the placental lobes.
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Image 14: Gross pathology images of the bilobate placenta with vasa previa running between the placental lobes.
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Image 15: Gross specimen show vasa previa and bilobated placenta.
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Image 16: Gross specimen show vasa previa and bilobated placenta.

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