Transactions of the Central Association of Obstetricians and Gynecologists, Twentieth Annual Meeting Memphis, Tenn., October 30 to November 1, 1952| Volume 65, ISSUE 3, P491-497, March 01, 1953

Circumvallate placenta

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      Placental pathology has been the subject of an increasing number of studies reported in recent obstetric literature. This trend is good, as this intermediary organ between the mother and the fetus is responsible for many complications of pregnancy and labor. One type of pathology of this organ that has been neglected, and often misunderstood, is circumvallate placenta.
      Standard textbooks on obstetrics have given scant attention to this condition, and minimized its significance. Williams1 stated, “Upon going over the clinical histories of patients presenting the abnormality, my impression is that it is practically without clinical significance, and is to be regarded merely as an interesting anatomic condition.” DeLee and Greenhill2 give few factual data about the clinical significance of circumvallate placenta, while devoting an entire chapter to placenta previa. There is also a paucity of reports regarding this entity in the current literature.
      In the course of this study of circumvallate placenta, a significant amount of pathology was found. We were impressed with the high incidence of maternal hemorrhage, late abortions and premature labors. The fetal loss is high, yet current fetal mortality reports rarely list circumvallate placenta as an etiological factor. In presenting this study, it is our desire to call to your attention the clinical significance of this entity.
      Our data are obtained from 8,562 consecutive deliveries at Butterworth Hospital, Grand Rapids, Mich., between June 1, 1949, and May 31, 1952. Circumvallate placenta occurred 41 times, giving a ratio of one in 208 deliveries. Hobbs and Price3 reported the incidence as one in 138 cases. Hunt, Mussey, and Faber4 reported one in 188 cases. Our incidence may be slightly lower because all abortions prior to 20 weeks of gestation were excluded.
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        Am. J. Obst. & Gynec. 1927; 13: 1
        • DeLee J.B.
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        Am. J. Obst. & Gynec. 1951; 61: 653
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        Am. J. Obst. & Gynec. 1951; 61: 20
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        Am. J. Obst. & Gynec. 1951; 64: 910
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        Am. J. Obst. & Gynec. 1952; 64: 53
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        Am. J. Obst. & Gynec. 1950; 59: 13
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        Am. J. Obst. & Gynec. 1952; 63: 999
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        Am. J. Obst. & Gynec. 1952; 63: 1091
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        Am. J. Obst. & Gynec. 1951; 62: 764
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        Am. J. Obst. & Gynec. 1951; 62: 1062
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        Am. J. Obst. & Gynec. 1952; 64: 126