Contents
The anterior or posterior fundic placenta: what it means
The term fundic relates to the fundus of the uterus. A fundal placenta is therefore a placenta located at the bottom of the uterus, which is considered the ideal position. He can be anterior or posterior, depending on whether it is implanted on the anterior (ventral) surface of the uterus, or posterior (dorsal) of the uterus.
The bilobed, trilobed or multilobed placenta
We speak of a bilobed placenta when it is made up of two lobes instead of one. If the second lobe is smaller than the main lobe (which includes the insertion of the umbilical cord), then this smaller lobe is called succenturial lobe, or accessory placenta.
A placenta can also be trilobé, either made up of three lobes, or multilobed if it is made up of more than three lobes. The consequences for pregnancy differ depending on whether or not this placental feature is associated with another complication (such as vasa previa when fetal blood vessels block the entrance to the cervix, placenta previa, etc.).
In some cases, the placenta can also have several very thin areas reduced to a single membrane: this is called a fenestrated placenta.
The calcified placenta
The placenta naturally calcifies as it matures. It usually reaches a state of advanced calcification at the very end of pregnancy. However, it happens that the calcification takes place too early, around 34 weeks of amenorrhea (7 and a half months) for example. The risk differs depending on the state of calcification of the placenta and the part affected by this calcification. If the maternal-fetal exchanges are still good and successive ultrasounds show that the baby is growing well, a calcified placenta may be of no consequence. On the other hand, if calcification seems to accelerate dangerously and interfere with maternal-fetal exchanges, an initiation of childbirth can be decided. The early classification of the placenta seems to be accentuated in smokers or ex-smokers.
The placenta accretes
We speak of placenta accreta when the placenta cannot be separated from the uterus. Instead of being attached to the endometrium (the lining that lines the uterus), it is inserted too deeply, and is directly in contact with the myometrium, the uterine muscle.
We speak of placenta accreta when the placenta is slightly inserted into the myometrium, placenta increta when it is fully inserted into that muscle, or placenta percreta when it reaches neighboring organs, especially the bladder. This type of placenta will especially cause difficulties at the time of childbirth, since it will not come off, or not completely, at the time of delivery. It can then cause bleeding from the delivery.
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This is an anomaly of insertion of the placenta. It is also referred to as a “inserted low” placenta. In this case, the placenta partially or completely covers the cervix. Usually diagnosed during morphological ultrasound (or 2nd ultrasound) in the second trimester, this poor placental position can however develop favorably during pregnancy, with the placenta gradually migrating. On the other hand, if it remains, it contraindicates vaginal delivery and requires a cesarean section, otherwise the risk of bleeding during delivery is too great. When placenta previa completely condemns the cervix, it is called an overlying placenta.
Note that the description of a placenta previa can also be accompanied by the following terms: lateral or parietal, marginal, partial or incomplete, central or covering.