# Another placenta question



## fiddledebi (Nov 20, 2003)

Hi all!

I'm working on processing through my daughter's birth two and a half years ago, and was wondering if anyone can help me understand a bit more about bi-lobed placentas. We had a difficult labor on pitocin and at one point when I was on a birthing ball, her heart rate dropped dramatically. I was rushed into the bed on my left side, oxygen mask on, midwife scrambling, me out of my head with right-on-top-of-each-other contractions, everyone was frantic and trying to figure out what to do. Once I had changed positions, DD's heart rate went back to normal, but fear made my midwife insist that I stay on my left side with the oxygen until, many hours (and an epidural) later, I was fully dilated and able to push DD out.

When my midwife had broken my water for me, it came out clear. When DD's head came out, though (about 4 hours later), it was covered in meconium. Then, about half an hour later when my placenta delivered, I suddenly had a room full of gaggling residents and curious nurses, all there to see the "fascinating" bi-lobed placenta I had delivered. I was made to believe that my daughter's health and even survival, as well as mine, were something of a miracle, given the fact that the placenta looked like lungs, and had a tiny umbilical vein connecting the two sides.

My questions:

1. Why does this happen?

2. Will it happen with future pregnancies?

3. Is it dangerous enough that, if they recognize it via ultrasound, they would insist on a c-section?

Thanks in advance, all!


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## pickle it (May 16, 2004)

Fiddledebi: Sure and I've never heard of this before, maybe you should post this question in Practitioner Database, where someone with more knowledge might be more likely to see it? I'm curious, but certainly can't help. Good luck researching.


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## mwherbs (Oct 24, 2004)

there is a magazine out called Placenta, and there are some docs out there who study placentas. But as far as I know I don't think they know why a bi-lobe placenta will develop. there might be some theories though.
I would guess since there was a small umbilical vein connecting them it probably happened early when the placenta formed and implanted.
I will look through my bookmarks I think I have a web address placenta formation, maybe that doc could answer some of your questions. From what I have read I don't think that it is a repeating kind of thing. We had one baby who's placenta was double thick with part of the cord imbedded in it very strange, the mother had other children before and after and nothing else like it. We have had other more common but still relatively rare things like velamentous insertions , where the cord travels across the membranes, and no one has ever had it a second time in our clients.
It may be possible to detect it in pregnancy but it would probably be at least a level 2 ultrasound and is not a typical skill so you would have to have an innovative tec and radiologist to read it.
I am not sure why the heart tones changed and it may have not been related to the bilobed placenta at all it might have been some other stress like a pinched cord, distress from pitocin or maybe just a transient reaction that resolved, with a position change and your position later may not have made a difference. One of the first things we do is to change mom's position to see if we can get heart tones to change. But usually we don't have mom stay in the same position the whole time. Can you talk to your midwife and ask her some of these questions? She would know her reasoning better than anyone else. I have had a couple of women who's babies did not like a certain position mom would get in and every time she would lay on her back or one gal it was her left side the baby's heart beat would really slow down, so they just had to avoid that position.
as far as mec not being in forewaters it means just that when ever the baby's head trapped that water in front of the head there wasn't any meconium in the water but sometime after that minutes or days later mec was in the water so it came after with the baby. So breaking the water ahead of time doesn't necessarily tell you anything.


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## Malama (May 11, 2002)

Aloha!
I looked this up in my placenta book.
Bilobed placentas are caused when the placenta develops on both the anterior and posterior walls because it implants in grooves in the uterus (uterine sulcus).
It says that there are no unfavorable short or long term pregnancy outcomes.
Its associated with mms over 34, smokers during pregnancy, excessive first trimester vomiting, diabetes and maybe associated with a maternal history of infertility.

i agree with the PP that the hr dips may not have had anything to do with your placenta. and from what i just read, doesn't seem like it's a risk for future pregnancies necessarily, or that it's a big risk in general..... just one of those odd placentas!


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## fiddledebi (Nov 20, 2003)

Thank you Malama and mwherbs!!! It is really helpful to read your explanations. I too have looked online for explanations, but don't feel like I understood all the medical jargon. Your posts were great.

Quote:

Its associated with mms over 34, smokers during pregnancy, excessive first trimester vomiting, diabetes and maybe associated with a maternal history of infertility.
None of these things describe me, oddly! I was 27, non-smoker, very little morning sickness, no diabetes, and got pregnant on the very first try! Oddly, I also had PUPPPs with none of the generally-accepted risks factors for that, either (no twins, not much weight gain, the baby was a girl). I guess I just got "lucky" with these things.









My midwife has retired, but I'll see what my new midwife (same practice) says from looking at my records.

Again, thank you!!!!


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