# bilobal placenta?



## jenangelcat (Apr 17, 2004)

There is a woman on my freecycle board looking for info on this;
_
I am currantly 21 weeks pregnant and found out I have bilobal
placenta which means there is two placenta and I am being reffered
to dr.siren for it, I am really concerned since my midwife is not
really able to give me much info on it and I cant find any info on
what it is I have._

I've googled it a can't find anything. Any ideas? Apparently they are moving towards a c-section.

Jen


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## amyro (Aug 6, 2004)

google "bilobate placenta" instead. Interestingly, I just attended a birth with a bilobed placenta the other day and everything went smoothly (it was a birth center birth). The risk with bilobed placentas is that there can be blood vessels that connect the two lobes that can rupture during labor, which can be life-threatening to the baby. This is extremely rare, however.

I looked it up on Up-to-Date (an evidence-based medical database which is very medical model but still something I rely on for assessments of the literature on rare things like this.) The bilobate placenta is discussed in the section on velamentous insertions of the umbilical cord (another thing you can google). Here is their assessment:

Given these risks, in the setting of a suspected velamentous insertion it would appear prudent to perform a careful anatomic fetal survey to look for structural anomalies, assess fetal growth, evaluate for vasa previa, continuously monitor the fetal heart rate intrapartum, and exercise caution when exerting traction on the umbilical cord during the third stage of labor. Moreover, the patient should be advised to call her physician with the onset of labor and, in our opinion, such pregnancies should not be allowed to proceed beyond 40 weeks of gestation. However, there are no data from large or controlled studies on which to base these recommendations. There is also no evidence that additional measures (eg, elective induction of labor or prophylactic cesarean delivery) are indicated. Finally, it should be noted the diagnosis of velamentous insertion is usually not made in the antenatal period and failure to make such a diagnosis is not a breach of the standard of care [66].

By the way, I had a totally perfect and normal birth at home with a velamentous insertion AND a succenturiate lobe. I never had an ultrasound so I never knew I had them until afterwards. It did get a little hairy when my cord snapped off my placenta and I needed two doses of pitocin to get the placenta out and stop the bleeding, but everything was totally fine in the end and I didn't even bleed excessively after all was said and done. I don't know if I would have done anything differently (planned a hospital birth, for instance) if I had known I had those placenta anomalies, because there is the small (but increased) risk of a ruptured vasa previa. But I think a planned cesarean is way overboard.

-Amy


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