Placenta at 15 mm - Is it a matter of concern?

Dr. Honey Nandwani., BDS

Dr. Neha Rathod
Obstetrician And Gynaecologist

Hi Dr. Honey, very interesting case, regarding the placental localisation, there's nothing to worry about, as the placenta migrates at the rate of.0.1mm/week when the placental edge is covering the os and will definitely move up.
Single umbilical artery as known, is a most common umbilical abnormality effecting about 1:100 to 1:500 pregnancy, it's a matter of concern and not an alarming sign and will need further investigation

30.Jun, 10:08am

Dr. Mavani Jimesh Himatbhai
Obstetrician And Gynaecologist

If it is just reaching up to Internal OS and 15mm away from it at 22 weeks without any episode of bleeding than it is mostly not to worry. But if any episode of bleeding till now than that is something to be taken care of and require rest. As placenta is posterior and 15mm away from IO. It will no matter of concern as the pregnancy advances.
But do individualize patient and counsel the patient and relative accordingly. And if only single umbilical artery than do rule out Gestational diabetes by GTT. In that also sometimes placenta is bigger than normal and do reach near IO.

30.Jun, 10:08am

Dr. Meeta Bansal
Obstetrician And Gynaecologist

Hello Dr Honey,
Placental location 15 mm from the os at 22 wks is not worrisome as in most of the cases it will progress upwards. As of single umbilical artery , you investigate her thoroughly for congenital anomalies and be vigilant for IUGR and fetal demise.

30.Jun, 10:31am

Dr. Purushottam Sah
Obstetrician And Gynaecologist

At 15.0mm away from internal OS the placenta at 22 weeks may migrate upwards as the pregnancy advances, if there is no bleeding then it is low risk at present, but will need rescan in 3rd trimester. Regarding single umbilical artery in about quarter of cases there may be congenital abnormality of the fetus, as level 2 ultrasound anomaly scan doesn't show any abnormality, most probably it is not of much concern as most babies with single UA are born normal..

30.Jun, 10:32am

Dr. Sunita Kothari
Obstetrician And Gynaecologist

Hello dear user placenta is away from the internal OS by. 5mm, nothing to worry, because as pregnancy advances uterus also increase in length and width and this distance of placenta from internal OS also increases, so at this stage you can do some safety measures like thatii there should not be constipation, and not hold urine for long to avoid pressure on uterus as bladder and rectum are situated above and below the uterus, and avoid wt lifting sex, at time of labor pain position of baby should be by vertex means head down then no problem but if it remains same then advised LSCS

30.Jun, 10:37am

Dr. Balakrishnan R
Obstetrician And Gynaecologist

Hi Dr. Honey, How are you doing ?
Placental location is not a concern at this early gestation. As this is not a central placenta completely covering os, it will surely migrate to upper segment. As it in the posterior segment & hopefully the uterus has no scar of myomectomy etc, chances of migration is high. Even if the placenta does not fully migrate to upper segment, all that matters will be if the head at term descends below the placenta. If placenta , as it is posterior, is significantly low the diameter of engagement will be compromised & you will have to take a decision of CS .
As scan has already ruled out renal & cardiac anomalies, all you will need is follow up. Look out for sequential growth. Baby may be prone for growth restriction for no reason. Baby will reach term if no other problems arise. After crossing 28-30 weeks closer & frequent monitoring with doppler will be good for monitoring .
Hope I have been helpful in management & all the best

30.Jun, 10:49am

Dr. Honey Nandwani
Dentist

Thanks all for the useful information..
Can you please tell that the patient should go for chorionic villus sampling or amniocentesis to rule out any abnormalities related to single umbilical artery?

Thankyou.

30.Jun, 10:52am

Dr. Balakrishnan R
Obstetrician And Gynaecologist

Hi again,
had there been any significant anomalies or any confusion about any diagnosis, then having such an investigation would be warranted. Invasive procedures like CVS & Amnio carries it's own risk. Now baby has no risk if left alone, then why put the baby at risk by such procedures. If you are expecting a genetic problem, the first proof against it is absence of any significant abnormality till now & adequate growth till date.
I would say only wait , watch & monitor. She may lose baby not due to the single umbilical artery , but due to the invasive procedure
All the best

30.Jun, 10:59am