A case of circumvallate placenta causing preterm premature rupture of membranes post-amniocentesis

Kumari Pritti, Vineet Mishra, R. Aggarwal, S. Choudhary
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Abstract

We report a case of circumvallate placenta which led to preterm premature rupture of membranes (PPROM) and leakage in a mother at 17 weeks of gestation. The mother underwent amniocentesis after the triple marker test showed an increased risk for trisomy 21. We encountered difficulty in aspirating amniotic fluid due to the abnormal placental structure, which was not known at the time of the invasive procedure. The mother experienced leaking 7 days post-procedure, followed by miscarriage. Autopsy examination revealed that the placenta was circumvallate, which not only caused difficulty in aspirating the amniotic fluid but also could be the cause of PPROM, a well-known complication of the circumvallate placenta. We emphasize that examining the placenta is very important to identify the cause of events in certain situations; circumvallate placenta or abnormal placenta can be suspected in cases where hindrance is encountered (not able to aspirate amniotic fluid even if the needle is visible in the amniotic sac) during amniocentesis.
一例羊膜腔穿刺术后导致胎膜早破的环状胎盘病例
我们报告了一例胎盘早破(PPROM)病例,该病例的母亲在妊娠 17 周时发生胎膜早破和胎漏。在三重标记检测显示 21 三体综合征风险增加后,该母亲接受了羊膜穿刺术。由于胎盘结构异常,我们在抽吸羊水时遇到了困难,因为在进行侵入性手术时我们还不知道胎盘结构异常。术后 7 天,产妇出现羊水漏出,随后流产。尸检显示胎盘为环形,这不仅导致羊水难以吸出,还可能是导致早产的原因,而早产是众所周知的环形胎盘并发症。我们强调,在某些情况下,检查胎盘对于确定事件的原因非常重要;在羊膜腔穿刺过程中遇到阻碍(即使针头在羊膜囊中可见,也无法吸出羊水)时,可怀疑为环状胎盘或异常胎盘。
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