Brief Answer:
The ultrasound of your baby looks normal and you have an unusually shaped placenta

Detailed Answer:
Hello, and I hope I can help you today.

The ultrasound you had was performed to check the anatomy of the baby. I reviewed your report and will do my best to explain it to you.

The ultrasound first took measurements of the fetus to determine its current weight, which is 414 grams, and then examined and measured the internal organs.

The heart, kidneys, bladder, abdomen, thorax and stomach looked normal. They were not able to see the sex of the baby, which can happen if the baby won't open its legs for a good view.

The only thing of significance of the ultrasound is that it showed that you may have a succenturiate placenta, which means the placenta may have an extra lobe. This is not really a risk, other than it is important for your midwife to make sure both placentas deliver. However, diagnosing a placental abnormality at 20 weeks is very difficult and I would not even assume this diagnosis is correct until you have another ultrasound when the placenta gets bigger.

So the bottom line is- your baby looks physically normal, and you may have an unusually shaped placenta. The placenta will need to be followed during the pregnancy, but at this time there is nothing to be concerned about.

I hope I was able to adequately answer your question today and that this information was reassuring. If you need any further information, please do not hesitate to contact me.

Best wishes,

Dr. Brown

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Brief Answer:
The extra placental lobe is a chance finding

Detailed Answer:
Hello again,

First of all, having an abnormally shaped placenta is a chance event. It has nothing to do with twinning and the calcification mentioned on the ultrasound is a normal finding in third trimester placentas. Having one in the second trimester may mean that a small area of the placenta may have some scarring, which has no impact on the pregnancy as long as the placenta grows.

The placenta supplies the baby with oxygen and nutrients, and in women with placental abnormalities are usually followed with ultrasounds to make sure the baby is growing properly. As long as they baby grows well, the only issue will be making sure that the whole placenta is delivered when you give birth.

The remark that the radiologist made of not seeing Doppler flow near your cervix means that you do not have placenta previa or vasa previa, which are two placental complications that can be more serious. So that is also a normal finding.

So based on these ultrasound findings, as long as your baby grows, the extra placental lobe is just an incidental finding. It is a chance event and not caused by any disease, and the exact cause is unknown.
All that your prenatal caregiver needs to do is make sure you get an ultrasound every month to evaluate the growth of the placenta and the baby.

I hope this additional information was helpful.

Regards,

Dr. Brown

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Brief Answer:
They describe the placental interface because it rules out placenta accreta

Detailed Answer:
Hello again, and I apologize for the delayed reply.

The interface between the placenta and the uterine wall is described because any one with an abnormal placenta is at risk for a condition called placenta accreta, which is where the placenta actually grows into the wall of the uterus. "Heterogeneous" just means the interface just doesn't look smooth (under ultrasound) which is not a diagnosis but just a description. So there is no evidence you have placenta accreta, but they likely will need to look at that area further on your subsequent ultrasounds

An "echogenic" area seen on an ultrasound just means that a shadowing is seen on the scan. Shadowing is caused by an area of increased density, which can be a nonspecific finding, buy that can be seen sometimes with fibroids, or an area of earlier bleeding under the placenta (even from the first trimester), If they saw this area earlier in the pregnancy with larger dimensions, that means that whatever caused the shadowing is going away by itself. Any finding that is less than 1cm in size is not significant and only needs to be examined again at your next ultrasound.

A lot of the terminology used in radiology reports just describes the appearance of a finding rather than a diagnosis of disease. Also many things are described that do not have clinical significance. There can be echogenic areas and heterogeneous areas seen on ultrasounds of normal placentas, and also on ultrasounds of the liver, kidneys and other body organs.

The bottom line is that the only abnormal finding on your ultrasound is the succenturiate placenta. There is no evidence of any other placental abnormalities, nor is anything wrong with the baby's anatomy. The ultrasounds will be more sensitive to pick up any other problems in the placenta when it gets bigger- at 20 weeks the placenta is less than 10 cm in diameter.

I hope this clarifies things and I wish you the best of luck with the rest of your pregnancy.

Take care,

Dr. Brown

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