Urgent help/advice required!

[Tiggly]

Help! I need some information on a "post accessory lobe" and what this might mean for the baby/pregnancy/delivery!! Any help appreciated!!tia!!

[Tiggly]

bump

[funnypeculiar]

blimey, no idea, but bumping for you...

[Tiggly]

thanks anyway!!anyone else??

[lulumama]

no idea....gis a clue??

where is it?? and what is it???


and i thought i knew a fair bit....

[lulumama]

seriously...is it something to do with the baby,the uterus , the birth canal....?

[Tiggly]

aparantly it is to do with the placenta?? been told that c-section is the only answer (this is not about me, but about my friend who had her heart set on a vaginal birth iykwim).

[lulumama]

will have a search tomorrow....getting tired now.....has she been told why it will make vaginal birth impossible/

[MKG]

Sorry I suck at links. This is something that you want to talk to your doctor about. Keep in mind I could find "pos accessory lobe" as you write it. Hope this helps.

"Succenturiate Lobe
A succenturiate (accessory) lobe is a second or third placental lobe that is much smaller than the largest lobe. Unlike bipartite lobes, the smaller succenturiate lobe often has areas of infarction or atrophy. The risk factors associated are advanced maternal age, primigravida, proteinuria in the first trimester of pregnancy, and major malformations in the fetus. The membranes between the lobes in such placenta can be torn during delivery, and the extra lobe can be retained after rest of the placenta has been delivered, with consequent postpartum bleeding. "

source:
www.neonatology.org/syllabus/placenta.html

[lulumama]

think it is to do with extra bits of placenta and therfore a risk of heamorrhage...your friend needs to get as much info as she can about this and ensure she understands it....it is really important , IMHO, to know what is going on in your pregnancy and how and why it will impact on the birth.......

[boredwitless]

just googled it and from what i can tell it's apool of blood that develops in the pacenta that causes no problems in preg but can cause major haemorrage in the 2nd satge of labour which is why she will have been told she needs asection.

[lulumama]

x post MKG...if it is a risk of retained parts....is that a reason for c.s? honestly don;t know.....interesting....

[lemonaid]

An accessory lobe is also known as a "succenturiate lobe", if you're Googling. I think the main concern with it in delivery terms is the risk of the lobe getting left behind and leading to serious blood loss, but I'm not sure (and I don't know what the "post" bit means).

If you bump this up tomorrow one of our resident midwives may well see it and be able to advise.

[lulumama]

x post again!

[lemonaid]

Ah, I type too slowly (and am watching Fantastic Four). All those points now made far more ably by others

[lemonaid]

x post again again...

[Tiggly]

thanks very much all, if anyone does find any more information about the complications with a natural birth then i would very much appreciate it. i have begun to google it and worked out a bit, but would it mean 100% certain, a c-section delivery?? help is appreciated and hope we can gather all the information required to make an informed decision on the situation.

[MKG]

From what I've found, and I'm no expert, a vaginal delivery is possible. However, there is the risk that part of the placenta may not be expelled. and it also can become a problem as to where the other lobe is located. I believe they could d&C it out, but it may be too much blood loss. IMHO I think that a C-section would be the safest route for your friend to ensure that everything is removed with as little blood loss as possible. I was reading that this is also associated with more severe problems but not always.

[MKG]

Here is another abstract that I found.


"Abstract
Presentation We detected an unusual placental lake under the membranes between the two lobes of a placenta bilobate with a turbulent blood flow in it. This was an extraordinary maternal lake: simply the accumulation of maternal blood inside the intervillous space in an area where villous structures were absent between the placental lobes. The lake reduced in size and became almost invisible during the Braxton Hicks contractions, and enlarged up to its previous dimensions at the end of contractions. This extraordinarily huge lake showed an interesting dynamic appearance on sonographic examination.
Outcome Although it caused no complications during the course of the pregnancy it produced an obstetric hemorrhage, which took place during the second stage of the delivery. Pathologic examination confirmed the diagnosis of placenta bilobate. We present its interesting appearance and clinical outcome in this paper."

source: www.springerlink.com/content/rbqwyhn864p3f0qm/

[Tiggly]

Thanks very much MKG for looking for information for me, I shall certainly pass this on. Apologies for not responding earlier but I have only just managed to log on to my computer after a very long day!

[MKG]

Tiggly,

Don't worry about it, When I had a fibroid and a hemhorrage diagagnosed a few weeks ago I was thankful for fellow mnetters that looked information up.

Good luck with your friend.