Rheinboldt M, Delproposto Z. Ultrasound of placental abnormalities: a pictorial overview. Emerg Radiol 2015;22(4):401–8. [CrossRef] [Pubmed] At present, no detectable cause of placental lacquers has been identified. Since we are not yet aware of the causes, little can be done to prevent them. Any concerns about smoking or other habits that increase the likelihood of placental lakes could be shifted until the right causes are identified. No correlation or association has been reported between the presence of placental lakes and preterm labour. Jauniaux and Nicolaides [8] postulated that the etiology of maternal lakes is due to incomplete transformation of spiral arteries leading to focal overpressure, resulting in disruption of villosiformal tissue, leading to fetomaternal hemorrhage. In our case, however, there was no evidence of abnormal blood flow from maternal uterine arteries at 20 weeks, nor was there any biochemical evidence of placental dysfunction with normal PAPP-A at 12 weeks` gestation. However, if the placental lake covers more than 10% of the placenta and appears abnormally large, the risk of placenta accreta is minimal. In this case, the doctor will order an ultrasound, especially if there are several large placental lakes.
If the expectant mother has had uterine surgery in the past, or if the placental lake is abnormally close to cervical OS, she needs to be diagnosed further. Ultrasound will eliminate all doubts about its appearance. Rice NSV, Brizot ML, Schultz R, Nomura RMY, Zugaib M. Placenta lakes on sonographic examination: correlation with obstetric results and pathological findings. J Clin Ultrasound 2005;33(2):67–71. [CrossRef] [Pubmed] Placental lakes usually do not cause major complications. There are some cases where pregnant women may have problems, but they are not due to placental lakes. Let`s take a look at some complications that can affect pregnant women and that can be mistakenly caused by placental lakes: Research has found no difference in pregnancies in women with placental lakes and those without placental lakes. There were no adverse events during pregnancy due to placental lakes. No abnormalities were observed in the baby`s gestational age and birth weight (6). Given that the fetal prognosis was extremely poor and there were concerns about disruption of marginal placental attachment with possible massive antepartum hemorrhage, the decision was made to terminate the pregnancy.
This was tried medically, but massive bleeding occurred and the baby was born by hysterotomy. Total blood loss was 2200 ml. There was no evidence of a retroplacental clot at birth and placental histology showed an eccentrically inserted cord. The placenta was 80 mm in diameter and 20 mm thick, the fetal surface was inconspicuous. The maternal placental surface was disturbed by an infarction zone corresponding to 10% of the surface. There was no villi. The baby male at birth 140 g, which is significantly lower than the 3rd percentile. The baby was euploid for chromosomes 13, 18 and 21 at the postnatal assessment. It is a life-threatening condition that, in some cases, can result in the death of either the mother or baby, or both. Placental detachment is often caused by an anemic condition of the mother and multiparity, but placental lakes are not even remotely associated with this condition.
The authors did not find a similar case in the medical literature. The etiology of this case is unclear. During implantation, there is an interaction between the endometrium and extraembryonic membranes. The villi-like trophoblastic cells anchor the placenta in the endometrium and the trophoblastic cells then leave the placenta to invade maternal tissue to improve blood flow to the placenta. The basic placental structure (with spiral arteries supplying the placental bed and drained through the venous cavities) is established four weeks after implantation [1],[2]. The analysis, carried out after 12 weeks, showed that the mother lake had not yet developed at that time. A few days later, the patient presented with hemorrhage and placental morphology was noted as normal. We assume that the placental anchoring mechanism was damaged during this event, which then turned into the huge mother lake. Since the placenta was not normally attached, the supply of oxygen and other nutrients to the placental villi would be impaired, resulting in the observed placental infarction and severe restriction of fetal growth. There can be serious health complications if the mother or baby is not ready to give birth, but placental lakes are not directly responsible for any of them. In fact, preterm labor or delivery can be caused by high blood pressure or gestational diabetes in the mother. Placental lakes may be relevant in the following situations (4) (7).
Muramatsu K, Itoh H, Yamasaki T, et al. A fall from a huge placental lake; Prenatal differential diagnosis and clinical management. J Obstet Gynaecol Res 2010;36(1):165–9. [CrossRef] [Pubmed] © 2021 Holly George et al. This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided that the original author and publisher are duly credited. For more information, see the copyright policy on the journal`s website. All relevant data can be found in the document and its supporting information files. An ultrasound may show placental lakes during pregnancy; These are enlarged blood-filled spaces in the placenta. Placental lakes may be visible on the ultrasound image as one or more black areas. The placenta nourishes the unborn baby, and having a healthy placenta is important for optimal growth and development. Placental lakes are rarer.
Some studies suggest that placental lakes may have a frequency rate of 2.2% to 17.8% (3). One study that monitored placental lakes in pregnant women found that some lakes tend to shrink, some disappear while others remain (7). Any changes in the size and presence of placental lacquers will be detected during your routine ultrasound. Placental lakes or placental lakes are spaces inside the placenta that are filled with maternal blood. A placental lake could contain small, dilated veins through which maternal blood flows (1) (2). The patient presented four days after her dating ultrasound with an impending miscarriage. An ultrasound was performed, which showed a viable intrauterine pregnancy with a discrete placental appearance. Problems caused by them may or may not occur, and you may even give birth to a healthy baby. Therefore, do not panic if you have placental lakes. Any complications associated with pregnancy are very likely to be detected and treated early if you see the doctor for a regular ultrasound.
Jauniaux E, Nicolaides KH. Placental lakes, lack of diastolic flow from the umbilical artery and poor fetal growth in early pregnancy. Ultrasound Obstet Gynecol 1996;7(2):141–4. [CrossRef] [Pubmed] The causes of placental lakes are not fully understood. These are generally thought to be avilleous vascular spaces, which are spaces inside the placenta through which no placental tissue flows, only blood vessels (3). Placental lakes can occur when the placenta is slightly thicker than usual (4). Placental lakes may seem like a worrisome medical term and cause concern in pregnant women. It may happen that your doctor does not even report its observation during an ultrasound.
Fortunately, you`re not the only one spotted with this, as most placentas around the third trimester can have one, and sometimes even three, placental lakes. Although this may not directly affect the baby or the birth process, it is advisable to consult a doctor if this is noticed during scans. Placental lake or accumulations of blood inside or outside the placenta can be detected by ultrasound and be huge black spots on the placenta or even deeper. Thus, placental lakes can also be called blackheads or pools of blood.