There is a marked variation in the morphology including size, shape and weight of the placenta. Variation of the cord is also quite common. Only those of clinical importance are described.


Morphology: One (usual) or more small lobes of placenta, size of a cotyledon, may be placed at varying distances from the main placental margin. A leash of vessels connecting the main to the small lobe traverse through the membranes. The accessory lobe is developed from the activated villi on the chorionic leave. In cases of absence of communicating blood vessels, it is called placenta spuria. The incidence of placenta succenturiata is about 3%.

DIAGNOSIS: Diagnosis is made following inspection of the placenta after its expulsion.

(1) With intact lobe: -  the features have already been described

(2) With missing lobe: - (a) there is a gap in the chorion and (b) torn ends of blood vessels are found on the margin of the gap.

CLINICAL SIGNIFICANCE: If the succenturiate lobe is retained, following birth of the placenta, it may

lead to:

(1) Postpartum hemorrhage which may be primary or secondary

(2) Subinvolution

(3) Uterine sepsis

(4) Polyp formation.

TREATMENT: Whenever the diagnosis of missing lobe is made, exploration of the uterus and removal

of the lobe under general anesthesia is to be done.


Two types are described: (1) Circumvallate placenta (2) Placenta marginata

DEVELOPMENT: The placenta of such type is due to the smaller chorionic plate than the basal plate. Recurrent marginal hemorrhage as diagnosed on serial ultrasound is thought to be the cause. The chorionic plate does not extend to the placental margin. The membranes (amnion and chorion) are folded, rolled back upon itself to form a ring which is reflected centrally. This leaves a rim of bare placental tissue.

MORPHOLOGY: Circumvallate placenta - (1) The fetal surface is divided into a central

depressed zone surrounded by a thickened white ring which is usually complete. The ring is situated at varying distances from the margin of the placenta. The ring is composed of a double fold of amnion and chorion with degenerated decidua (vera) and fibrin in between

(2) Vessels radiate from the cord insertion as far as the ring and then disappear from view

(3) The peripheral zone outside the ring is thicker and the edge is elevated and rounded.

Placenta marinate - A thin fibrous ring is present at the margin of the chorionic plate where the fetal vessels appear to terminate.

Clinical significance: There is increased chance of:

(1) Abortion

(2) Hydrorrhea gravidarum (excessive watery vaginal discharge)

(3) Antepartum hemorrhage.

(4) Growth retardation of the baby.

(5) Preterm delivery.

(6) Retained placenta or membranes.

PLACENTA MEMBRANECEA: The placenta is unduly large and thin. The placenta not only develops

from the chorion frondosum but also from the chorion laeve so that the whole of the ovum is practically covered by the placenta.

CLINICAL SIGNIFICANCE: (1) Encroachment of some part over the lower segment leads to placenta previa.

(2) Imperfect separation in the third stage leads to postpartum hemorrhage.

(3) Chance of retained placenta is more and manual removal becomes difficult.


There are many Homoeopathic remedies which can manage such conditions very effectively.

The medicines are:-

  • Belladonna
  • Caulophyllum
  • Cantharis
  • Cimicifuga
  • Pulsatilla
  • Secale
  • Sepia