Management of a rare case of placenta trophotropism

There are a number of variations of placental shape or implantation. Multilobed placentas are thought to arise due to implantation in areas of decreased uterine perfusion. An example is lateral implantation in between the anterior and posterior walls of the uterus. Other local factors leading to multilobation are implantation over leiomyomas, in areas of previous surgery, in the cornu, or over the cervical os. After implantation, there is preferential growth in areas of superior perfusion and atrophy in areas of poor perfusion. This is called trophotropism. We describe a singular case of uterine synechia, where is layed the succenturiate lobe from the anterior to the posterior wall, obstacles fetal head descent in the pelvis. Due of that synechia, a caesarean section is necessary for fetal trasverse situation with reverse breech extraction.