What to do if the placenta is low. What to do with a low location of the placenta - treatment of pathology and preventive measures. The most common diagnoses during pregnancy

24.04.2019

The placenta supplies the baby with oxygen, vitamins and trace elements, and cleans the amniotic fluid from waste products. Its formation begins as early as 10-12 weeks of gestation, but attachment to the uterine membrane occurs much earlier, at the chorionic stage. Low placentation during pregnancy occurs due to the placement of the placenta in the lower region of the uterus, which threatens a number of complications both during gestation and at the time of childbirth.

The transformation of the chorion into the placenta lasts up to 16-17 weeks. However, the growth of an organ important for the baby continues in parallel with the development of the baby - up to 36 weeks. The low location of the placenta can shift upward by the time of childbirth, then the risk of negative consequences will decrease. But if the displacement of the placenta occurs towards the internal uterine pharynx, will be less than 5-6 cm from it, or partially or completely block the lumen, this will already be called low placenta previa. Then the danger will increase.

Is low placentation dangerous for the expectant mother and baby

Placental attachment is determined at the beginning of pregnancy. If a low location of the placenta was diagnosed, and by 24, 25 or 26 weeks it has not moved, complications may arise in the mother and baby. The danger is associated with an increase in fetal weight by the 2nd trimester, which causes pressure on the embryonic organ. It sinks even lower, the risk of occlusion of the cervical canal increases.

This can lead to the following consequences:

frequent bleeding will cause anemia in the pregnant woman;
a low hemoglobin content in the mother's blood will lead to hemorrhagic shock, which entails a threat to the health and life of the baby;
when the vessels are squeezed, blood flow deteriorates, which threatens with hypoxia and delayed development of the baby;
insufficient space for the fetus in the uterus leads to an incorrect presentation of the baby;
detachment of the embryonic organ leads to impaired blood circulation in the fetus;
premature detachment will cause premature labor;
a low-located placental organ prevents the baby's head from dropping into the small pelvis, which will lead to difficulty in natural childbirth;
during contractions, the embryonic organ is able to displace and block the birth canal, which will make natural childbirth impossible (an urgent cesarean section will have to be performed);
if a cesarean section is necessary, low placentation along the anterior wall of the uterus complicates the operation and leads to large blood loss.

If a pregnant woman in the third trimester has frequent and heavy bleeding, or there is a danger of fetal hypoxia, the mother is left in the hospital under the round-the-clock supervision of a doctor until the onset of labor.

If it is impossible to bear the child for the prescribed period (40 weeks), they try to keep the pregnancy up to 37 weeks. Then a cesarean section is prescribed, since natural delivery in such a situation is not recommended. In case of urgent need, the operation is performed earlier.

Symptoms of the disease

It was noticed that low placentation was recorded in 15% of women aged 30–35 years.

The reasons may be different, but the main ones are:

damage to the mucous membrane of the uterine wall - formations of a different nature, trauma;
physiological features - bending of the uterus, poorly developed genitals;
inflammatory processes - endometriosis, salpingitis, ICD and others;
mechanical damage to the walls of the uterus in the past - abortion, difficult childbirth, curettage, surgery;
hormonal imbalance - irregular or heavy periods;
diseases of internal organs - cardiovascular, liver, genitourinary system.

When the baby seat is not attached very close to the uterine pharynx, no external symptoms of pathology are observed. It is possible to detect a threat only at 12-13 weeks by means of an ultrasound scan.

The lower this organ is located to the exit from the uterus, the stronger the signs of low presentation or placentation will appear:

pain in the lower abdomen, having a pulling character;
slight spotting after intense physical exertion;
pain in the lower back and lower abdomen with detachment.

In addition to the above symptoms, 20% of pregnant women with low placentation have:

headache or dizziness;
low pressure;
nausea and vomiting;
swelling.

The sooner a feature is diagnosed, the lower the risk of developing dangerous pathologies. Therefore, at an early stage, you should definitely visit a gynecologist. Low placentation early in pregnancy is diagnosed in 80% of women. But after 30 weeks, the majority of the embryonic organ rises.

Gynecological examination for women with low placentation is categorically contraindicated.

How does this condition affect pregnancy?

Often the baby's seat is attached to the back of the uterus. Its attachment to the bottom (above) is considered the norm. But sometimes it is attached to the front wall. If its location is very low, less than 6 cm from the edge of the exit from the uterus, it is fraught with consequences. After 23–27 weeks, the child begins to move, and after 31 weeks, the movements become more active. During this period, it can damage the placental organ or the umbilical cord, especially with breech presentation.

The second disadvantage of this feature is poor blood supply to the lower part of the uterus, which threatens the fetus with a lack of oxygen.

If at 18 - 19 weeks, low placentation is recorded along the posterior wall, then the placental organ by the end of the term in most cases migrates higher. And with the front attachment, everything can be the other way around, since the migration is directed in the opposite direction.

Another danger is the extrachorial type of placentation, where the placenta is displaced to the center, creating a kind of shelf. This arrangement requires close monitoring of the pregnant woman throughout the entire period of bearing the baby.

What not to do with low placentation

Certain features of pregnancy make a woman take a closer look at her health. In order not to aggravate the circumstances, and not to lead to an even greater omission, it is necessary to follow the doctor's recommendations.

With this diagnosis, the following are contraindicated:

sharp movements;
excessive physical activity;
vaginal procedures;
lifting weights;
stress and overwork.

It is not recommended to sit cross-legged as this position interferes with normal blood circulation. You also need to lie down and get up carefully, without jerking. Even coughing and sneezing can trigger bleeding. Riding on public transport is also not advisable, especially during rush hour.

Sex with low placentation is possible only in the absence of obvious symptoms and contraindications - detachment of the placental organ, pain, bleeding.

When having sex with a partner, it is important to follow basic precautions:

Compliance with hygiene. Be sure to visit the bathroom before starting intimacy;
No sudden movements. Strong shocks can be harmful, therefore friction must be done gently, the penetration is shallow.
Positioning. The pressure on the uterus will be less if the woman is lying on her side.

With the threat of termination of pregnancy or low placental presentation, sexual intercourse is contraindicated. During this period, even masturbation and anal sex can cause serious complications due to the contraction of the uterus during orgasm, which will lead to detachment of the placenta. Therefore, you also need to masturbate with caution, if there are no prerequisites for pathology.

What are the methods of treatment

This disease is not treated with medication. According to statistics, 8-9 out of 10 cases, the placental organ independently takes the correct position, since the uterus is growing. Therefore, a diagnosis made at 20-22 weeks or 32 weeks of pregnancy should not be considered critical. Until 33–36 weeks, the position of the placenta changes, which means that there is a possibility of complete disappearance of the pathology.

In order not to aggravate the process, carry the baby and give birth naturally, you need to listen and follow all the doctor's orders. Throughout pregnancy, with a low location of the placenta, it is important to be observed by a specialist and regularly do ultrasound. Three times an ultrasound examination, this is the norm - the first at 15-17 weeks, the second at 21-24 and the last at 34-36 weeks.

Starting from 28-29 weeks of pregnancy, with a strong development of pathology, a number of drugs are prescribed to maintain pregnancy until the required period:

Papaverine and Ginipral contribute to an increase in the elasticity of the muscles of the walls of the uterus, an increase in tone and the removal of spasmodic impulses.
Increases hemoglobin Ferlatum, Hemofer, Aktiferin.
Strengthens blood circulation, improves the nutrition of the placental tissue Curantil, folic acid and vitamins E and Magne B6.
Increases the level of progesterone - Utrozhestan.

In some cases, if there is a risk of placental detachment, the doctor advises placing a pessary.

With bleeding and severe pain, you must quickly call for medical attention. At this time, nothing can be done, it is better to just lie down until the ambulance arrives.

Features of childbirth

If, before the onset of labor, the woman in labor underwent a complete examination and monitoring of the course of pregnancy, natural delivery in most cases will go well.

But the course of labor is influenced by several factors:

the place of attachment of the placenta;
the nature of the course of pregnancy;
the occurrence of complications during the gestation period;
concomitant pathologies.

If the placental membrane does not overlap the uterine pharynx, the obstetrician punctures the amniotic fluid. As a result, the baby presses the placenta against the uterine wall with its head, preventing it from exfoliating.

Caesarean section is preferable in case of placental presentation or abnormal fetal position - bottom down.

Preventive measures

For prevention purposes, special attention should be paid to the nutrition of the mother. Increase the amount of vitamins and minerals entering the body that have a beneficial effect on pregnancy. Calcium, magnesium and iron are especially beneficial.

Relax more and walk in the fresh air. When resting, it is recommended to place your legs slightly higher, placing a pillow or roller. This will activate blood circulation in the placenta, which will facilitate its movement upward.

Excitement, overexertion and stressful situations are bad for the position. It is worth remembering that even with such symptoms, women can carry and give birth on their own, without surgery, as evidenced by numerous reviews on the Internet. You just need to follow all safety rules and listen to the observing doctor.

You can do special exercises for pregnant women or go to the pool. But these questions should be discussed with the gynecologist. Exercise with low placentation should be light, without sudden movements. Lifting weights and running are prohibited.

It is better not to have sex games during this period. The placenta is located only 30-40 mm from the edge of the cervix, and rhythmic tremors can provoke its movement closer to the edge.

Is it possible to wear a bandage with low placentation, the attending physician will answer. Different types of placentation require different treatment and prevention.

Conclusion

Having read in more detail what low placentation means and how it manifests itself, we can safely judge that it does not pose a particular danger if the pregnant woman is under the strict supervision of a doctor throughout the entire period of bearing the baby. However, there may be complications if the recommendations are not followed. Then you must immediately consult a doctor.

The placenta is one of several temporary organs that develop in a woman's body during pregnancy. The importance of the placenta in the development of the fetus is difficult to overestimate: it is an intermediary between the child and his mother, transfers nutrients and oxygen from the mother's blood to the baby, removes toxins and waste products of the fetus, filters the mother's blood from harmful substances and infections, thereby protecting the baby, whose immunity is not yet able to withstand the effects of the external environment.

Given all this, it is easy to understand why doctors closely monitor the condition of the placenta, its location, and so on.

The placenta is formed only by the 4th month of pregnancy. Prior to that, its functions were distributed between other temporary organs: the fetal membrane and the corpus luteum, formed at the site of the bursting follicle. For the development of the baby, it is very important that the placenta is formed correctly, and even its location is of great importance for the correct course of pregnancy.

What are the features of the location of the placenta, and how does it affect the course of pregnancy?

The most ideal option for placing the placenta in the uterine cavity is to attach it along the back wall in the upper part of the uterus, closer to the bottom. The fact is that the walls of the uterus are designed in such a way that as the fetus grows, they stretch very much. However, they do not stretch evenly.

The uterus is designed in such a way that stretching occurs mostly along front wall... It becomes thinner and more extensible, while the back wall remains tight and is much less prone to stretching.

That is why nature laid down the attachment of the ovum to the back wall, because the placenta, unlike muscle tissue, does not have the ability to stretch. Thus, the placenta attached to the posterior wall experiences significantly less stress, which is not at all good for it.

So it turns out that the back wall is an ideal option for the attachment of the fetus, and then the development of the placenta.

Placenta location options

For various reasons, the ovum can attach not only to the upper part of the back wall of the uterus, but also to its other parts. Side attachment is quite common: to the right or to the left of the back wall. In some, also very common cases, the placenta is fixed on the anterior wall of the uterus.

All these options for the location of the placenta are not considered a pathology, although in such cases there is a deviation from the ideal, nature-intended location. Women with a lateral placenta, as well as with a placenta attached to the anterior wall, most often, without complications, carry and give birth to children naturally. Of course, among them there are also those who are faced with various pathologies, but, as a rule, they have other reasons for complications.

Of course, placenta located on the anterior wall undergoes somewhat heavy loads due to constant stretching of the walls of the uterus, fetal movements, and actions of the mother. To some extent, this increases the risk of damage to the placenta, premature detachment, and so on. The direction of migration of the placenta may also change.

Due to the constant stretching of the muscles of the uterus, the placenta can gradually sink too close to the pharynx of the uterus, and sometimes even block the exit from the uterus into the birth canal. If 6 centimeters or less remains between the edge of the placenta and the cervical pharynx, they say, if the placenta partially or completely blocks the exit from the uterus, this pathology is called placenta previa.

However, low placentation and placenta previa can be caused by a number of other reasons, which will be discussed later. Back presentation occurs much less frequently than on the front wall. We have already discussed above why this is happening.

Causes of the anterior placenta previa

What are the reasons for placenta previa along the anterior wall? Unfortunately, these reasons are not fully understood. However, some of them have already been established reliably. In particular, these include various endometrial damage- the inner layer of the uterus. These can be inflammatory processes, scars from operations, for example, a cesarean section, the consequences of curettage after miscarriages or abortions.

Myoma of the uterus, as well as its other pathologies can cause placenta previa along the anterior wall. It is noticed that in women giving birth for the first time, this pathology occurs much less frequently than during the second and subsequent pregnancies. This is most likely due to the condition of the uterine mucous membrane.

However, not only from the mother's side, reasons for this pathology may arise. In some cases, they are hidden in developmental lag fetal egg. Because of this lag, the fertilized egg does not have time to implant in the endometrium. In this case, implantation takes place in the lower part of the uterus.

It also happens that the ovum attaches to the anterior wall in the upper part of the uterus, however, as a result, the placenta migrates as a result of stretching of the uterus to the lower part.

Anterior presentation

Distinguish between full and partial presentation. It is not hard to understand that full presentation a situation is called when the placenta completely overlaps the cervical pharynx.

Partial presentation also divided into 2 different types: lateral and marginal. Marginal - when the placenta passes along the very edge of the pharynx of the uterus. Lateral presentation is when the placenta still blocks the exit from the uterus, although not completely.

Symptoms of the anterior presentation and how dangerous it is

Unfortunately, very often the anterior placenta previa proceeds completely asymptomatic... Of course, this does not mean that it will be impossible to diagnose the pathology. We will talk about how to define the problem later. The main thing in the absence of symptoms is that it is not always possible to diagnose presentation on time.

In some cases, placenta previa makes itself felt bleeding... This means that it has arisen. Actually, this is precisely the main danger of presentation, although not the only one.

As you remember, the placenta supplies the fetus with nutrients and oxygen. When the placenta is located low, and even more so it blocks the exit from the uterus, it turns out that the child presses on it with all his weight. It can pinch blood vessels in the placenta. This, in turn, can cause oxygen starvation - hypoxia.

As the fetus grows, the pressure on the placenta increases, in addition, the child's movements become more active, he touches the placenta. As a result, premature placental abruption... In this case, the consequences can be dire not only for the child, but also for the mother. Especially if she has problems with blood clotting.

Bleeding during presentation can occur already in the second trimester, immediately after the end of the formation of the placenta. However, most often it occurs at a later date, sometimes just before childbirth, or even during childbirth.

Therefore, if a symptom of placenta previa becomes vaginal bleeding, it is necessary to urgently consult a doctor in order to establish the cause and begin treatment.

Separately, it is worth talking about childbirth with presentation. Full presentation, a condition where the placenta blocks the exit from the uterus, completely excludes the possibility of natural childbirth.

The placental tissue simply will not release the fetus into the birth canal. But in the case of partial presentation, natural childbirth, in principle, is possible. The main thing is that doctors taking part in childbirth closely monitor the woman in labor. In case of bleeding, it still makes sense to carry out an emergency caesarean section.

Diagnostics of the anterior presentation

There are several ways to diagnose placenta previa. Including at gynecological examination... Full and partial presentation by palpation is felt in different ways. With full presentation, it is felt to the touch that the pharynx of the uterus is completely blocked by the placenta.

With partial presentation, both placental tissue and fetal membranes are felt. By the way, on examination, the lateral and marginal presentation are perceived in the same way. So the gynecologist will not be able to determine what type of partial presentation is in question without additional devices.

If a woman was initially diagnosed with low placentation, for example, during the first scheduled ultrasound, then subsequently she will be regularly examined, including with the help of ultrasound. Then, in the case of migration of the placenta and the development of presentation, this will be revealed in a timely manner during the next study. Ultrasound will show the presence of pathology even if it is asymptomatic. That is why women are advised to attend all routine examinations and ultrasound examinations.

Treatment of women with anterior presentation

Unfortunately, modern medicine is not able to influence the location of the placenta. Treatment of placenta previa is reduced to constant medical supervision and timely examinations. In this case, they monitor not only the condition of the fetus and placenta, but also the pregnant woman. Blood tests are required on a regular basis. The hemoglobin level and blood clotting ability are checked. The fact is that anemia or acute blood clotting can play a bad joke with the expectant mother in case of bleeding.

If, for a period of more than 24 weeks, a woman diagnosed with anterior placenta previa has vaginal bleeding, regardless of how severe it is, the woman is hospitalized. Moreover, be sure to go to the hospital where there is a special intensive care unit. In case of extensive blood loss. The main and first appointment for all women with bleeding during pregnancy is absolute rest.

Regardless of how quickly it is possible to stop the bleeding, the pregnant woman remains in the hospital until the onset of labor. The woman must be constantly examined. In addition, few women take the recommendation of resting seriously. Well, is it a violation of the regime to cook dinner for your husband? Violation, like running with a broom or mop. In the hospital, the doctors will monitor the observance of bed rest especially.

Further treatment is prescribed depending on the condition of the fetus, woman, severity of bleeding, and so on. If the fetus is premature and the mother feels okay and the bleeding is not severe, they will be applied every effort to maintain pregnancy... If a threat to the mother's life is identified, then the pregnancy will be terminated.

However, such cases are extremely rare. Usually it is possible to prolong the pregnancy at least until the time when the baby's life can be saved. Of course, this is also not the best option, but premature babies, as a rule, grow up completely normal. More often than not, women carry the child to an acceptable time.

We hope you now know what placenta previa is. Finally, I still wanted to say that, in general, it does not matter at all to which wall the placenta is attached: to the back or front. This circumstance hardly in any way facilitates or complicates the situation. However, during the examination, it is still customary to indicate to which wall of the uterus the placenta is attached. In the end, a woman can use this information.

So, if you have an anterior presentation, you know for sure that it is especially important for you to take care of your stomach, and it makes sense to minimize even light effects on it. So, you should not allow everyone to touch the belly. Especially in the later stages, as this can cause training contractions. Sharp contractions of the muscles in the uterus can cause detachment and bleeding.

Replies

The placenta is the most important link between the mother's body and the fetus developing inside it. The placenta begins to form almost immediately after the embryo is attached to the inner wall of the female uterus. During pregnancy, through the placenta, the fetus is supplied with oxygen and essential nutrients, and it is also protected from all sorts of negative external influences. In most cases, the placenta is located at the fundus of the uterus - in this part of the organ, the most suitable conditions are created to ensure normal placental blood flow.

However, in some cases (about 15-20% of the total), patients have pathologies in the development of the placenta. So, if a fertilized egg is fixed in the area of the lower part of the female uterus, in the process of further formation of the placenta, the latter can block the baby's birth canal. In such a situation - if the distance between the lower edge of the placenta and the pharynx of the uterus is less than 5-6 cm - we are talking about low placentation, often diagnosed at the 21st week of the term.

Next, you are invited to familiarize yourself with the basic information about the pathology in question, the reasons for its appearance, recommendations for behavior when diagnosing a low placenta and the characteristics of delivery in patients with a similar deviation.

It is known that after fertilization of a female egg with a male sperm, a fertilized egg is formed. To successfully transform into a full-fledged person, he needs to find a suitable place for implantation in the internal cavity of the mother's uterus. Normally, such places are the back wall or the bottom of the organ.

Along with this, under the influence of various kinds of factors, the embryo can be implanted in some other place. This usually happens when the embryo simply does not have time to get to its destination.

As noted, low placentation comes into play if the placenta is 5-6 cm below the internal pharynx. Increasing in size, a low-lying placenta can simply block the birth canal, which prevents natural delivery.

However, during pregnancy, the situation often changes for the better. As the child grows, the uterus also increases in size, as a result of which the placenta attachment also rises, and the threat to the fetus decreases.

Under any circumstances, when diagnosing low placentation, a woman should be under qualified medical supervision, because This pathology in rare cases leads to the occurrence of some complications, for example, placental abruption, fetal hypoxia, etc.

In accordance with the average statistical data, in multiparous women, low placentation is observed more often than in patients with the first pregnancy. For the timely detection of pathology and taking measures to improve the condition of the woman and the fetus, the pregnant woman should regularly undergo an ultrasound scan. The specific frequency of research will be determined by the doctor. Typically, they are done between 12-16, 22-25, and 32-34 weeks.

The main reasons for the development of the deviation

To date, there is no consensus among doctors about the reasons for the development of low placentation. In general, a variety of factors can lead to the onset of pathology, including:

diseases of the cardiovascular system;
diseases of an infectious and inflammatory nature;
pathology of the uterus (fibroids, underdevelopment);
previously transferred artificial termination of pregnancy;
multiple pregnancy;
pathology of the endometrial mucosa (often occurs after an incorrectly performed cesarean section, when an infection enters the uterus).

Patients with low placentation should adhere to the following recommendations:

Important! Throughout pregnancy, women need to be more careful about their vaginal discharge. If there is blood in these, you should definitely consult a doctor, because this could be a sign of low placentation.

Considering the dangers of this pathology, it should be noted that due to the insufficient number of vessels in the lower part of the uterus, the fetus begins to receive less oxygen and the nutrients it needs.

As the child grows and its activity increases, due to the low location of the placenta, the pressure on it begins to increase, which can lead to bleeding or even detachment.

The small distance between the placenta and the pharynx can provoke partial or even complete overlap of the latter, which in some cases is fraught with miscarriage.

Currently, there are no 100% effective medications that can solve the problem of low placentation. Previously, there were recommendations on behavior for women with a similar problem. Some of them deserve more detailed consideration.

So, many patients are interested in why, when a low placentation is found, it is necessary to refrain from physical activity and sexual intercourse. Everything is extremely simple: under the influence of strong loads on the body, bleeding may occur. For the same reason, women are advised to avoid any sudden movements, minimize the use of public transport and even go to bed with extreme care, smoothly and slowly.

In general, patients with diagnosed low placentation are strongly advised to adhere to bed rest and sometimes tocolytics are prescribed - drugs that help reduce tone.

Drugs that doctors often prescribe for low placentation (table). Attention! Before use, a specialist consultation is required!

	pharmachologic effect	Indication for use	Release form	Price
Curantil	Myotropic vasodilator. Has an inhibitory effect on platelet aggregation, improves microcirculation.	- prevention and treatment of ischemic heart disease (acute myocardial infarction or condition after myocardial infarction, stable angina pectoris); - prevention of thrombosis after valve replacement surgery; - treatment and prevention of placental insufficiency resulting from impaired placental circulation; - treatment of endarteritis (intermittent claudication); - treatment and prevention of circulatory disorders of the vessels of the brain (HNMK, ischemic cerebrovascular accident, discirculatory encephalopathy); - treatment of vascular insufficiency and microcirculation disorders.	Coated tablets from yellow to greenish-yellow color, round in shape with a smooth uniform surface.	181 r
Actovegin	Actovegin has a pronounced antihypoxic effect, stimulates the activity of enzymes of oxidative phosphorylation, increases the exchange of energy-rich phosphates, accelerates the breakdown of lactate and beta-hydroxybutyrate; normalizes pH, enhances blood circulation, intensifies energy-intensive processes of regeneration and repair, improves tissue trophism.	Tablets Complex therapy of metabolic and vascular disorders of the brain (various forms of cerebral circulation insufficiency, dementia, TBI); peripheral (arterial and venous) vascular disorders and their consequences (angiopathy, trophic ulcers); diabetic polyneuropathy.	Solution for infusion: clear, colorless to slightly yellow solution. Solution for injection: clear, yellowish, practically free of particles. Tablets.	about 515 rubles
Magne-B6	Magne B6 is a magnesium preparation. Magnesium is a vital element that is found in all tissues of the body and is necessary for the normal functioning of cells, participates in most metabolic reactions. In particular, it is involved in the regulation of the transmission of nerve impulses and in muscle contraction. The body gets magnesium from food. A lack of magnesium in the body can be observed when the diet is disturbed (including when observing reduction diets) or when the need for magnesium increases (with increased physical and mental stress, stress, pregnancy, use of diuretics).	Established magnesium deficiency, isolated or associated with other deficiency conditions, accompanied by symptoms such as: - Increased irritability. - Minor sleep disturbances. - Gastrointestinal cramps. - Cardiopalmus. - Increased fatigue. - Pain and muscle spasms. - Tingling sensation in the muscles. If after a month of treatment there is no improvement in these symptoms, continued treatment is impractical.	Magne B6 tablets. Magne B6 oral solution. Magne B6 forte tablets.	447 - 631 rubles.
Gynipral	In connection with the influence on the 6a2-adrenergic receptors of the uterus, it has a tocolytic (relaxing the muscles of the uterus) effect. Corresponds to the drug hexoprenaline.	It is used as a tocolytic agent with the threat of premature birth (in the third trimester of pregnancy), with acute intrauterine fetal asphyxia (impaired blood supply to the fetus), during childbirth (with discoordinated labor - improper contractions of the uterus during childbirth), to suppress uterine contractions before surgery intervention (incision of the cervix, cesarean section)	In ampoules containing 0.025 mg or 0.01 mg each; tablets of 0.5 mg.	From 175,00 rub. up to RUB 267.00
Isoxuprine (Isoxsuprine)	It has a tocolytic (relaxing the muscles of the uterus) effect by stimulating beta-adrenergic receptors. Reduces the tone of the smooth muscles of the blood vessels of skeletal muscles, eliminates spasm (sharp narrowing of the lumen) of the vessels, increases the blood supply to tissues	Threat of premature birth, obliterating endarteritis (inflammation of the inner lining of the arteries of the extremities with a decrease in their lumen), Raynaud's disease (narrowing of the lumen of the vessels of the extremities), spasm of peripheral vessels	Tablets of 0.02 g of isoxsuprine hydrochloride in a package of 50 pieces; solution for injection (in 1 ml 5 mg of isoxsuprine hydrochloride) in 2 ml ampoules in a package of 6 pieces	-

Low placenta and labor

The order of delivery is determined by the individual characteristics of a particular situation. In about 90% of cases, the location of the placenta normalizes by itself and, in the absence of various kinds of obstetric pathologies and the patient's normal well-being, the child is born in a natural way. During childbirth, specialists constantly monitor the woman's well-being, the amount of blood lost, pulse, pressure, fetal condition and other significant parameters.

If the placenta is located more than 6 cm from the cervix, no complications should arise. With a smaller distance, the fetal bladder, as a rule, is opened by a specialist beforehand. The doctor presses the placenta with the baby's head, which prevents the first from exfoliating.

If by the end of the term the distance between the placenta and the internal pharynx is less than 2 cm, delivery is usually carried out by caesarean section. Also, this procedure is resorted to in case of heavy bleeding or other complications.

Thus, low placentation, although it is a rather serious pathology, with constant and qualified monitoring by specialists and adherence to the recommendations of the pregnant woman, childbirth usually takes place without significant complications and a healthy baby is born.

Respond in a timely manner to adverse changes in your condition, follow medical recommendations and be healthy!

Video - Low placentation during pregnancy 21 weeks

Continuing to talk about everything that is associated with the development of a unique embryonic organ - the placenta, one should separately talk about the location of the placenta during pregnancy, since this issue is of interest to many women. Is it important where it is located, and can this or that location somehow affect the fetus?

The uterus resembles an inverted vessel, so its bottom is located not from below, but from above. The placenta is a flat disc with two surfaces: one facing the fetus (the umbilical cord is located in its center), and the second - the maternal one - is attached to the uterus. Speaking about the location of the placenta, doctors mean precisely its maternal surface.

In most cases, the placenta attaches to the anterior or posterior wall of the uterus, passing to one of its lateral walls. The most favorable conditions are considered when the placenta is located on the back wall of the uterus closer to its bottom: this provides the best blood supply.

It is impossible to predict or calculate in advance what the location of the placenta will be - it only depends on where the fertilized egg will attach to the wall of the uterus. And this mechanism has so far remained unclear. However, usually the ovum does not attach to a surface with unfavorable conditions (for example, in places of damage to the endometrium).

When the placenta is located along the back wall, then, as we have already said, this ensures the best possible blood supply to it. In addition, this area is less prone to stretching. During movement, the fetus is less likely to touch and damage the placenta, provoking its detachment. Finally, the risks of placenta previa and its accretion are significantly reduced. This is also true for women after a cesarean section.

If the placenta is located on the anterior wall of the uterus

By itself, this location is not dangerous for your unborn baby. Most likely, you will notice movements at a slightly later date - after all, the placenta serves as a kind of buffer, and can extinguish still very weak tremors. Such an arrangement of the placenta during pregnancy will cause some inconvenience to obstetricians.- it will be more difficult for them to palpate the uterus and listen to the fetal heartbeat.

However, the risks of injury and subsequent placental abruption increase - in the case of active fetal movements, bruises and abdominal strokes. If a woman has a history of a cesarean section or surgery associated with curettage of the uterine cavity, the risk of placental accreta increases. Finally, the most unfavorable option is the low location of the placenta - in this case, there is a high probability that over time it will block the internal pharynx and vaginal delivery will become impossible. A cesarean section will be required.

It is possible to talk about the location of the placenta along the anterior or posterior wall already in the early stages, but doctors will determine its exact localization in relation to the height of its attachment only in the third trimester. Until that time, even if the placenta is low, chances are that as it grows and develops, it will rise up and free the area of the internal os of the cervix. Control ultrasound is recommended at 36 weeks of pregnancy. Placenta previa is a rather serious pathology, and can cause bleeding at any stage of pregnancy.

There are different views of doctors on the location of the placenta, and they are often very contradictory.... Some studies, for example, have found a link between the birth of large fetuses and the localization of the embryonic organ on the back of the uterus. Conversely, other researchers suggest that posterior wall placement is associated with intrauterine growth retardation. Finally, there are opinions that the optimal conditions for the development of the fetus are created by the placenta attached to the bottom of the uterus.

One way or another, a woman is not able to change the location of the placenta, so you just need to follow the recommendations of doctors if they have identified this or that deviation.

- This is a fairly common pathology in women with a gestational age of up to 30 weeks. Moreover, it occurs more often in women over 30-35 years old who have previously had a pregnancy. Where does this pattern come from and what can be dangerous about low placentation along the back wall and front, as well as full presentation of the child's place?

Where exactly in the uterus should the baby's place be located? On one of its walls or in the bottom, but not in the area of the internal pharynx (exit to the uterus of its cervix). If the baby's place is located directly on the internal pharynx, doctors diagnose -. While maintaining the diagnosis until the 36th week of gestation, doctors not only hospitalize the woman early in the hospital, but also perform a cesarean section for her in a planned manner. If the baby's place is just close to the lower part of the uterus, doctors make a slightly different diagnosis - low placentation during pregnancy, and this alignment is usually less dangerous. In this case, the baby seat is located at a distance of no more than 6 cm from the internal pharynx.

What it is

So, the placenta or "baby's place" is the main protection of the unborn baby during intrauterine life. It is a thickened membrane and forms in the wall of the uterus immediately after fertilization and attachment of the egg.

It is with its help that the unborn child receives nutrition, oxygen and protection from the penetration of various toxins and possible infections from the mother's body throughout your pregnancy.

An important point is the location of the placenta:

less than 6 cm (in practice 2 cm) from the internal os of the uterus - low placentation;
more than 6 cm from the exit (internal os) of the uterus - the normal position of the placenta.

Where does this data come from? The fact is that, according to studies, near the bottom of the uterus, blood flow most favorably affects the formation and blood supply of the placenta. And it is precisely the distance of more than 6 cm of the uterine pharynx that is considered optimal.

With a low attachment of the placenta, there are already some problems with the course of pregnancy. We will definitely consider with you how the low placenta affects the expectant mother and pregnancy.

In the meantime, let's find out why this happened, and what could have affected the attachment of the placenta? The reasons for this phenomenon can be both the anatomical features of the woman, and the transferred diseases of the genital area: infections, inflammation, abortion.

What is dangerous

Low placenta during pregnancy. Such a diagnosis, unfortunately, appears in a large number of medical records of pregnant women. And what is it and how dangerous is this state of affairs?

To begin with, normally the placenta should be attached closer to the bottom of the uterus, because it is here that the metabolism proceeds at maximum speed, which means that the blood flow will go at maximum speed, which is very good for the fetus. However, sometimes the placenta attaches below the bottom. And if the place of attachment is lower than six centimeters from the internal pharynx, then this is the low placenta.

In this case, one question is of fundamental importance - whether the placenta overlaps the pharynx of the uterus. After all, it is on the answer to this question that the decision depends on whether the birth will take place naturally or whether a cesarean section will be necessary.

There are three options:

The low-lying placenta does not overlap the internal pharynx;
The placenta partially overlaps the pharynx. This is called incomplete placenta previa;
The placenta completely overlaps the pharynx. This position is called placenta previa.

If you are diagnosed with the third option, then only in this case, a cesarean section cannot be avoided. The first two options are not an indication for a cesarean section, and you may well be able to give birth to a baby naturally.

In the case of placenta previa, the uterine pharynx is completely closed and this will prevent the baby from entering the small pelvis. And in case of childbirth, it takes place in full readiness for surgery if necessary. If the low placenta during pregnancy does not overlap the pharynx, then such a woman needs to remember that early placental abruption is possible and she needs to carefully monitor her health and follow all the recommendations of the attending physician.

Why is there an incorrect attachment of the placenta? Normally, a fertilized egg penetrates the wall of the uterus, creates a depression in it - a lacuna. It is through the lacuna that all the substances it needs begin to flow to the egg. Over time, the lacuna becomes the placenta. The best place for an egg to attach is the back wall of the uterus and its fundus. And it is there that the fertilized egg is normally located.

But if the walls of the uterus have any defects, then the egg cannot attach in the right place and is positioned below. Defects can be different. For example, such as:

Scars after surgical delivery;
Post-abortion scars;
Myomatous nodes;
Adenomyosis formations;
Congenital anatomical defects.

The low location of the placenta is dangerous because the nutrition of the fetus can be disrupted. Therefore, those pregnant women who have low placentation are likely to develop fetal malnutrition and hypoxia. And there may also be early placental abruption.

Placental abruption is not always complete when there is a lot of bleeding and the fetus dies. Sometimes the detachment may be partial. And in the place where this happened, blood begins to accumulate and a hematoma forms. The larger the area where the placenta has exfoliated, the worse the little man feels.

Not all pregnant women have a low placenta position until the end of pregnancy. Placental migration is common. This is because the lower part of the uterus is constantly changing and increasing in size. Therefore, the placenta attachment site rises.

Statistics say that only five percent of pregnant women who have been diagnosed with low placentation, this situation persists until the thirty-second week. Of the remaining five percent, only a third retains a low placentation for up to thirty-seven weeks.

Modern medicine does not know how to deal with the low location of the placenta. However, you need to see your doctor regularly and hope you don't fall into the unhappy five percent.

Causes

Experts name several reasons why the placenta in a pregnant woman may be low. One of them lies in the anatomical features of the organs of the female reproductive system. This can be facilitated by both congenital pathologies (physiological abnormalities) and those acquired as a result of exposure to negative factors. Low placentation may be a consequence of past inflammatory processes, genital infections and vascular diseases of the pelvic organs, or surgical interventions in the area of gynecological organs. Pregnant women of advanced age also fall into the risk group for the formation of low placentation.

Placentation occurs most often in women who are not giving birth to their first child. Notice this when conducting ultrasound. The position of the uterus is constantly diagnosed by doctors. In particular, they do an ultrasound scan - at 16, 24-26 and 34-36 weeks, they can also carry out a dynamic echographic study.