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Why is the placenta low? The concept of low placentation during pregnancy: what does it mean and what threatens such an arrangement of the placenta? Symptoms of a low placenta

- a complication of pregnancy, which is characterized by localization children's place in the lower segment of the uterus, closer than 6 cm from its internal pharynx. The danger lies in the fact that the anomaly does not manifest itself in any way. It is possible to determine the low location of the placenta only during ultrasound scanning or with the development of complications - damage, detachment of the organ, accompanied by pathological signs. Treatment is carried out on an outpatient basis, a therapeutic and protective regimen is indicated and drug therapy. In most cases, with a low location of the placenta, delivery is carried out using a caesarean section.

General information

The low location of the placenta is an obstetric anomaly, accompanied by improper attachment of the child's place. With such a pathology, there is a risk of fetal hypoxia due to squeezing of the umbilical cord. Also, the low location of the placenta threatens its premature detachment on later dates pregnancy due to fetal pressure. Women over 30 years of age are most susceptible to low placentation. Upon detection low location placenta prognosis is not always unfavorable. As the uterus increases in volume, there is high probability migration of the child's place and its location in the future on the front or back wall. With this development of events, the pregnancy proceeds normally, and childbirth is possible naturally.

As a rule, a low location of the placenta is detected during ultrasound screening of the first trimester, however, closer to the 20th week, in about 70% of cases, the child's place migrates, and the diagnosis is removed. By the end of pregnancy, this pathology persists only in 5% of patients. If a low location of the placenta is detected in the third trimester, the probability of its displacement is extremely small.

The reasons

Scientists have not yet been able to finally establish the causes of the low location of the placenta. However, based on numerous studies, it has been suggested that the abnormal attachment of the child's place occurs against the background of diffuse hyperplasia of the chorionic villi and marginal death of individual elements of the decidua. Thinning of the myometrium, which has developed as a result of numerous abortions, curettage and other gynecological manipulations, can cause such changes and lead to a low location of the placenta. The risk of obstetric anomalies increases against the background of previous miscarriages, inflammatory and infectious diseases reproductive organs.

The low location of the placenta is often diagnosed after a caesarean section as a result of the formation of a scar on the uterus. FROM more likely pathology develops during multiple pregnancy, if a woman has a history of 3 or more births, against the background of benign diseases, for example, fibroids. Congenital anomalies of the uterus, in particular, a bicornuate or saddle uterus, the presence of partitions in the organ cavity, also increase the possibility of a low location of the placenta. To the group increased risk includes patients who are prone to bad habits subject to stress, performing heavy physical work.

Classification

Symptoms of a low placenta

Clinically, the low location of the placenta in most cases is not manifested. Usually women feel well, and it is possible to detect an abnormal attachment of a child's place during a planned obstetric ultrasound. The low location of the placenta may be accompanied by pathological symptoms, if complications began to develop against its background. With premature detachment, it is possible drawing pains in the abdomen, sacrum, bleeding. It is extremely rare that this diagnosis contributes to the development of late toxicosis. In addition, the low location of the placenta in late gestation can lead to fetal hypoxia. Oxygen deficiency is manifested by a decrease motor activity child with a fast or slow heartbeat.

Diagnosis and treatment

It is possible to identify the low location of the placenta during ultrasound screening of the I, II or III trimester of pregnancy, which are routinely prescribed by an obstetrician-gynecologist to all patients for a period of 12, 20 and 30 weeks, respectively. Determination of abnormal attachment of a child's place on early stages is not critical, since closer to the middle of gestation, it migrates and takes the correct position without risk to the health of the woman or fetus. Ultrasound at a low location shows not only its exact localization, but also the thickness, the level of blood flow in the vessels, and the condition of the fetus. Evaluation of these parameters makes it possible to suspect more serious complications, in particular, hypoxia, entanglement, and incipient detachment.

Treatment for low placenta depends on gestational age, as well as general condition woman and fetus. Detection of an anomaly in the first trimester does not require additional therapy enough to limit physical activity. FROM high probability the child's place migrates as the uterus increases in volume. Hospitalization with a low location of the placenta is indicated with a threat premature detachment, severe fetal hypoxia or closer to childbirth in the period of 35-36 weeks to examine the patient and determine the delivery plan.

The low location of the placenta requires correction of the daily regimen. The patient should rest as much as possible. It is important to completely exclude psycho-emotional and physical stress, sexual contact, since all this can provoke complications in the form of detachment. With a low location of the placenta, you should walk less, refuse to travel to public transport. It is recommended to rest in the supine position, while the leg end should be raised to increase blood flow to the pelvic organs, in particular, to the uterus and placenta.

Drug treatment with a low location of the placenta is not prescribed. At the same time, pregnancy management requires more careful monitoring, most likely, an obstetrician-gynecologist's consultation will be prescribed more often than usual. Correction of the condition of the patient or fetus is carried out only if there is a threat or the development of complications against the background of abnormal attachment. With the onset of placental abruption, the use of drugs that improve blood flow in the vessels of the umbilical cord is indicated, vitamin complexes. If, against the background of a low location of the placenta, uterine hypertonicity is present, tocolytics are used.

With a low location of the placenta, delivery is possible, both through the natural genital tract, and with the help of a caesarean section. The first option is possible when placing a child's place no lower than 5-6 cm from the internal os of the uterus, as well as good condition mother and fetus, sufficient maturity of the cervix and active labor activity. A planned caesarean section is performed when the low location of the placenta is accompanied by the threat of premature detachment, with severe fetal hypoxia.

Forecast and prevention

The vast majority of pregnancies with a low placenta have a favorable outcome. In 70% of patients with this diagnosis, closer to childbirth, the child's place is occupied by correct position along the anterior or posterior wall of the uterus. In other cases timely diagnosis and the appointment of a security regime make it possible to avoid complications, carry the pregnancy up to 38 weeks and give birth absolutely healthy child. In 40% of women with a low location of the placenta, childbirth is carried out by caesarean section. In other cases, children are born through the natural birth canal. Sometimes on the part of the fetus there are signs of intrauterine hypoxia.

Prevention of a low location of the placenta is early diagnosis and treatment of gynecological anomalies that contribute to the thinning of the uterine mucosa. Also, women should avoid abortions, timely register for pregnancy with an obstetrician-gynecologist. The elimination of stress will help reduce the likelihood of developing a low location of the placenta, physical activity after conception. You should also avoid working in hazardous enterprises, refuse bad habits, get plenty of rest and ensure a sufficient supply of nutrients to the body of the expectant mother. A positive effect on the health of women and fetuses is walking on fresh air. Each patient must follow all the recommendations of the obstetrician-gynecologist, take necessary tests and conduct screening studies to detect low placenta as early as possible and start therapy.

The placenta supplies the baby with oxygen, vitamins and trace elements, and cleanses 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 chorion stage. Low placentation during pregnancy occurs due to the placement of the placenta in the lower region of the uterus, which threatens with a number of complications both during the period of 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 important organ for the baby continues in parallel with the development of the baby - up to 36 weeks. The low location of the placenta can shift up by the time of delivery, then the risk negative consequences decrease. But if the displacement of the placenta occurs towards the internal uterine os, is less than 5-6 cm from it, or partially or completely blocks 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

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

This can lead to the following consequences:

  • frequent bleeding will cause anemia in a pregnant woman;
  • a low content of hemoglobin 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, the blood flow worsens, which threatens with hypoxia and a delay in the 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 birth;
  • a low-lying placental organ prevents the baby's head from lowering into the small pelvis, which will lead to difficulty natural childbirth;
  • during contractions, the embryonic organ is able to move and block the birth canal, which will make natural childbirth impossible (you will have to urgently perform a caesarean section);
  • if necessary, caesarean section 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 round-the-clock medical supervision until the onset of childbirth.

When unable to bear a child due date(40 weeks), they try to keep the pregnancy up to 37 weeks. Then a caesarean section is prescribed, since natural delivery in this situation is not recommended. In case of urgent need, the operation is carried out earlier.

Symptoms of the disease

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

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

  • damage to the lining of the uterus different nature, injury;
  • physiological features - bending of the uterus, poorly developed genitals;
  • inflammatory processes - endometriosis, salpingitis, KSD and others;
  • mechanical damage to the walls of the uterus in the past - abortion, difficult childbirth, curettage, surgical operations;
  • hormonal failure - irregular or heavy periods;
  • disease internal organs- cardiovascular, liver, genitourinary system.

When the child's place is attached not very close to the uterine pharynx, no external symptoms pathology is not observed. You can detect a threat only at 12–13 weeks by checking an ultrasound scan.

The lower this organ is located towards the exit from the uterus, the stronger the symptoms will appear. low presentation or placentation:

  • pain in the lower abdomen, having a pulling character;
  • small bloody issues after strong physical exertion;
  • pain in the lower back and lower abdomen during detachment.

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

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

The earlier a feature is diagnosed, the lower the risk of developing dangerous pathologies. Therefore, on early term you should definitely visit a gynecologist. Low placentation at the beginning of pregnancy is diagnosed in 80% of women. But after 30 weeks, for most, the embryonic organ rises.

Gynecological examination for women with low placentation is categorically contraindicated.

How does this condition affect pregnancy?

Often the child's place is attached to the back wall of the uterus. Its attachment to the bottom is considered the norm (above). 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, this is fraught with consequences. After 23–27 weeks, the child begins to move, and after 31, the movements become more active. During this period, it can damage the placental organ or the umbilical cord, especially in breech presentation.

The second disadvantage of this feature is the 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 fixed along the posterior wall, then the placental organ migrates higher by the end of the term in most cases. And with a front mount, everything can be the other way around, since migration is directed in the opposite direction.

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

What not to do with low placentation

Certain features of pregnancy make a woman take better care of her health. In order not to aggravate the circumstances, and not lead to even greater omission, it is necessary to follow the recommendations of the doctor.

With such a diagnosis, the following are contraindicated:

  • abrupt movements;
  • excessive physical activity;
  • vaginal procedures;
  • weight lifting;
  • 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 cause spotting. Riding in public transport is also not desirable, 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 observe basic precautions:

  1. Compliance with hygiene. Required before starting intimacy visit the bathroom
  2. Without sudden movements. Strong shocks can hurt, so the friction must be done gently, the penetration is shallow.
  3. Position selection. The pressure on the uterus will be less if the woman lies on her side.

With the threat of abortion 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 placental abruption. Therefore, you also need to masturbate with caution, if there are no prerequisites for pathology.

What are the treatments

There is no medical treatment for this disease. According to statistics, 8-9 out of 10 cases, the placental organ independently takes the correct position, as the uterus grows. 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, bear the child and give birth naturally, you need to listen and follow all the doctor's instructions. Throughout pregnancy, with a low location of the placenta, it is important to be observed by a specialist and regularly do ultrasound. Three times holding 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 strong development pathologies prescribe a number of drugs to maintain pregnancy until the required period:

  1. 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.
  2. Increases hemoglobin Ferlatum, Hemofer, Aktiferin.
  3. Increases blood circulation, improves nutrition placental tissue Curantyl, folic acid and vitamins E and Magne B6.
  4. Increases the level of progesterone - Utrozhestan.

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

With bleeding and severe pain syndrome need to call quickly medical care. At this time, you can’t do anything, it’s better to just lie down until the ambulance arrives.

Features of childbirth

If before the onset of labor, the woman in labor passed full examination and control of the course of pregnancy, natural delivery in most cases will be successful.

But several factors influence the course of childbirth:

  • place of attachment of the placenta;
  • the nature of the pregnancy;
  • the occurrence of complications during the gestation period;
  • associated pathologies.

If the placental membrane does not overlap uterine os, the obstetrician performs a piercing amniotic sac. As a result, the baby presses the placenta against the uterine wall with its head, preventing it from exfoliating.

Caesarean section is preferred in case of placental presentation or wrong position fetus - butt down.

Preventive measures

For prevention purposes, Special attention mom's food. Increase the amount of vitamins and minerals entering the body that have a beneficial effect on pregnancy. Calcium, magnesium and iron are especially useful.

Get more rest and walk outdoors. During rest, it is recommended to place the legs a little higher, placing a pillow or roller. This will ensure the activation of blood circulation in the placenta, which will help move it up.

Anxiety, stress and stressful situations have a bad effect on the situation. 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 supervising doctor.

Can be practiced special gymnastics for pregnant women or go to the pool. But these questions should be discussed with a gynecologist. Exercises with low placentation should be light, without sudden movements. Lifting weights and running are prohibited.

Sexual games should not be carried out in given period. The placenta is located only 30 - 40 mm from the edge of the cervix, and rhythmic rumblings 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 placentation require various treatments and prevention.

Conclusion

After reviewing in more detail what low placentation means and how low placentation 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 a baby. However, there may be complications if recommendations are not followed. Then you should immediately consult a doctor.

The placenta is a special organ that forms during pregnancy. Starting from the 7th week, it provides the fetus with nutrition, oxygen, and waste products are removed with its help. In other words, the placenta is a very important organ that provides intrauterine life your unborn baby.

Placenta, attachments of which are low - how is it?

It is normal if the placenta is located in the upper part of the uterus (near its bottom). Pathology is considered to be its location in the immediate vicinity of the entrance to the cervix (internal os). during pregnancy, this is the case when the placenta is attached at a distance of approximately 5 cm from the entrance to the cervix. If the attachment occurred at the entrance to the cervix, up to 5 cm from the internal os, this condition is called It can be lateral, marginal or complete, depending on how much the placenta overlaps the area of ​​​​the internal os. Low attachment of the placenta and its presentation are different things, the second condition is considered a more serious pathology and requires more attention. While the low location of the placenta during pregnancy, with the approach of the due date, it may cease to be a problem at all. The point is that according to the statistics low attachment placenta occurs in approximately 30% of women in early pregnancy, and after the 20th week, the uterus begins to grow rapidly, and the placenta usually "migrates" upwards, and only in one of two hundred cases remains in place, near the cervix. And yet, despite such favorable forecasts, you should not neglect your health and let everything take its course, with the hope that “maybe it will resolve itself.” If at the first ultrasound you have determined the low location of the placenta during pregnancy, this is a reason for serious observation by a doctor throughout the entire period of gestation.

Why did this happen?

It is not always easy to determine the causes of this pathology. Of course, for those who have been diagnosed similar condition, on big occasion the reasons are not so important. It is important to carry out if necessary adequate treatment and give birth to a healthy baby. But it is important for your attending physician to know that you have done any operations on the uterus before, because main reason is a violation of the uterine wall. Most often, the placenta, the attachment of which is below the permissible norm, is found in those who smoke, have abortions, who have had miscarriages, frequent inflammation of the genital organs, a sick heart, kidneys, etc. Hence the conclusion, take care of yourself, take care of your health even before pregnancy.

Is it possible to determine this pathology without ultrasound by symptoms?

The main method for diagnosing the low location of the placenta during pregnancy is ultrasound, since the symptoms of this pathology are not always pronounced. A woman may have scanty spotting, accompanied by unpleasant (not painful) sensations in the lower abdomen, hemoglobin in the blood is almost always reduced.

What to do, how to treat low placenta attachment?

Without unnecessary emotions and panic, you should regularly visit a doctor who monitors pregnancy, the main treatment for this condition is constant monitoring. If life-threatening complications for the fetus are detected, it is advisable for a woman to be hospitalized, protected from physical exertion and emotional experiences, provide good nutrition. If you do not follow all the doctor's recommendations, you can lose the baby (great since the low position of the placenta is often accompanied by fetal hypoxia. You will be asked to undergo an additional ultrasound, according to the results of which the doctor will determine how the birth will take place (on its own or caesarean). In any case, tune in just on positive result, because very soon you will meet with your baby.

The placenta is an important organ, the main purpose of which is to connect the blood circulation of the mother and child during pregnancy. The first signs of the placenta are laid at the very beginning of the term, but this organ acquires its final form only by the 16th week. From the placenta to the baby, 2 arteries and 1 vein are sent along the umbilical cord (sometimes it happens). Thanks to these vessels, the child is fed, waste products are removed from his body, there is a constant supply of oxygen to the cells of the fetus and protection from major infections.

Where should the placenta be located?

The placenta is located where the fertilized egg is attached to the wall of the uterus after the end of the movement through the fallopian tube.

Positive aspects of the location of the body on the back wall of the uterus

This does not mean that women who have been diagnosed with a placenta along the anterior wall of the uterus during pregnancy need urgent treatment! It's just that such a pregnant woman should know what possible complications may be in this case.

There are a lot of options for attaching the placenta and they depend only on individual features body of the expectant mother. This may be the fundus of the uterus, completely left or Right side uterus, posterior wall. You can find out how the baby's place is located in your case with the help of the second planned ultrasound at 19-24 weeks of pregnancy.

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

In such cases, there are some inconveniences:

  1. obstetrician difficult to listen fetal heartbeat,
  2. it is more difficult to palpate the position of the child in the uterus,
  3. baby moving future mom will feel less distinctly and the first tremors may begin later than usual (18-22 weeks), because the placenta in given location acts as a "pillow", which reduces sensitivity.

But, despite these inconveniences, in itself, such an arrangement is not dangerous for the health of the pregnant woman and the fetus.

In very rare cases, complications occur:

  1. Increased chance of placenta previa. Here you need to connect your imagination. Imagine (for greater clarity, use the drawings above) that the placenta is attached to the back wall of the uterus very low to the internal pharynx (read). As the belly grows, it will rise and by childbirth, in most cases, it will already be at a safe distance from the pharynx. But if the child's place is located low and on the front wall, then over time the uterus will grow and the placenta will move, it increases the likelihood that it will completely or partially block the internal pharynx. In this situation, the obstetrician-gynecologist will decide in favor of a caesarean section in order to protect the woman in labor from possible bleeding. Therefore, with this location of the placenta, special attention should be paid to the distance to the internal os of the uterus.
  2. If a woman has had a caesarean section or other operation "on the uterus" in the past, then the likelihood of placenta accreta increases.
  3. The risk rises. The baby in the womb leads active life: he moves, pushes, squeezes the umbilical cord. This is not dangerous, but if the child's place is fixed along the front wall, the risk of detachment increases. When the due date approaches, practice contractions and excessive contractions may occur with an unusual position. this body also increase the likelihood of detachment.

Do not be afraid and try on all possible complications for yourself. They are very rare, in 1-3% of pregnancies, in other cases, childbirth takes place safely in a natural way.

Today, many future women in labor are worried about what to do if the placenta is low. That is what we will talk about in this article.

The placenta is low. general information

In medicine, the placenta is understood as an organ that is responsible for blood exchange between the mother's body and the fetus itself. It is located on the back wall of the uterus. The thing is that this area, according to experts, is best supplied with blood due to various kinds of anatomical reasons, therefore, the metabolism in this case will occur the best way. However, in fact, there are some reasons according to which it may happen that the placenta is located low. If the organ is six centimeters below the pharynx of the uterus, doctors, as a rule, state this diagnosis.

It is important to note that in this case, special attention is paid to the fact whether the organ covers the so-called uterine os. It is on this that the course of pregnancy and, accordingly, its resolution subsequently depends. So, if the organ is low located and does not cover the uterine os, we will talk about the so-called. On the other hand, if it completely covers it, about the complete one. As for the last case, here the future woman in labor will most likely begin to prepare for caesarean section. The thing is that a normally located placenta does not overlap the pharynx, which means that the baby appears naturally. Otherwise, as a rule, there is an impossibility of passing the head through the birth canal.

If the placenta is just low, the woman is most often allowed to have a natural birth. However, in this case, specialists are always ready, since there is a high probability of detachment, which most often ends

Low position Possible causes

This state of affairs is considered normal when, during fertilization, the embryo is introduced into the wall of the uterus and independently creates a small depression (lacuna), through which they will subsequently be transported useful material. Then such a recess turns into a placenta. However, if there are any defects in the uterus, scars, mechanical injuries after abortion, the embryo is simply not able to attach itself. Subsequently, he will choose the most favorable place, and the placenta will already be there and formed, and not in the usual place.

Effects

As a rule, this diagnosis is always associated with improper metabolism between the future woman in labor and the fetus. As a result, there is a place to be hypoxia crumbs and even hypertrophy.

Conclusion

Experts warn that not always a low position accompanies a woman until the moment of childbirth. The thing is that the so-called migration of the placenta is often observed. This is primarily due to the fact that the lower segment is constantly growing and changing, which means that the place of attachment of the organ subsequently rises somewhat. According to available statistics, only five percent of future women in labor have this diagnosis until the 32nd week.