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Low location of the placenta during pregnancy. Why is low placentation dangerous? Low placenta migration

Low placentation during pregnancy is a serious complication that requires constant monitoring of the woman and the provision of emergency care if necessary.

The placenta is a temporary organ that forms by the second week of pregnancy, woven from the vessels of the mother and the fetus. It attaches to the wall of the uterus, grows, develops and reaches maturity. Body functions:

  • saturation of the child's blood with oxygen and removal of carbon dioxide;
  • delivery of nutrients to the fetus and disposal of waste products;
  • synthesis of hormones necessary for the normal development of pregnancy and preparing the female breast for milk production;
  • immune protection of the baby in the womb.

The attachment of the placenta to the back or lateral wall of the uterus is considered the norm. But if it is too low, problems can begin.

Low placenta previa is an abnormality in the course of pregnancy. It is characterized by attachment in the lower part of the uterus, which covers completely or slightly the internal pharynx. This means that complications are possible during childbirth and childbirth.

Schematic representation of the problem

The condition often goes away spontaneously when the upper parts of the uterus are displaced. This phenomenon is called placental migration. But in general, the risk of fetal death is quite high: from 7 to 25%.

The cause of death of a baby can be acute hypoxia due to insufficient placental blood supply or premature birth.

This pathology is dangerous for a pregnant woman. Bleeding that occurs with placenta previa causes death in 1-3% of women.

The exact attachment point allows you to find out an ultrasound scan in the 3rd trimester. Normally, the location of the organ is located at a distance of 5 or more centimeters from the internal os of the uterus.

Causes

Most of the causes of low placentation are due to diseases and conditions that occurred before pregnancy.

What causes the deviation:

  • inflammatory and infectious processes in the genitals;
  • damage to the lining of the uterus;
  • miscarriages or abortions in the past;
  • gynecological interventions;
  • multiple pregnancy. Women with twins or triplets are automatically at risk;
  • childbirth by cesarean section;
  • fibroids, endometritis and other diseases of the uterus;
  • smoking, excessive alcohol consumption;
  • many genera;
  • anomalies in the structure and development, work of the uterus;
  • the woman's age is over 35 years old.

The most common cause of low presentation is past curettage of the uterus. The procedure damages the mucous membrane, which prevents the ovum from attaching to the upper part of the organ.

See a doctor

The insidiousness of the deviation is that it practically does not manifest itself. Symptoms appear already at an advanced stage, when irreversible processes, for example, detachment, take place in the body. These signs are:

  • heaviness in the lower abdomen, pulling pains;
  • bloody issues. When they appear, you need to call an ambulance;
  • death of the fetus in the womb or its excessive activity due to hypoxia - a lack of oxygen;
  • severe toxicosis - 30% of women with this diagnosis suffer from it;
  • in about half of the pathology cases, ultrasound reveals a breech presentation of the fetus.

The pregnant woman herself cannot suspect an anomaly in herself until vivid symptoms appear. The condition is seen on scheduled ultrasound. The study allows not only to identify the problem, but to determine its degree and severity.

Types of low presentation, depending on the location of the placenta:

  • back. This arrangement of the organ is the most favorable option. In most cases, in the later stages, the baby's place moves upward, freeing the birth canal. Pregnancy is relatively comfortable;
  • front. In this case, you need to prepare for difficulties. If the baby is large and active, he will press on the placenta. This will cause problems with the umbilical cord, the risk of entanglement and pinching. Such presentation rarely changes to childbirth, which means that the birth canal will not be free;
  • full or partial, when the organ obstructs the pharynx of the uterus. Deviation requires great care. It is important to discuss all the details with the doctor before giving birth and prepare that you will have to give birth by caesarean section.

What to do

Diagnosis with low placentation allows you to determine how dangerous this condition is for a pregnant woman and a child. Are carried out:

  • analysis of symptoms: discharge, abdominal pain;
  • ultrasound is the main type of diagnosis, safe and informative. Held at 12, 19-20 and 30 weeks;
  • bimanual examination of the vagina (provided that there is no bleeding).

After confirming the diagnosis of low placenta previa, the doctor prescribes treatment and gives recommendations to correct the situation. If desired and competent actions, the location of the organ can be changed.

If the pregnancy is proceeding normally, and the term has not reached 35 weeks, the treatment is conservative. Shows strict bed rest, observation of the fetus and the intensity of bleeding. Any loads, sexual contacts are prohibited.

There are no medications that elevate the placenta. Medications are prescribed to help improve the condition of the pregnant woman and facilitate the migration of the child's place. It:

  • tocolytics, antispasmodics - stimulate stretching of the lower parts of the uterus;
  • drugs that reduce the tone of the myometrium;
  • iron supplements - prescribed for women with bleeding to prevent iron deficiency anemia;
  • medicines that activate placental blood circulation - to avoid the development of hypoxia in the fetus;
  • magnesium, intravenous glucose, vitamins.

The drug Utrozhestan helps to prevent premature birth with low placentation. To prevent breathing disorders in the fetus during childbirth, glucocorticosteroids are prescribed.

If the presentation is partial, accompanied by slight bleeding, conservative treatment helps to save the child. But a woman should remember that at the slightest discharge and deterioration of health, an ambulance should be called immediately.

With severe bleeding, poor condition, a woman is terminated pregnancy for health reasons.

  • severe blood loss (more than 200 ml);
  • drop in pressure, anemia;
  • full presentation together with open bleeding.

Ultrasound snapshot

The choice of the method of delivery, provided that the pregnancy is prolonged, depends on the indications. With full presentation, the pharynx of the uterus is closed, therefore, a cesarean section is performed. It is also carried out with:

  • placental abruption;
  • polyhydramnios;
  • improper location of the baby;
  • scars on the uterus;
  • multiple pregnancy;
  • over 30 years of age.

If the presentation is partial, natural childbirth is not excluded. But only on condition when the child is head down, active labor and cervical maturity. In case of sudden bleeding, a puncture of the fetal bladder is made. This helps to stop the bleeding and allow a normal delivery.

If the cervix is ​​not ready, the baby's head is small, a cesarean section is performed.

What is dangerous

The consequences can be dire

Low placenta previa during pregnancy is a condition that is dangerous for both the woman and the fetus. Among the unpleasant consequences:

  • the child can damage the placenta with vigorous movement. This is especially true for late periods, when a large baby presses on the organ and is able to hook the placenta membrane;
  • with low placentation, the cervix is ​​not intensively supplied with blood, which is fraught with the development of fetal hypoxia;
  • the anomaly threatens with complications in childbirth, since the child's place prevents the baby from leaving the womb;
  • insufficient placental blood circulation can cause increased fetal activity, which is fraught with permeation and cord clamping;
  • detachment of the placenta is a dangerous condition that leads to the death of the fetus, and sometimes the woman. With a complication, the stomach begins to ache, bleeding appears;
  • in pregnant women with such a diagnosis, low blood pressure is often observed, and late gestosis develops.

The organ is densely intertwined with blood vessels connected to the uterus. This ensures the placental blood exchange. And the blood carries vitamins, proteins, oxygen, hormones and other substances necessary for life to the fetus.

With a low presentation, the blood supply to the lower part of the uterus is impaired. Consequently, the nutrition of the fetus with useful components is inadequate. This increases the risks of intrauterine growth retardation and hypoxia.

If placental insufficiency and deterioration of blood flow are diagnosed, supportive therapy is prescribed to compensate for the lack of nutrients in the fetus.

This is what threatens low placentation. A child due to an anomaly can suffer at any stage of pregnancy. To protect him and himself from complications will help caution and strict adherence to the doctor's recommendations.

When will rise

Low placental presentation is found at different times. At the same time, it is difficult to predict the consequences, and it is not known how long it will take to rise. Depending on the trimester of pregnancy, therapeutic actions to correct the pathology depend.

  • 1 trimester. The first scheduled ultrasound scan is performed at 12-13 weeks, at the same time an anomaly is detected. You should not worry in this period, since in 70% of cases the placenta rises by 20-21 weeks;
  • 2 trimester. By the time of twenty weeks, the placental blood circulation is improving, but with a low presentation it is disturbed, especially if the fetus is large and presses on the organ from above. In this case, the gynecologist puts the pregnant woman in a hospital with strict adherence to bed rest and drug therapy. Usually, by 22-23 weeks, the baby seat rises up. If the situation does not change, the doctor gives the woman lifestyle recommendations and continues to try to correct the situation;
  • 3 trimester. Mainly by 32-34.5 weeks, the placenta shifts upward under the pressure of the growing uterus. Then the problem disappears. If during pregnancy she did not stand in place, at 36 weeks the issue of caesarean section is decided. This is especially important with full presentation.

Curettage of the uterus could be the cause

Depending on the trimester and the nature of the location of the placenta, different actions are taken to correct the anomaly. It is important for a woman to be patient and not panic.

In most cases, the placenta rises by the end of pregnancy. If this does not happen, but the woman and the baby are doing well, a cesarean section is performed.

What not to do

Pregnant women with low placentation need to be constantly monitored by a doctor. If you follow his recommendations exactly, everything will be fine. And what not to do:

  • worry. Modern medicine successfully treats pregnant women with low anchorage of the placenta. In 90% of cases, a woman gives birth to a healthy baby. Moreover, 60% of births are carried out naturally, and only 40 - with the help of a cesarean section;
  • have sex. Sex at any time can damage the organ and lead to detachment. This only applies to women with low placenta previa;
  • play sports, do abdominal exercises, lift weights, walk a lot. Decide which is more important, an active lifestyle or a child's health;
  • do douching and any other vaginal manipulation so as not to harm the pregnancy;
  • worry, be nervous, irritated. This will lead to an unhealthy emotional atmosphere and aggravate the condition. Develop resistance to stress;
  • ride public transport, visit crowded places. There they can push, which will cause an even greater prolapse of the organ;
  • ignore the doctor's recommendations, do not go to preservation when necessary.

You must be patient


If the presentation is low, the woman is advised to put a pillow under her feet so that they are above the level of the body. This will help the placenta take the right place faster.

Low placentation is not a disease, but a special condition. The situation requires, first of all, not treatment, but correction. Much depends on the mood of the pregnant woman, her actions, how accurately they correspond to the advice of doctors.

Preventive measures will help to avoid anomalies. These include:

  • prevention of infectious and inflammatory diseases, their timely treatment;
  • maintaining a healthy lifestyle: proper nutrition, adherence to work and rest, not alcohol and tobacco abuse;
  • protection from unwanted pregnancy so that there is no history of abortion;
  • carrying out a caesarean section only in cases where there are vital indications;
  • implementation of gynecological manipulations and operations in proven clinics by experienced doctors.

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The low location of the placenta scares expectant mothers and causes them a lot of fears about the outcome of pregnancy and childbirth. What is its danger and what to do if the diagnosis of "low placentarity" has already sounded, we will tell you in this material.


What it is

The placenta is a unique organ. It only appears during pregnancy and disappears after the baby is born. The task of the placenta is to provide the baby with nutrition, the delivery of all substances, vitamins, oxygen necessary for its normal growth and development. At the same time, the placenta helps to remove metabolic products of the crumbs into the mother's body.

Placenta previa is a concept that designates the location of this temporary and very necessary organ in the uterine cavity. Presentation is always a pathology, because the term itself has the meaning of finding the placenta on the path along which the child will need to pass during childbirth.

Normally, the place of attachment of the placenta should be such that the baby's "childish place" does not interfere with being born into the world. When it comes to presentation, this means that the placenta is located low, partially or completely blocked the exit to the small pelvis.


Low placentation is common in early pregnancy. Up to 20 weeks of pregnancy, partial or marginal presentation is recorded in about 10% of pregnant women. But the placenta has the property of rising above the cervical region following the walls of the uterus growing with the fetus. Therefore, by the 30th week of pregnancy, only 3% of pregnant women have presentation, and by 40 weeks - only 0.5-1% of expectant mothers. The process of raising the placenta above is called migration.

Low placentation

Norm

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The placenta is finally formed only by 10-12 weeks of pregnancy. Prior to this, the place of "ingrowth" of the ovum into the endometrium is called the chorion. Presentation is of three types.

  • Complete- the internal pharynx is completely covered by the placenta. This is a very dangerous threatening condition in which spontaneous childbirth is impossible and there is a high probability of death of the fetus or mother as a result of spontaneous massive bleeding.
  • Incomplete- the placenta partially covers the internal cervical os. Independent natural childbirth, in most cases, is also impossible, the danger for the baby and mother is great.
  • Low or low- the placenta is located above the entrance to the cervical canal, but the distance from it to the "child's place" does not exceed 7 centimeters. The internal pharynx is not closed by the placenta. If the "child's place" is too low and affects the edge of the pharynx, the presentation is called marginal.

Natural childbirth with such a placenta previa is quite possible, however, they will require special attention from doctors, and from pregnant women - extreme caution in the process of bearing a fetus.


Doctors can determine the type and degree of presentation by means of an ultrasound scan. At each scheduled ultrasound of the placenta, close attention is paid. Its localization along the front or back wall of the uterus is determined, and the distance from the internal pharynx (the entrance to the cervical canal) to the edge of the "child's seat" is measured.

If it is at least 3 centimeters, a diagnosis of "low placentation" or "first degree of placenta previa" is made.

It should be noted that the lower presentation is the safest of all three types of presentation. The forecasts of doctors with him are more favorable, but such an arrangement of the "child's place", of course, is not a variant of the norm either. Certain dangers and risks exist.


Causes of low placentation

By and large, it is almost impossible to somehow influence the placenta formation site. It will appear where the ovum will be able to gain a foothold at the time of implantation.

A fertilized egg is implanted into the uterine cavity about 8-9 days after fertilization, from that moment a chorion is formed, which subsequently becomes the placenta. It is impossible to determine exactly where the fertilized egg will "float". But there are risk factors that increase the likelihood that the blastocyst will anchor too low.

First of all, these factors include pathologies of the structure of the uterus, diseases of the woman's reproductive system, the consequences of surgical interventions.


So, in women suffering from inflammatory processes of the endometrium, having undergone abortion or other curettage, with a history of cesarean section, the chances of low placentation during subsequent pregnancy are higher. Such reasons are called uterine or intrauterine. These include:

  • endometriosis;
  • operations performed on the uterus - (abortion, removal of fibroids, diagnostic curettage, cesarean section);
  • complicated previous childbirth;
  • uterine fibroids;
  • underdevelopment and abnormal congenital structure of the body of the uterus;
  • incompetence of the cervix (isthmic-cervical insufficiency);
  • pregnancy with several fetuses at the same time.



The reason for the fixation of the ovum in the lower part of the uterus may be the enzyme deficiency of the membranes themselves. Such reasons for the development of a low placenta are called fetal. These include:

  • hormonal disorders in a woman;
  • inflammatory diseases of the appendages, fallopian tubes, ovaries.

In repeated pregnancies, a low placenta is more likely than in the first pregnancy. The more a woman gives birth, the higher the likelihood of developing a lower placentation with each subsequent pregnancy.



It is believed that both overweight women and women who have not been able to quit smoking with the onset of pregnancy are at risk. If in the previous pregnancy the placenta was located low, with a high probability, according to experts, the "child's place" will be located below and in the subsequent pregnancy. In addition, there is a certain genetic dependence - a woman can inherit a tendency to lower placentation from her own mother.


Diagnosis and symptoms

A low placenta previa may be indicated by spotting at any stage of pregnancy. The doctor may be confused by the increased values ​​of the height of the fundus of the uterus, which are ahead of the actual gestational age, as well as the incorrect position of the fetus in the uterine cavity - the pelvic or transverse presentation of the baby is often accompanied by low placentation.

Bloody discharge from the genital tract with an inferior placenta previa usually first appears after 12-13 weeks of pregnancy. They can be more or less abundant. They often last until the very birth.

But the most common bleeding is in the last trimester of pregnancy, when the walls of the uterus are stretched so much that there are partial micro-detachments of the "child's place" from the uterine endometrium.


In a third of pregnant women with low placentation, such bleeding is observed after 35 weeks of gestation. Six out of ten women experience fairly heavy bleeding during labor. Even a careless strong cough, laughing, sex, constipation, exercise and severe stress can provoke bleeding in pregnant women with a low placenta position. Any tension of the uterine muscles is dangerous by slight detachment and exposure of blood vessels.

In women in whom low placentarity is manifested by episodic or persistent bleeding, decreased hemoglobin level, anemia develops, low blood pressure, dizziness, and attacks of sudden weakness are often observed.

If a placenta previa is suspected, the doctor does not conduct a manual intravaginal examination, because this can provoke premature labor or bleeding, which can be fatal for both the fetus and the pregnant woman.


Ultrasound scanning is considered the best diagnostic method. Ultrasound allows you to determine the position of the "child's seat" with an accuracy of a millimeter.

Sometimes the low position of the placenta has no symptoms. The woman does not complain about anything, and only the ultrasound doctor at the next examination draws attention to the fact that the "child's place" is lower than she would like. In this case, more careful monitoring of the state of the placenta is required: control ultrasounds designed to track the migration process are prescribed and carried out at 12, 20 (or 21-22) weeks and at 30 weeks. More frequent scans may be recommended as needed.


Dangers and risks

What threatens a low placental location is not difficult to guess. In the early stages, it is dangerous with the threat of spontaneous miscarriage, and at a more solid gestational age - with the threat of premature birth. In women with such a problem at the end of the second and third trimesters, gestosis often develops, which only increases the risks of an unfavorable outcome. Half of pregnant women have iron deficiency anemia.

If the placenta is formed in the early stages and is attached low, then the probability that the child will take an incorrect position in the uterine cavity increases by 50%. The child will instinctively choose a position in which his head will not come into contact with anything, including the placenta.


The baby with a high degree of probability will not accept a cephalic presentation, but a breech presentation, which will greatly complicate the process of childbirth or even be an indication for a cesarean section.

For a baby, a low-lying placenta is a risk factor for the likelihood of developing hypoxia. Prolonged chronic oxygen starvation can cause the death of a baby, irreversible changes in the structures of his brain.

Also, placental insufficiency, which develops if the "baby seat" is omitted, can lead to a delay in fetal development. The lower part of the uterus is less well supplied with blood than the body and the fundus of the uterus, which is why the baby will receive less nutrients it needs.

The abnormal location of the organ feeding the baby is dangerous. If the placenta is attached low, a woman at any time may experience bleeding, which can have very sad consequences.


Treatment

Despite the level of modern medicine, there is no universal way to treat low placentation. There are no such pills and injections to raise the "child's seat" higher. We can only hope that the migration will happen on its own, and in most cases this is exactly what happens.

The task of doctors is to quickly cope with periodic bleeding and maintain a pregnancy as long as possible: until the baby is fully viable. Compliance with medical recommendations is a top priority for every pregnant woman with a low placenta.

To reduce the tone of the uterus, antispasmodic drugs are prescribed: "No-shpa", "Papaverin", "Ginipral". To replenish the iron deficiency of a pregnant woman, it is recommended to take courses of iron preparations "Ferrum Lek", "Sorbifer". For better uteroplacental blood flow, to eliminate the symptoms of delayed development of the baby, fetoplacental insufficiency, "Curantin", "Trental" are recommended, as well as folic acid, B vitamins, "Ascorutin" and vitamin E in large therapeutic doses.




Quite often, a woman is recommended to daily administration of magnesium solution intramuscularly (10 ml each) and Magne B 6 tablets twice a day. If there is hormonal deficiency, prescribe "Utrozhestan" or "Duphaston" in an individual dosage. With an asymptomatic course, you can be treated at home, with frequent episodes of bleeding, it is recommended to undergo treatment in a day hospital at a gynecological specialized clinic.

In a later period, a woman more often than other pregnant women will have to visit a gynecologist and do CTG of the fetus to make sure that the baby's cardiac activity is normal and that there is no pronounced oxygen starvation. Drug therapy is likely to continue until birth if the placenta does not rise.


As already mentioned, a woman will have to be extremely careful. She is prescribed a calm regime, stressful situations, physical activity, lifting weights, bending forward are contraindicated for her. With a low placenta, you should never jump, travel on uneven roads by car or bus for any period of time, because shaking can provoke severe bleeding.

A woman should not have sex because orgasm stimulates the uterine muscles, which will increase the likelihood of placental abruption. Not only direct sexual intercourse is prohibited, but also other forms of sexual satisfaction - oral, anal sex, and masturbation. Any action that can lead to a contraction of the uterine muscles is contraindicated.


Air travel is also undesirable. The optimal posture for rest (and you need to rest in any free minute) is lying on your back with your legs thrown upside down. If you can't lie down (the woman is at work), you should raise your legs higher while sitting.

To do this, you can use a small makeshift footrest.

How to give birth?

With low placentation, childbirth can take place both naturally and by surgery - caesarean section. The final decision on the tactics of obstetric care is determined at approximately 35-36 weeks of pregnancy based on the results of the control ultrasound.

If the placenta has not risen, doctors will most likely recommend prompt delivery. Caesarean section is done if a woman has a low placenta combined with a pelvic or transverse presentation of the fetus, if she is pregnant with twins or triplets, if the uterus has scars from previous surgical interventions.

They are also trying to send pregnant women over 30 years of age who have undergone several abortions and have a burdened gynecological history for surgery. If the pregnancy is accompanied by regular bleeding, a planned caesarean section may also be considered.


Sometimes the need for emergency surgical intervention arises already during childbirth, for example, if the bleeding does not stop after the passage of water, if there is a weakness of the labor forces.

In the absence of bloody discharge, a ready and mature cervix, normal size of the pelvis, a medium-sized child who is in the cephalic presentation, independent childbirth is allowed.

Stimulation of labor with medicines with low presentation is not carried out in any case, labor should develop independently.


- this is one of such cases. But, having heard such a diagnosis from a doctor, one should not panic, because this is not a pathology, but a borderline state.

Often, by the end of pregnancy, there is no longer any threat. As medical statistics show, in 99% of cases, childbirth with this condition goes well.

The placenta and its role during pregnancy

What is placenta? This is a child's place, the mass of which reaches 1.5 kg, and the diameter is 15 cm. The connection between mother and baby is provided by an extensive network of numerous blood vessels located in the placenta.

The role of the placenta during pregnancy is enormous., because it performs very important functions. It is she who secretes a number of hormones, including those responsible for maintaining pregnancy.

Through it, the fetus receives minerals, nutrients, vitamins, as well as oxygen - everything that is so necessary for the normal development of the baby. In addition, the placenta will also excrete carbon dioxide.

The state and full development of the child directly depends on the functioning of the placental-phytoplacental system.

Low placentation during pregnancy: what is it

After a successful conception, the fertilized egg-embryo looks for a favorable and suitable place for anchoring in the body of the uterus. Often this place becomes the bottom of the uterus or the back wall.

However, for a number of reasons, the embryo may seek for itself "another refuge" in order to gain a foothold normally. This is exactly how the low formation of a place for the fetus - the placenta - happens.

Reason for diagnosis low placentation during pregnancy, the location of the placenta becomes below 5.5cm internal pharynx. However, this is not such a rare condition.

So, in 15% of cases, the placenta is attached to the underside of the uterus... Increasing in size, it can block the birth canal. But the situation during pregnancy can change for the better.

When the fetus grows and the uterus increases in size, the attachment point also rises higher, which means that there is no longer such a threat to the fetus.

It is worth noting that such a diagnosis is a serious situation when a woman is forced to be under the close supervision of her doctor, since there is a risk of placental abruption.

Most often, such a diagnosis from a doctor can be heard by patients who have not had this pregnancy for the first time. This condition can be detected during examination - ultrasound examination. Do Ultrasound on -, -, - pregnancy.

What is the reason?

Even doctors do not undertake to name the exact reasons for the low location of the placenta. However, low placentation is not uncommon for women who have given birth.

Often this condition is facilitated by inflammatory processes that provoke changes in the inner walls of the uterus.

There are a number predisposing factors that can lead to this condition: complicated first birth, abortion, uterus, chronic endometritis, parity (a large number of births), as well as the woman's age (if she is over 35 years old).

Rules of behavior

If a woman heard such a diagnosis from a doctor, she should observe a series of simple requirements:

  • do not make fast, abrupt movements, do not run, do not jump, and also avoid physical exertion;
  • give up sex life;
  • give the legs an elevated position in the lying and sitting position;
  • minimize movement in public transport;
  • when bleeding or bleeding occurs, immediately consult a doctor, and in the event that the bleeding is severe, call an ambulance;
  • you should not refuse inpatient treatment in the pregnancy pathology department, if this option is offered by the attending physician.

The mother does not need special treatment in this condition., however, the expectant mother is obliged to closely monitor her condition.

How is childbirth going with this diagnosis?

If the distance between the cervix and the placenta is more than 6 cm, childbirth is proceeding normally... If the distance is a little less, then in this case, too, the birth is likely to go well.

If the doctor decides that the low location of the placenta is undesirable, then he will pierce the fetal bladder. After that, the baby's head will fix the placenta. But in this case, the process of childbirth should be supervised by experienced professionals.

If the fetus is in the wrong position (legs forward), then doctors will perform a cesarean section to avoid complications.

If a woman has low placentation, a situation of complete overlap of the exit from the uterus may occur. In this case, will be done on pregnancy caesarean section.

Dear ladies, it should be borne in mind that in most cases, for pregnancy, the placenta shifts - it rises up (behind the growing uterus), which means that any threat to the mother or baby disappears.

During pregnancy, the placenta protects the fetus. Thanks to her, he breathes, feeds and receives immune protection. The placenta is located at the top of the uterus, bordering the fertilized egg. Over time, the placenta develops, and at this time various deviations from the norm can happen to it. One of them is low placentation during pregnancy.

What does low placentation mean?

This pathology is detected at about 30 weeks and usually concerns mothers of thirty and older. In this case, the placenta is located 6 cm below the internal uterine pharynx. This is because the egg is implanted down the wall of the uterus. And if the pharynx of the uterus overlaps, then the placenta is subject - another pathology.

Causes of low placentation

This is why the placenta is in the wrong place:
  • After abortion, caesarean section, uterine infections, and other inflammatory diseases, the mucous layer of the endometrium is damaged.
  • Underdevelopment of the uterus or fibroids. They only get rid of it when it is malignant.
  • Multiple pregnancy. In this case, complications are possible: low placentation, histosis, anemia, toxicosis.
Bleeding and severe abdominal pain are the main signs of low placentation during pregnancy. They can appear as a result of excessive physical exertion, as well as coughing, constipation, while taking a bath.

Bleeding begins with light discharge and soon becomes profuse. Just at the 30th week, the uterine tone increases - this becomes the cause of bleeding. If it becomes permanent, it can cause anemia, hypotension.

Why is low placentation dangerous?

Oxygen, trace elements, nutrients enter the fetus in insufficient quantities, because there are no vessels at the bottom of the uterus.

The fruit grows, its activity increases. Due to the low location of the placenta, the pressure on the uterus increases. This can separate the placenta or cause severe bleeding.

Due to the fact that the placenta is located close to the pharynx, it can be completely blocked, which is fraught with miscarriage.

Women with low placentation during pregnancy should lie in bed all the time and medications that normalize the tone. If there is a need to prepare the baby's lungs for intrauterine existence, the mother is prescribed glucocorticoid hormones.

Low placentation treatment

There are no effective medications for low placentation. However, women with this anomaly are advised to:
  • Refusal of increased physical activity - jumping, running, carrying weights, sudden movements, etc.
  • Sexual abstinence. Putting pillows under your feet while lying down.
  • Regular visits to the gynecologist.
  • It is advisable to go to preservation.

How to give birth with low placentation?

Usually women with this trait give birth naturally if there are no complications. During the period of childbirth, the patient is closely monitored.

It should be noted that if the placenta was lifted up before delivery, then in the last trimester it returns to its original place. If the distance between the cervix and the placenta is more than 6 cm, this is normal. If it is lower, doctors open the amniotic fluid in advance. The placenta does not flake off because it is pressed by the baby's head. If by the end of pregnancy the placenta is still in the vicinity of 2 cm from the internal pharynx, then a cesarean section is inevitable. It is also prescribed for heavy bleeding or complications.

In spite of everything, low placentation during pregnancy does not lead, as a rule, to serious consequences, provided that the patient is provided with full medical supervision, and she follows all the basic recommendations.

  • Why is the low location of the placenta dangerous?
  • Low placenta migration
  • Why is the placenta attached so low?
  • Low placentation at 12 weeks gestation. What's next?
  • Low placentation at 22 weeks gestation. What's next?
  • Low placentation at 36 weeks gestation. Childbirth with a low placenta

    • The fundus of the uterus is located ... at the top. It is there, closer to the bottom (that is, from above) that the placenta should be attached. But this does not always happen, and in about 15% of cases, expectant mothers will find out during a routine ultrasound examination about the low location of the placenta.

    What does this threaten and is it possible to do something?

    Where is the low location of the placenta?

    Usually, they say about low placentation when 5.5-6 cm remains from the pharynx of the uterus to the edge of the placenta. The doctor sees this result even on the planned ultrasound scan at 12 weeks and makes a note about this in the card of the expectant mother. At such a short time, it does not really matter, because the placenta grows and moves until the 36th week of pregnancy.

    Why is the low location of the placenta dangerous?

    Doctors have two reasons for concern.

      Poor blood supply to the lower part of the uterus compared to the upper. The poorer the blood supply to the placenta, the less nutrients the baby receives.

      The pressure that the growing fetus exerts on the placenta - after all, no one canceled the force of gravity! The compressed placenta not only does not fully fulfill its functions, but can also flake off, which will already become a direct threat to pregnancy.

    ” But, as we have already emphasized, until 22-24 weeks, all this is not of fundamental importance.

    Low placenta migration

    During pregnancy, the placenta moves, and this is not surprising.

      Firstly, it is a living organ, in which some areas may die off, and some may grow.

      Secondly, it must meet the child's nutritional needs, which means it must increase in size as the baby grows.

      Thirdly, it attaches to the wall of the changing size of the uterus, and its position changes along with its stretching.

    It is possible to predict the movement of the placenta based on the place of its attachment, which the doctor notes during the first ultrasound.

    ” The most favorable location is on the back wall of the uterus, which is closer to the spine. It stretches less during pregnancy and, most likely, by the middle of term, the placenta will have time to rise to a safe height.

    The least favorable location is from the bottom and from the front - it is this part of the uterus that stretches most of all, and the placenta simply may not have time to "crawl" higher.

    Why is the placenta attached so low?

    The reason, in fact, is one - damage to the endometrium of the uterus in those places where the placenta should normally be attached. But it can be caused by a variety of circumstances. Among them:

      scars after cesarean section or other operations on the body of the uterus;

      tissue damage after an abortion or removal of neoplasms;

      changes in the endometrium after infectious diseases;

      large neoplasms (for example, uterine fibroids), which in themselves do not prevent pregnancy, but "occupy the best places";

      malformations of the body of the uterus (for example, a saddle or bicornuate uterus);

      multiple pregnancies (twins may have , and in the second case, one of them is often attached too low).

    It is clear that you cannot fix the shape of the uterus or the scar after the operation in any way, but the one who is warned is already armed! Now you know that you shouldn't miss your planned ultrasound scan at the 12th week of pregnancy.

    Low placentation at 12 weeks gestation. What's next?

    Nothing! For a short period of time, even not the most successful location of the placenta does not affect the course of pregnancy in any way. Listen to the doctor's recommendations (they may relate to the restriction of physical activity and the additional intake of a complex of vitamins and minerals), carefully monitor your well-being, immediately contact the antenatal clinic for bloody discharge and pain in the lower abdomen ( however, this should be done at any time and in any position of the placenta).

    ” And don't miss your next ultrasound - it's usually done in 10 weeks!

    Low placentation at 22 weeks gestation. What's next?

    Most likely, during the next examination, the doctor states that the placenta has already migrated along the wall of the uterus and you can no longer be afraid of the course of your pregnancy. If the placenta is still located at the very throat of the uterus, then, alas, some measures will have to be taken.

      Limit physical activity. Even special sets of exercises for pregnant women can hurt you now, not to mention running, jumping, lifting weights ...

      Give up intimacy, at least from its traditional forms with deep penetration. You should not once again disturb the area of ​​the uterus to which the placenta is attached.

      Try to rest more, if there is an opportunity to lie down - lie down ( Do you remember that gravity is working against you right now?) Place a small pillow under your feet while you sleep.

    ” But the most important rule is don't worry! The chances are very high that the situation will change by the 36th week of pregnancy!

    Low placentation at 36 weeks gestation. Childbirth with a low placenta

    ” If you are unlucky and the placenta is still at the very edge of the uterine pharynx (recall, the critical figure is 5.5 cm), then most likely you will have planned hospitalization and a cesarean section.

    Many women are in the mood for natural childbirth and worry that "everything went wrong." But in this case, surgical intervention is quite justified: the volumetric placenta prevents the baby from "moving out", which seriously delays and complicates childbirth, and besides (and this is the most dangerous) it can exfoliate ahead of time. Until the child was born and took the first breath, the placenta and umbilical cord are also his respiratory organs, without them hypoxia quickly sets in, the baby literally "suffocates" in the womb. A tragic situation requiring emergency intervention, and the outcome can be much worse than with a planned operation!

    Finally, with the borderline position of the placenta - the very same 5.5-6 centimeters, when natural childbirth is also possible, but there is still a risk of an unfavorable development of the situation, the doctor can pierce the fetal bladder at the very beginning of labor.

    ” When the amniotic fluid is poured out, the baby's head quickly sinks to the uterine pharynx and, as it were, presses and pushes the placenta away.

    However, such a decision is possible only if the baby is located correctly; low placentation and - unambiguous indications for operative delivery.

    Remember, no matter how your pregnancy proceeds, the main thing is the health of the mother and baby. Modern obstetrics can handle the most difficult situations, the main thing is to stay calm and follow your doctor's recommendations!

    Prepared by Anna Pervushina