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Why is the placenta low? Low location of the placenta during pregnancy, what to do

Many mothers-to-be are concerned about how dangerous a low placenta can be.
Normally, the placenta - the organ through which the exchange between the blood of the mother and the fetus - is attached closer to the bottom of the uterus or along its back wall. These are areas that, due to anatomical reasons, are best supplied with blood, which means that the metabolism will proceed in the best way. However, there are reasons why the site of attachment of the placenta may be lower. If it is located below 6 cm from the internal os of the uterus, it will be a low location of the placenta.
At the same time, it is fundamentally important whether the placenta covers the internal uterine os or not - both the course of pregnancy and its resolution depend on this. In the event that the low-lying placenta does not completely overlap the internal pharynx, they simply speak of low placentation, if it partially overlaps - about incomplete presentation, and if completely - about complete placenta previa. In the latter case, self-delivery becomes impossible and the pregnant woman is prepared for a planned caesarean section. The fact is that the complete overlap of the uterine pharynx will not allow the head or pelvic end of the child, depending on the presentation, to be inserted into the small pelvis and ensure the normal course of childbirth. In addition, the onset of labor usually results in placental abruption and life-threatening bleeding. If the internal os is not completely covered, independent childbirth is possible, but the possibility of an urgent operation after their onset remains high.
If there is simply a low location of the placenta, the woman is usually allowed to spontaneous delivery, but one should always be aware of the possibility of placental abruption, which can lead to acute fetal hypoxia.
What causes placental attachment pathology?
Normally, during fertilization, the embryo penetrates the wall of the uterus, creates a depression in it - a gap through which the necessary substances enter, later all this is transformed into the placenta. The best place is the bottom and back wall - this is where the egg usually attaches. But if there are any defects on the uterus - scars after abortions or operative childbirth, myomatous or adenomyotic nodes or congenital anatomical defects, the fetal egg cannot attach in the right place and does it lower, where possible. The placenta is also formed there.
The low location of the placenta is always fraught with malnutrition of the embryo, therefore, in women with low placentation, there is an initial threat of hypoxia and fetal hypotrophy, in addition, one should always be on the alert for placental abruption. This detachment does not always occur completely, causing severe bleeding and fetal death - sometimes detachments of small areas appear, under which blood accumulates in the form of a hematoma - there is no external bleeding and the pregnancy persists, but the larger the area of ​​\u200b\u200bthe exfoliated placenta, the worse the child feels.
Fortunately, far from all pregnant women with a low location of the placenta, this condition remains to the end - the so-called placenta migration occurs, this is due to the fact that the lower segment of the uterus is constantly changing, becoming larger, and the placenta attachment at the same time rises higher and higher. Thus, according to statistics, only 5% of women retain low placentation until 32 weeks (those who have been diagnosed), and only a third of the remaining retain this feature until 37 weeks.
There are no tricks or methods for treating a low location of the placenta, you just need to constantly be observed by a doctor and hope to enter that very successful percentage!

While carrying a child, a woman feels herself But not everything is always smooth. Quite often, the fair sex, who are in an interesting position, have various problems. One reason for concern is low placentation in pregnancy. 20 weeks is the limit by which the location of the placenta can change, and it can rise higher. Let's look into this problem in detail.

Low placentation during pregnancy

20 weeks is the period until which doctors do not make any verdict and just wait. Quite often, such a pathological location of the placenta is detected at the next ultrasound and has no signs.

What to do when making this diagnosis?

So, you have a low placentation during pregnancy (20 weeks). What to do in this case? There are several recommendations that a specialist can give you.

Preventive measures

First of all, you need to be calm and careful. This will help prevent bleeding and

Do not lift heavy objects and do not work hard. Try to get more rest and be calm. Long trips by car and travel are not recommended.

In almost all cases, when the child's place is located close to the pharynx, sedatives are prescribed to the pregnant woman, for example: valerian tablets or motherwort tincture.

Try not to make sudden movements. In some cases, doctors even prohibit their pregnant patients from sneezing or coughing heavily.

Treatment of complications

If bleeding occurs, it is urgent to take a horizontal position and call an ambulance. You will most likely be offered hospitalization. Never refuse the advice of a specialist and do not argue with him.

The main treatment is the appointment of drugs that stop the bleeding. These can be the following drugs: Tranexam tablets, Dicinon injections and other drugs.

Prenatal correction

In some cases, the location of the placenta may change just before the birth. That is why specialists often conduct ultrasound and find out where the child's place is. After finding out all the data about the placenta, the doctor decides how to carry out the birth.

Afterword

Do not panic too much if you have a low placentation at 20 weeks of pregnancy. Reviews of women suggest that in most cases the child's place rises higher and takes the correct location in the reproductive organ.

Otherwise, an experienced specialist will give you good advice and make the right decision about the method by which childbirth will be carried out. Trust professionals and be calm for your health and the life of your baby.

Low placentation during pregnancy is a serious complication that requires constant monitoring of the woman and 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 fetus. It attaches to the wall of the uterus, grows, develops and reaches maturity. Organ functions:

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

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

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

Schematic representation of the problem

The condition often resolves spontaneously when the upper sections 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 the baby can be acute hypoxia due to insufficient placental blood supply or premature birth.

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

The exact place of attachment allows you to find out the ultrasound 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 mucous membrane of the uterus;
  • miscarriages or abortions in the past;
  • gynecological interventions;
  • multiple pregnancy. Women with twins or triplets are automatically at risk;
  • childbirth by caesarean section;
  • fibroids, endometritis and other diseases of the uterus;
  • smoking, excessive alcohol consumption;
  • many births;
  • anomalies in the structure and development, the work of the uterus;
  • the woman's age is over 35 years.

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

See a doctor

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

  • 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 - lack of oxygen;
  • severe toxicosis - 30% of women with this diagnosis suffer from it;
  • in about half of the cases of pathology on ultrasound, a breech presentation of the fetus is detected.

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

Types of low presentation depending on the localization of the placenta:

  • back. This arrangement of the body is the most prosperous option. In most cases, in the later stages, the child's place moves up, freeing the birth canal. Pregnancy proceeds relatively comfortably;
  • front. In this case, you need to prepare for difficulties. If the baby is large and active, it will put pressure on the placenta. This will cause problems with the umbilical cord, the risk of entanglement and clamping. Such a presentation rarely changes for childbirth, which means that the birth canal will not be free;
  • complete or partial, when the organ obscures the cervix 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 the pregnant woman and the child. Held:

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

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

If the pregnancy proceeds normally, and the period has not reached 35 weeks, the treatment is conservative. Strict bed rest, observation of the fetus and the intensity of bleeding are shown. Any loads, sexual contacts are forbidden.

There are no medications that raise the placenta. Prescribe medications that help improve the condition of the pregnant woman and contribute to the migration of the child's place. This:

  • tocolytics, antispasmodics - stimulate the stretching of the lower parts of the uterus;
  • agents that reduce the tone of the myometrium;
  • iron-containing preparations - are prescribed to women with bleeding to prevent iron deficiency anemia;
  • medicines that activate placental circulation - to avoid the development of hypoxia in the fetus;
  • magnesia, intravenous glucose, vitamins.

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

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

With severe bleeding, poor condition of the woman, pregnancy is interrupted for health reasons.

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

Snapshot of ultrasound analysis

The choice of method of delivery under the condition of term pregnancy depends on the indications. With full presentation, the cervix is ​​​​closed, so a caesarean section is performed. It is also carried out with:

  • placental abruption;
  • polyhydramnios;
  • wrong position of the baby;
  • scars on the uterus;
  • multiple pregnancy;
  • age after 30 years.

If the presentation is partial, natural childbirth is not excluded. But only under the condition that the child is head down, active labor and the maturity of the cervix. With sudden bleeding, a puncture of the fetal bladder is made. This helps to stop the bleeding and lead to a normal birth.

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

What is dangerous

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 active movements. This is especially true for later periods, when a large baby presses on the organ and is able to hook the placental 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 circulation can cause increased fetal activity, which is fraught with entanglements and clamping of the umbilical cord;
  • placental abruption is a dangerous condition that leads to the death of the fetus, and sometimes the woman. With a complication, the stomach begins to hurt, bleeding appears;
  • in pregnant women with such a diagnosis, low blood pressure is often observed, late preeclampsia 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 worsens. Consequently, the nutrition of the fetus with useful components is defective. This increases the risk of intrauterine growth retardation and hypoxia.

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

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

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 planned ultrasound 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 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's place rises up. If the situation does not change, the doctor gives the woman advice on lifestyle and continues to try to correct the situation;
  • 3rd trimester. Mostly 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 fall into place, at 36 weeks the issue of caesarean section is decided. This is especially important with full presentation.

The cause could be uterine scraping.

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 towards the end of pregnancy. If this did not happen, but the woman and the baby feel well, a caesarean section is performed.

What Not to Do

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

  • worry. Modern medicine successfully manages pregnant women with low placental attachment. In 90% of cases, a woman gives birth to a healthy baby. Moreover, 60% of births are carried out naturally, and only 40 - by caesarean 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 exercises on the press, lift weights, walk a lot. Decide what is more important, an active lifestyle or the health of the child;
  • do douching and any other vaginal manipulations so as not to harm the pregnancy;
  • worry, worry, be annoyed. This will lead to an unhealthy emotional atmosphere and aggravate the condition. Develop stress resistance;
  • ride public transport, visit places with a large crowd of people. There they can push, which will cause an even greater omission of the organ;
  • ignore the doctor's advice, do not lie down to save when necessary.

You must be patient


If the presentation is low, the woman is advised to place a pillow under her feet so that they are above body level. This will help the placenta to 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 the regime of work and rest, not abuse of alcohol and tobacco;
  • protection against 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.

Thank you 0

Expectant mothers are very concerned about the question, what danger can a too low location of the placenta during pregnancy represent?

In the normal state, the placenta is the organ through which the exchange between the blood of the fetus and the mother takes place. It is attached along the back wall of the uterus or closer to its bottom. These are the areas with the best blood supply (due to many anatomical reasons). That contributes to the best course of metabolism. However, there are several reasons why the site of insertion of the placenta itself may be significantly lower. Its location below six centimeters from the internal os of the uterus is considered low.

The following point is of fundamental importance in this case: whether or not the placenta covers the internal os of the uterus. Not only the course of the pregnancy itself, but also its successful resolution largely depends on this. If the placenta is located low and does not cover the internal os at all, then we are talking only about low placentation. With partial overlap, we are talking about an incomplete presentation. If the placenta completely covers the internal os, then in this case they speak of complete presentation.

In this situation, independent delivery becomes completely impossible, so the woman is being prepared for a planned caesarean section. This is due to the fact that such a complete overlap of the cervix of the uterus does not allow the child, regardless of its presentation, to be inserted into the small pelvis, thereby ensuring the normal course of childbirth. Also, with the onset of contractions, placental abruption usually begins and bleeding opens, which threatens the woman's life.

In cases where the pharynx is not completely covered, there is still hope for independent childbirth. However, there is still a high (after their onset) possibility of an urgent operation. In the case of a simply low placenta, all women are brought to independent childbirth, however, it should be remembered that the placenta can detach. This leads to acute hypoxia of the fetus itself.

Why does a low placenta occur during pregnancy?

During fertilization, normally, the embryo implants directly into the wall of the uterus and creates a small depression or gap in it. All the necessary substances come through it. All this is later transformed into the placenta. The best place for this is the very bottom and back wall of the uterus - usually the egg is attached here.

However, in cases where there are any defects on the uterus:
a) scars after abortions or operations,
b) myomatous or adenomyous nodes,
c) congenital anatomical defects,
it becomes quite difficult for the fertilized egg to attach itself in the right place. Therefore, it is attached where it is possible, that is, much lower. The placenta will also form in the same place.

The location of the placenta below the norm is fraught with malnutrition of the embryo, which is why in women with this problem there is initially a threat of hypoxia as well as fetal malnutrition. There is also a constant threat of placental abruption. Moreover, detachment may not occur completely, thereby causing severe bleeding and subsequent death of the fetus. Quite often, its small areas exfoliate, under which hematomas (blood accumulations) form. At the same time, external bleeding is not observed and pregnancy persists, however, the larger the area of ​​\u200b\u200bthe placenta itself, which exfoliated, the worse the baby has.

To the great relief, not all pregnant women in whom the placenta is low, this condition persists until the very end of pregnancy. Quite often, the so-called migration of the placenta occurs and this circumstance is connected with the fact that the lower segment of the uterus is constantly changing. At the same time, it often increases and raises the site of attachment of the placenta higher and higher.

According to statistics, low placentation persists only in 5% of women up to 32 weeks (of those who have been diagnosed with this). And only 1/3 of the remaining retains the described feature until 37 weeks. We note right away that there are no methods or techniques for treating a low location of the placenta. A pregnant woman needs to be under the constant supervision of a doctor and hope that she will fall into this happy percentage.

The low location of the placenta is a fairly common pathology of pregnancy, which is very common in the first two trimesters.

Under good pregnancy conditions, the placenta should attach to the bottom of the uterus or to its posterior wall, sometimes with a transition to the lateral ones. It is in these places that it has the best blood circulation and is protected from possible injuries. The low location of the placenta is a pathology in which its attachment occurred 6 centimeters below the cervical os. This can only be seen with an ultrasound. In most cases, by the end of pregnancy, it rises and releases the uterine os.

Causes

The placenta is formed where the egg is attached. If there is any defect in the wall of the uterus in the place intended for this, then in order to “survive”, it will attach itself to any other area where all the conditions for this are available. Such a pathology can occur after infectious diseases, abortions or difficult births. Also, the low location of the placenta can be caused by the presence of uterine fibroids.

dangers

The main danger that can arise when the placenta is low is the termination of pregnancy. As a rule, this occurs due to which in turn causes an ever-growing uterus. Its maximum pressure falls precisely on the lower segment, where the placenta is located.

Signs of placental abruption

The main and most visible sign is bleeding resulting from damage to the uteroplacental vessels. As a result, it separates. Between the walls of the uterus and the placenta, blood accumulates and a hematoma is formed, which gradually increases and intensifies the process of detachment. This leads to compression of the placenta and the cessation of its functioning. There are 3 degrees of this pathology:

To avoid all of the above complications, women who have a low placenta should carefully monitor their condition. It is advisable to abandon sexual relations, thermal procedures and, of course, physical exertion. To accelerate the rise of the placenta, going to bed, you need to put your feet on a pillow or other hill. And most importantly, at the slightest ailment and the appearance of pain or spotting, do not hope that everything will pass soon, but immediately consult a doctor.