Aging of the placenta 1 to 2 degrees. The thickness and degree of maturity of the placenta: norms for weeks of pregnancy and deviations from them. Premature aging of the placenta

15.11.2021

Pregnancy is a great and emotionally intense time in any woman's life. However, this period is accompanied not only by inexhaustible joy, but also by exciting moments. Basically, all worries arise about the health of the unborn baby. And today we will tell you about the degree of maturity of the placenta by week in the table.

What do the words "degree of maturity of the placenta" mean?

First you need to understand what the placenta is. This is a temporary organ that appears exclusively during pregnancy and connects the mother and the child. It is the placenta that is vital for the baby. It gives him oxygen, destroys toxins and all the necessary nutrients pass through it. Therefore, it is so important that the placenta is normal and performs well the tasks assigned to it.

Like any other organ, the placenta develops, changes occur in it, which are called the degree of maturity of the placenta. Development means an increase in the thickness of the organ, the appearance of new vessels. It is possible to see these changes only with the help of an ultrasound examination, which should be carried out by a specialist to make sure that the mother does not have any abnormalities, nothing threatens the child's life.

4 degrees of maturity of the placental layer

To date, the thickness of the placenta is determined by the weeks of pregnancy and there are 4 degrees of maturity of the placenta. It is very important that the degree corresponds to the required period, which means that everything is normal.

This table will help expectant mothers to figure out on their own what degree of maturity should be in a certain week:

Placenta maturity = 0	From the moment of pregnancy to 27-30 weeks. The doctor should give you such a nominal degree at this time. However, it happens that the degree of maturity is 0-1, such deviations may occur due to a viral cold or alcohol or tobacco consumption;
Placenta maturity = 1	27-34 weeks. Grade 1 at this stage of pregnancy indicates that your placenta is developing normally and your baby is getting what it needs to grow healthy. If the specialist puts a grade of 1-2, then complex treatment is necessary: the correct menu, vitamins and medications that normalize blood circulation in the placenta;
Placenta maturity = 2	34-39 weeks. If at this time you have grade 2, then the placenta is wealthy. In general, this period is the most stable, and even if you have slight deviations from the norm, it is not scary;
Placenta maturity = 3	37 weeks and until the very birth. However, if grade 3 is associated with hypoxia, then it is necessary to take measures: instead of natural childbirth, it is best to perform a cesarean section.

It must be said that the younger the placenta (less its degree of maturity), the more functions it performs. Already before the birth of a child, her reserve of possibilities is limited, the placenta becomes old, which means dense. Therefore, if the degree of maturity of the placenta is ahead of pregnancy, then this becomes dangerous for the child, since an early aging organ cannot give the baby the required amount of nutrients and oxygen.

However, such a diagnosis does not always necessarily entail placental insufficiency, before you panic, carefully listen to the conclusion of your gynecologist.

What happens at each stage of placenta maturation?

As a rule, expectant mothers want to know everything in great detail about what is happening with their baby, so the question is: the degree of maturity of the placenta is 2, what does this mean? - occurs very often in the doctor's office.

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Let's take a look at the processes that accompany each degree in order.

The zero degree should be up to 30 weeks, at which time (starting from 12 weeks) the placenta begins to grow and gain strength. Its structure is completely even and smooth, the placenta fully fulfills all the tasks assigned to it. However, the mother does not always set a 0 degree, it happens that the doctor sets 0-1, which means premature aging of the placenta. You can see such a picture on ultrasound due to waves and blotches on the placenta, indicating its maturation. With such a history, a gynecologist will prescribe treatment for you.

Grade 1 should accompany you up to 34 weeks, which will indicate that this organ is developing at the right pace. If the mother is given a degree of 2 or even 3, then there is no need to panic, the gynecologist will conduct the necessary research and prescribe treatment if the situation requires it.

Sometimes the early maturity of the placenta does not threaten the child in any way, and in this case, the actions of the doctor and yours will be aimed at bringing the blood circulation back to normal. And this can be done with the help of a balanced diet, walks in the fresh air, vitamins and medicines. If the diagnosis is accompanied by the word "hypoxia", then, most likely, you will have to stay in the hospital under supervision, where doctors will try to keep you and your baby healthy. Only when the procedures do not give positive results, you will have to resort to premature birth.

From 34 to 39 weeks of gestation, the degree of maturity of the placenta should be equal to 2, at this time the organ has a relief structure, there are more inclusions, the gyrus becomes more expression.

Grade 3 is a normal diagnosis just before childbirth itself, which means that the placenta has played a role in carrying the baby. It has become old, as evidenced by its structure: deposited salts, deep waves, a large number of inclusions. The placenta performs the smallest number of functions at a given time.

Why does this organ become prematurely mature?

This question is asked by all mothers who have been diagnosed with this. And experts answer it like this:

A pregnant woman does not monitor her health, and the child suffers from this. Neglect can be expressed in smoking or systematic use of alcoholic beverages;
The mother does not have enough nutrients, therefore, the child also receives less of them;
The pregnant woman has late toxicosis;
Diseases that are caused by viruses and bacteria can also lead to the fact that the degree of maturity of the placenta does not correspond to the norm;
If the mother is expecting several children;
Lesions that are observed in the uterus;
There were abortions or unsuccessful pregnancies (miscarriages);
Chronic diseases of the endocrine system;
Individual characteristics of the organism.

However, this is an open list of reasons, there are a lot of them, and specifically yours can be found out only after a complete and professional examination.

The placenta is a very important, albeit temporary, organ that exists while the fetus develops and grows. After the birth of the baby, she dies off and is rejected.

Moreover, like any human organism, the placenta goes through all stages: birth, maturation and aging.

This process is quite natural, but it is necessary that everything happens in due time, because otherwise there is a risk of various pathologies or threats to pregnancy.

Its main function is to fully support the life of the baby while it is in the mother's belly. The properties of this embryonic organ can hardly be overestimated, since it is the placenta that is considered the most important component for the process of intrauterine development.

The most important tasks of the placenta are:

protection of the fetus from the negative effects of the environment, the penetration of bacteria, viruses, etc.;
release of hormones necessary to maintain pregnancy;
removal of harmful substances;
providing the child with the necessary nutrients and nutrients, oxygen;
performing the functions of many organs of the baby until their full development and independence (as excretory, endocrine and other systems).

The placenta does not appear immediately after conception. First (approximately on the tenth day), cells are actively dividing, which are responsible for the future connection of the mother and the fetus. As a result of this process, the production of special enzymes begins, which slowly line the uterine cavity, creating conditions for the baby to access the nutrients of the mother's body. Next comes the formation of stable blood circulation between a woman and a child.

Placental development: what is maturity?

The early placenta will form only by 9-10 weeks. As pregnancy develops, the placenta also develops: it increases in thickness, its vessels grow, etc.

There is a concept of maturity of the placenta, which is practically the main indicator for assessing structural, physiological changes, determining the presence of pathologies, abnormalities or disorders.

The placenta develops so that the baby's needs, which are constantly changing, can be met in time and in full.

In this regard, functionality is lost, that is, the child may be more susceptible to viruses, begins to receive less oxygen, etc.

Research numbers: what do they mean?

There are four degrees of maturity of the placenta, each of which reflects a certain stage in the development of this organ and the physiological changes that occur in it.

It is necessary that the degree of maturity of the placenta clearly corresponds to the period of your pregnancy, because this indicator indirectly indicates the state of health and well-being of your child.

Table. Placenta maturity by week of pregnancy

Placenta maturity	The nature of the structure of the placenta	Type and characteristics of the tissue of the chorionic part, which is adjacent to the fetus	Areas of calcium deposits (salts)
Up to 27-30 weeks - 0 (zero)	Homogeneous	The fabric is even and smooth	Almost not
From 27 to 36 weeks - 1 (first)	With few seals	Separate echogenic inclusions appear, the chorionic plate acquires a slight waviness	Microscopic presence
From 34 to 39 weeks - 2 (second)	Pronounced seals are present	Waviness increases, many shallow depressions can be discerned	Explicitly visible
After 36 weeks - 3 (third)	Possible placental cysts	The chorionic membrane acquires a pronounced tortuosity, and the placenta itself acquires a lobular structure	A lot

How do you diagnose the problem?

Each stage of pregnancy must correspond to a certain degree of maturity of the placenta.

If these indicators are in order, then the doctor will be able to conclude that the organ is functioning normally and is able to fully satisfy the needs of a developing and growing baby in oxygen and nutrients.

If the indicators do not correspond to the norm, then this will become a diagnosis of organ pathology. Next, the doctor will decide on corrective treatment or preventive measures to prevent the baby and pregnancy from being harmed.

To determine the degree of maturity of the placenta and the nature of its changes, various diagnostic methods are used:

(CTG);
hormonal research.

The difficulty is that each diagnostician on an ultrasound scan can quite subjectively assess the degree of maturity of the placenta, because the indicators are determined practically "by eye".

That is why, at the slightest doubt, it is necessary to confirm the diagnosis with other diagnostic methods and studies.

For example, the same Doppler ultrasonography can give completely normal readings, saving you from unnecessary fears. This method is based on the assessment of blood flow through the placenta, and the ability to do it allows the reflection of ultrasound waves.

If the pregnancy is proceeding normally, then after twenty weeks the blood resistance in the vessels that connect the woman's uterus, placenta and baby will begin to decrease. Only Doppler ultrasonography will be able, at the same time, to assess the condition of the baby: whether he receives enough nutrients, oxygen, etc.

Ultrasound readings about the degree of maturity of the placenta may not correspond to Doppler measurements.

CTG is another additional diagnostic method. Thanks to him, you can find out how your child is feeling right now. Such a cardiac monitoring study with the help of special attached sensors helps the doctor calculate how often the baby moves, catch and listen to his heartbeat, and record the contractions of the woman's uterus.

All these indicators will indicate either the normal work and functionality of the placenta, or about its failures and violations.

Possible deviations and their reasons

If your research results are marginally different from ideal book standards, don't worry too much. It is important not just to find out the "dry numbers" that reflect the degree of maturity. Much more important is the assessment of the condition and well-being of the baby.

That is why Doppler and CTG are performed: check how the child is feeling, whether everything is in order with him, whether its size and development correspond to the duration of your pregnancy, etc. The doctor will certainly tell you how the pregnancy is going, and whether real cause for concern.

Dangers of Premature Aging of the Placenta

If the second degree of maturity of the placenta was found before the 32nd week, or the third degree - earlier than the 36th, doctors talk about its premature or early aging.

There are many reasons for this pathology:

hormonal disorders;
chronic diseases of a woman (problems with the cardiovascular system,);
infectious diseases leading to intrauterine infections of the child;
(hypertension);
improper or uncontrolled use of vitamins (especially calcium);
or ;

One of the most common reasons is simply an unhealthy lifestyle: the presence of bad habits, the use of alcohol, drugs, smoking.

Premature aging in itself is not yet a direct threat to the life or health of the baby. However, in combination with other abnormalities or violations, this can lead to negative consequences:

Occurs due to lack of oxygen. The child will suffer and this will affect his health. In some cases, even the death of the fetus was recorded.

Intrauterine growth retardation.

It occurs due to insufficient intake of nutrients and vital substances into the baby's body. This can result in malnutrition, growth retardation, etc.

(if there is a very large non-compliance of the indicators with the norms).

Doctors will try to check the correctness of the diagnosis using other diagnostic methods. If it is confirmed again, then the woman will be prescribed comprehensive treatment and prevention measures. You may need to go to the hospital under medical supervision. Urgent delivery is sometimes recommended.

Why can late maturation be observed?

This pathology is much less common than the previous one. The placenta is considered immature if it has not reached the second or third degree before the end of pregnancy.

Sometimes the reason for such a diagnosis can be a simple technical error: if a mother and a child are present, then the placenta will have swelling, which on ultrasound will seem to be a zero degree of maturity.

However, due to such a symptom, a serious complication can be overlooked.

Prolonged immaturity of the placenta sometimes leads to the fact that it does not fulfill its necessary functions at all, or it does them incorrectly. This threatens to turn into mental retardation of the child, other developmental anomalies, and even lead to his death and stillbirth.

Doctors note that pathology is possible in the presence of congenital malformations of the baby. Sometimes it can be observed in pregnant women and diabetes.

Instead of a conclusion

Do not panic or self-medicate under any circumstances. The degree of maturity of the placenta is not yet a clinical diagnosis, but only an important diagnostic sign.

Doctors will carefully monitor the well-being and condition of the child in order to detect the presence of serious reasons for concern in time and take appropriate measures. You also need to take care of your health, as well as follow all the recommendations and prescriptions of the doctor.

Seven days after fertilization, the human embryo, freely located in the uterus, begins to sink into its mucous membrane. Having attached to the back (less often to the front) wall of the uterus with its villous membrane, chorion and allantois, the embryo enters the so-called fetal period of its development. At this time, a temporary organ is formed - a child's place or placenta.

What role does this structure play in the process of intrauterine development of the unborn child, which means the degree of maturity of the placenta - these and other issues will be considered by us in this article.

Why is a placenta needed?

Everything that grows and develops must eat and breathe. And the future baby is no exception. From the mother's blood, glucose, amino acids and, of course, oxygen enter its cells. It turns out that the blood vessels of the fetus and the mother are not anatomically connected with each other. This fact is of fundamental importance, otherwise the ballast substances from the mother's bloodstream would clog the blood of the embryo. On the other hand, proteins of the embryo, foreign to the mother's immune system, would provoke serious disturbances in homeostasis in her. So it is the placenta that creates the necessary barrier, while simultaneously providing through its special structures - cotyledons - passive exchange of plastic compounds and gases between the organisms of the mother and her unborn child. In embryogenesis, complex metamorphoses take place not only in the development of the fetus, but also the degree of maturity of the placenta changes by week. The table below will reveal to us the dynamics of these changes.

The fruitful part of the child's place

As we have already found out, the placenta is formed as a temporary organ, starting from 3-6 weeks of pregnancy. The fertilized egg - the zygote - begins to split and becomes covered with a villous layer called the chorion. At 10-12 weeks, an early afterbirth is formed, and the chorionic villi grow into the endometrium of the uterus.

At first, the structure of the placenta is amorphous, but from 12 weeks the baby's place gradually takes on the appearance of a flat disc. By the end of pregnancy, its diameter reaches 20 centimeters, and its weight is 0.5 kg. The surface of the child's place facing the embryo is called fetal. The histological structure of the amniotic membrane and the chorion that forms it indicates a direct connection with the body of the embryo, which is carried out through the umbilical cords and the ring that enter the epithelium (skin) of the developing child.

Placenta functions

Together with the maternal part, represented by the endometrium, the child's seat performs a number of important functions: trophic, respiratory, barrier, excretory, endocrine. We examined the first three earlier, recall that thanks to such processes, the embryo receives the necessary nutrients, vitamins, solutions of mineral elements in the form of compounds.

The respiratory function of the placenta is carried out by the diffusion of oxygen and carbon dioxide molecules circulating in the blood vessels of the umbilical cord. The barrier property of the placenta prevents the penetration of antigens into the body of both the mother and the fetus. The ability of a child's place to produce hormones such as progesterone and prolactin determines the idea of the placenta as an endocrine gland. The excretory function of the child's place is to evacuate toxic products from the blood of the embryo through the umbilical veins: creatine, urea and excess salts.

Parameters of a normally developing fetus

Regular ultrasound examination of the unborn child allows you to determine what degree of maturity the placenta should be, based on the woman's gestational age. The shorter the period, the more processes of biosynthesis of carbohydrates, proteins and lipids are carried out by the cells of the embryo and the more intensive are the metabolic processes between the blood of the mother and the fetus.

The tissue structure and metabolism of the child's place during this period corresponds to 0 degree of maturity of the placenta by week. The table compiled according to the results of diagnostics of a normal pregnancy and presented below shows that up to 30 weeks is characterized by the following physiological norm of the state of the child's place: the almost smooth surface of its fetal part, the homogeneity of the tissue structure and the absence of deposits of calcium salts in them. However, even with the full compliance of the ultrasound results obtained with the above listed parameters of the rate of development of the placenta, the decisive indicators will be the heart rate and the provision of the organs and tissues of the fetus with oxygen.

Aging of the placenta: norm or pathology?

The baby's seat is a temporarily functioning organ, therefore, its tissues gradually coarse (their consistency becomes denser), which leads to a deterioration in the processes of diffusion and osmosis, as well as to a decrease in the blood flow rate in the placental vessels. The most significant week for elucidating the mechanisms of aging of the placenta is 34 weeks. The degree of maturity of the placenta during this period increases greatly, and by the 39th week of pregnancy, the afterbirth becomes very dense, and its functioning decreases.

This is a genetically and physiologically normal phenomenon that occurs during pregnancy. The dependence of the state of the child's place on the trimester of pregnancy is determined as the degree of maturity of the placenta by week. The table below provides visual information showing the correlation between the period of fetal development and the histological picture of placental structures.

Why is the baby seat getting old?

In some cases, the aging rate of the organ linking the mother and child may increase. For example, according to the result of an ultrasound scan, the doctor puts the 2nd degree of maturity of the placenta, although the gestation period is less than 32 weeks. There may be several reasons: a past viral infection, regular intoxication as a result of smoking, chronic diseases of the woman herself (hypertension, diabetes mellitus, thrombophlebitis) or Rh-conflict.

How much this will affect the development of the fetus is determined by the attending physician, who will choose the correct treatment strategy. Usually it includes both additional diagnostic procedures and examination in a hospital setting.

The relationship between the gestational age and the state of the placenta

As you can see, many different factors can affect the degree of maturity of the placenta. The norms given in the table will help the expectant mother compare them with her own ultrasound indicators.

Early aging of the placenta is not necessarily a life-threatening symptom for the mother and fetus. For example, if the 3rd degree of maturity of the placenta, detected at 34-36 weeks of gestation, is not associated with disturbances in blood circulation in the vessels of the uterus and the child's place, or with a diagnosed violation of embryogenesis, or with Rh-conflict, then there is no reason for concern. Otherwise, the pregnant woman will be offered a course of treatment in a hospital, and as an extreme option - artificial childbirth.

How pregnancy pathologies affect early maturation of the placenta

Let us remind you once again that the baby's place is the most important temporarily functioning structure that connects the organisms of the mother and the unborn baby. The afterbirth unites the circulatory systems of the pregnant woman and the embryo, thanks to which nutrients and oxygen from the maternal blood diffuse into the organs and tissues of the fetus. Thus, all disorders of the general blood flow will have multiple negative consequences. For example, gestational hypertension (increased blood pressure in a woman) from the 20th week of pregnancy can lead to the formation of defective vessels in the placenta. This inevitably entails the processes of decompensation of the arteries of the placenta, which leads to its premature aging, not to mention the threat of the development of hypoxia in the fetus.

In this article, we found out how the various stages of pregnancy and the degree of maturity of the placenta are interconnected by week. The table compiled based on the results of ultrasound diagnostics with Doppler will help expectant mothers to get the information they need.

The placenta (baby's place, afterbirth) is an organ that appears in the uterus when carrying a child. Its main duty is to ensure the life of the embryo, its development and growth. This organ will be fully created by the 12-week gestation period and will increase in size, just like the baby. To determine the state of the organ, there is a definition - the degree of maturity of the placenta.

Until the onset of the 3rd trimester, it has a zero level, the maximum maturation is the 3rd degree of maturity of the placenta. During the zero degree, the structure of the placenta is homogeneous, later the initial features of maturation appear. The period of maturity of the placenta is noted by weeks and detailed monitoring of its condition and ratio to the gestational age is constantly carried out. Small differences in its functioning can cause significant developmental disabilities. It is possible to assess the state of the organ only by ultrasound.

What is the placenta for?

It is a one-of-a-kind organ that unites the unborn child and his pregnant mother. Thanks to the placenta, all the necessary elements are supplied to the embryo, and the well-being of pregnancy depends on it.

The functions of the placenta are to perform the following tasks:

helps to breathe (provides an influx of air to the embryo, removal of carbon dioxide);
provides nutrition (delivers nutrients from mom to baby);
removes waste products of the fetus;
performs the function of a barrier, protecting the baby from harmful elements;
provides a healthy hormonal background, forms a large number of hormones necessary for a normal pregnancy.

How the placenta is formed

The placenta begins to form at 5-6 weeks of pregnancy and grows so quickly that it even outstrips the embryo in growth rates. By the end of the gestation period, the child and the mother are united by a baby seat measuring 15-20 cm in diameter, and weighing about half a kilogram.

Further, from 33 weeks in the placental tissue, maturation processes are tied. The onset of labor is associated with the greatest maturity of the placenta. By the end of the term, she ceases to carry out her own functions, the baby's body releases a certain hormone into the mother's blood, which provokes the onset of contractions.

Placenta thickness by week

1 degree of maturity of the placenta

Until the 30th week of pregnancy, the placenta is at zero maturity. The placenta is homogeneous in structure, has smooth tissues. It effectively satisfies all the needs of the fetus, perfectly fulfilling its purpose. Sometimes it happens that already from the 27th week, the early transition of the placenta to the first degree of maturity begins. Its state changes - blotches, waves and other initial signs of ripening appear on the surface. In some cases, when it was not possible to establish 1 degree of maturity of the placenta, doctors set a degree of 0-1. The transition that occurred earlier than the prescribed period is called premature aging. In this case, the doctor may prescribe additional treatment to normalize the supply of food and oxygen to the fetus, and improve placental blood flow.

According to the norms, 1 degree of maturity of the placenta lasts until the 34th week. In this case, there is no reason to worry about the health of the baby. But often at the 30th or 32nd week during a planned ultrasound, a 2 or 3 degree of maturity of the placenta is diagnosed. These values do not always indicate a dangerous placental insufficiency, therefore, an additional comprehensive examination is carried out for each specific case.

2 degree of maturity of the placenta

During pregnancy without any complications, the placenta reaches the second degree of maturity from the end of the 34th week. Waviness, tortuosity of the placenta increase up to the 37th week, the number of echo-positive fragments, convolutions on the membrane increases.

If the second degree of maturity of the placenta was detected before the gestation period reached 33 weeks, additional examination is necessary. The complex of diagnostic measures, as a rule, includes blood tests, smear analysis for flora, CTG of the fetus. The results of these procedures will show whether there is a risk to the fetus and whether there are pathologies. It should be noted that premature maturity of the placenta does not always harm the development of the fetus. Then all measures will be aimed at maintaining the condition of the placenta and improving blood circulation. Most often, outpatient treatment is prescribed with the use of drugs such as Actovegin, Curantil and others. It is very important to take vitamin supplements, take daily walks in the fresh air and improve the diet to prevent oxygen deficiency.

If hypoxia has already been diagnosed, and the fetus is experiencing a lack of nutrients and other essential compounds, then the pregnant woman is hospitalized. The hospital will carry out a course of treatment with medicines, regular CTG procedures and other supportive measures designed to support the health of the woman and the child.

If, during a comprehensive examination, a dangerous complication is detected that harms the health of the child, and supportive therapy does not lead to significant improvements, doctors may resort to premature birth.

3 degree of maturity of the placenta

3 degree of maturity of the placenta during full-term pregnancy is the norm. The vital activity of the organ slows down, the placenta is prepared for the end of gestation. The term for the development of the placenta ends, and at the end, the physiological aging of the placenta occurs. Signs of aging of the placenta are considered to be deep folds reaching the basal layer. The surface is covered with numerous inclusions and deposits of salts, spots of arbitrary shape. After 37 weeks, pregnancy is defined as fully term. In emergency cases, a cesarean section is prescribed if the child has an acute lack of oxygen or placental abruption

In some cases, the 3rd degree of maturity of the placenta does not correspond to the actual gestational age. This poses a threat to the development of the fetus in connection with acute hypoxia, provokes premature birth. Once the risk is identified, doppler is done. This procedure helps to assess the quality of the blood supply to the fetus and understand what the risk is. Sometimes the 3rd degree of maturity of the placenta is observed at the 30th week of pregnancy. This usually occurs after uterine bleeding or previous illnesses. This condition cannot be cured, so the only solution is to induce labor.

The main prerequisites for early aging of the placenta

There are more than enough circumstances leading to this. Often, such a difficulty appears in pregnant women who are careless about their own health or experiencing health problems.

Causes initiating untimely aging of the placenta:

smoking and drinking alcohol;
lack of vitamins and essential minerals;
viral and enterobacterial infections;
past miscarriages, abortions and pathologies in the uterus;
multiple pregnancy;
endocrine system ailments;
preeclampsia;
physiological characteristics of a woman.

Why is premature aging of the placenta dangerous?

Aging of the placenta is considered a natural and irreversible process, but in certain circumstances it happens ahead of time, which indicates a pathology and will require additional research.

The following conditions are considered as circumstances of deviations from the norm:

childbirth with complications, multiple abortions;
thyroid problems and diabetes mellitus;
genital infection;
rhesus conflict;
late toxicosis, preeclampsia;
exfoliation of the placenta;
multiple pregnancy.

Usually, a violation of the placenta is formed asymptomatically and practically does not affect a woman's health. For better diagnosis, in addition to ultrasound, dopplerometry and fetal cardiotocography can be prescribed.

Any treatment in the course of deviations is carried out under the strict supervision of a physician. All activities are aimed at preserving the course of pregnancy. However, if urgently needed, doctors may resort to calling a premature birth in order to preserve the life of the baby and the health of the mother.

Carrying a child is a process thought out to the smallest detail, but sometimes the program laid down by nature fails. In order to know that everything is going well, the fetus is developing at a normal pace, doctors, through long-term observations, have derived norms that make it possible to monitor the course of pregnancy and detect pathologies in time. The placenta is a very important organ, therefore doctors monitor its functioning and condition, thickness and degree of maturity. And when deviations appear, treatment is prescribed.

The role of the placenta in fetal development

The placenta (or baby's place) is a special organ, the formation and existence of which is possible only during pregnancy. It performs a number of important functions:

provides oxygen respiration of the fetus and the supply of all necessary substances to it;
removes carbon dioxide and metabolic products formed in the process of life and development of the baby;
protects the child from the penetration of hazardous substances from the mother's bloodstream;
produces hormones necessary for the normal course of pregnancy and the successful development of breastfeeding after childbirth.

In some countries, the placenta has not only physiological, but also mystical significance. So, in Indonesia, she is considered the guardian angel of the child, after giving birth she is buried in front of the house and is revered throughout a person's life.

Since the importance of the state of the placenta for the course of pregnancy and the development of the fetus plays a primary role, doctors monitor the development of this organ, necessarily determine the place of its attachment, thickness, etc.

When do they begin to track the indicators of the thickness of the placenta

The formation of a child's place begins from the very beginning of pregnancy, when a fertilized egg is attached to the wall of the uterus. In this case, the so-called chorion is first formed, which develops and subsequently becomes the placenta. It can be determined by ultrasound from 11-13 weeks, that is, with the first scheduled ultrasound examination, but it begins to perform its functions by the middle of the second trimester.

The thickness of the placenta is measured by ultrasound

Measurement of the thickness of the placenta begins from the 20th week of pregnancy. It makes no sense to do this earlier, because the indicators obtained do not carry a semantic load. During an ultrasound scan, the specialist determines and fixes the width of the largest value of the child's seat, and then this indicator is compared with the previously developed and adopted standards.

Table: Normal Placenta Thickness by Week

Week of pregnancy	Lower and upper limit of the norm, mm	Average value, mm
20	16,7–28,6	21,96
21	17,4–29,7	22,81
22	18,1–30,7	23,66
23	18,8–31,8	24,52
24	19,6–32,9	25,37
25	20,3–34,0	26,22
26	21,0–35,1	27,07
27	21,7–36,2	27,92
28	22,4–37,3	28,78
29	23,2–38,4	29,63
30	23,9–39,5	30,48
31	24,6–40,6	31,33
32	25,3–41,6	32,18
33	26,0–42,7	33,04
34	26,8–43,8	33,89
35	27,5–44,9	34,74
36	28,2–46,0	35,59
37	27,8–45,8	34,35
38	27,5–45,5	34,07
39	27,1–45,3	33,78
40	26,7–45,0	33,50

Deviations in the thickness of the placenta from the norm: causes, consequences and treatment tactics

Pregnancy does not always proceed smoothly, in some cases, the development of the placenta does not correspond to normal indicators. If the thickness of the child's seat is less than normal, but they speak of hypoplasia, otherwise hyperplasia occurs.

Thickening of the placenta or hyperplasia

The diagnosis of hyperplasia is made when the width of the placenta in its thickest place exceeds the upper limit of the norm, and the greater the deviation, the more dangerous the situation. Such a pathology develops for various reasons:

sexually transmitted infections (chlamydia, syphilis, gonorrhea and others);
diabetes;
viral infections, including ARVI;
rhesus conflict;
fetal malformations;
anemia;
preeclampsia;
pregnancy with twins.

Twin pregnancy is a situation where hyperplasia is a normal variant. To provide two fetuses with oxygen and all the substances necessary for them at once, the baby's place becomes larger, the volume of placental tissue increases.

During pregnancy with identical twins, only one placenta is formed, which ensures the supply of all the necessary substances and oxygen to them, therefore, an increase in its size is considered a variant of the norm.

Hyperplasia is the body's response to the influence of external factors, an attempt to protect pregnancy. With an insufficient supply of oxygen to the child, the death of capillaries, an increased proliferation of the network of blood vessels occurs in order to prevent oxygen starvation of the fetus. Therefore, in modern medicine, a thick placenta is not an independent diagnosis, but a consequence of some other pathology.

Hyperplasia is detected during an ultrasound scan. In this case, most often, no accompanying symptoms are observed. Doctors consider pathology dangerous for the fetus when, in addition to thickening the child's place, there is reason to talk about a violation of its functions. If the placenta does not fully fulfill its role, the likelihood of consequences for both the baby and his mother is high:

the child does not receive the amount of oxygen he needs, which affects all his organs and systems; in severe cases, fetal death is not excluded;
possibly the onset of premature birth or the need for a cesarean section;
weakness of labor due to a violation of the hormonal function of the child's place can lead to complicated childbirth, birth trauma;
in the postpartum period, the risk of bleeding in the mother increases, there is a likelihood of problems with breastfeeding.

The expectant mother needs to pay attention to fetal movements: with a lack of oxygen, the baby's motor activity increases. A dangerous signal is a decrease in the number of movements. If warning signs appear, you should see a doctor as soon as possible.

Detection of hyperplasia requires mandatory medical supervision of the woman. First of all, it is necessary to establish the cause of the pathology and the tactics of treatment will depend on this. A comprehensive examination of the mother's health is carried out, cardiotocography and dopplerometry are prescribed to determine the child's heart rate and establish abnormalities in the placental circulation. Even if the functioning of the child's place is not impaired, doctors often prescribe drugs that improve blood circulation in the placenta (for example, Actovegin, Curantil). Treatment can be carried out both in a hospital and at home.

Hypoplasia or thin placenta

Hypoplasia occurs when the thickness of the placenta does not correspond to the norm, but is outside its lower border. At the same time, the fetus experiences oxygen starvation, the heart rate and placental blood flow are slowed down. All this leads to developmental delay, premature birth and even intrauterine death of the baby, therefore, medical intervention is required.

The lag in the thickness of the placenta from normal values can be caused by various reasons:

fetal malformations;
If the cause of hypoplasia lies in genetic abnormalities, then in this case, doctors talk about the primary form of pathology. She doesn't respond to medical treatment. In all other cases, hypoplasia is considered secondary, that is, caused by a concomitant disease, and is corrected with drugs.
high pressure;
atherosclerosis;
preeclampsia;
bacterial and viral infections;
the use of alcohol, drugs, smoking.

A thin placenta as a variant of the norm can only be in miniature women, in all other cases it is a sign of pathology.

Hypoplasia is detected only on ultrasound. Women with such a diagnosis are hospitalized, prescribed drugs to improve blood flow in the placenta, prevent the formation of blood clots, affecting blood clotting, vitamins and others, depending on the causes of the pathology.

Placental hypoplasia requires constant medical monitoring of the condition of the woman and the child, so the pregnant woman is hospitalized

What is placental maturity

In addition to thickness, there is such a thing as the maturity of the placenta. The fact is that this organ lives for only 9 months, during which all stages of development go through: from education to aging, and then rejection immediately after childbirth. As it goes through its life cycle, the child's seat changes its structure and appearance. So, if at first it is homogeneous, even and smooth, then as it matures (or aging) it becomes wavy, inclusions of calcium salts and seals appear in it, formed as a result of the death of blood vessels. This process is not pathological, it is inevitable for any pregnancy.

Maturity levels and their description

There are 4 degrees of maturation of the placenta:

zero, which is normally observed up to the 30th week of gestation - the baby's place has a homogeneous structure, its surface is smooth and even, there are no compaction and deposits of calcium salts;
the first, which corresponds to 27–36 weeks of gestation - the structure has ceased to be homogeneous, there are indurations and calcium salts, but there are few of them, the surface of the placenta has become wavy;
the second, which corresponds to 34–39 weeks of gestation - seals and inclusions of calcium salts are found more and more, the surface becomes more wavy;
the third, which is observed after 36 weeks of gestation - calcium salts and indurations in the structure of the placenta are found in large quantities, cysts may appear, the child's place acquires a lobular structure.

In addition to the described four degrees of maturity, in some sources you can find intermediate stages of maturation of the placenta: 0-I, I-II, II-III. The identification of such transitional periods is associated with the presence of signs characteristic of both one and another degree of aging. This is due to the fact that changes in the child's place occur gradually, starting from the edges and moving towards the middle.

There are 4 degrees of maturity of the placenta: zero, first, second and third

Why is premature and late maturation of a child's seat dangerous?

Although aging of the placenta is a natural process, it should take place on time. In case of non-compliance with the norms, they talk about the premature / late maturation of the child's place. Deviation both in one and the other direction is a sign of pathology, but it is necessary to judge whether the situation is dangerous, not only by the degree of aging, but also by the functioning, therefore, dopplerometry of the vessels of the fetoplacental complex is required, which makes it possible to assess whether there is enough oxygen goes to the fetus. If the research indicator is normal, there is no sense in sounding the alarm, the gynecologist can only recommend a second ultrasound scan after a while.

When the placenta does not perform its functions properly, the child does not receive enough oxygen, waste products are not fully excreted, therefore, both the fetus and the chorion itself are intoxicated, which only aggravates the situation. In this case, treatment is required, and if there is a threat to the life and health of the fetus, they resort to premature delivery.

Video: a specialist on premature aging of the placenta

The experience of moms facing placental development problems

In the past pregnancy was (premature aging). But also some calcifications. Went for 2 weeks. in a day hospital, where Actovegin was put, Cocarboxylase, and Wilprafen herself drank. Then everything became normal. What exactly helped and whether there was a need - I don't know.

I don’t want to scare you, but my diagnosis (premature aging) led to an emergency cesarean at 36 weeks. They said that they got it in time, that the child suffered in utero, there was not enough food for him ...

https://www.u-mama.ru/forum/waiting-baby/pregnancy-and-childbirth/365947/

At 34 weeks, they set grade 3, premature aging, panicked and sent to hospital. In the maternity hospital they did CTG, doppler - everything is perfect. The doctors shrugged their shoulders and discharged me home. No treatment was prescribed. She gave birth at 41 weeks exactly, and until the very birth there were no complaints about the Doppler and CTG. The child is healthy.

https://deti.mail.ru/forum/v_ozhidanii_chuda/beremennost/prezhdevremennoe_starenie_placenty_1494744767/

I had hypoplasia, the diagnosis was made at 7 months, and Curantil was prescribed. They put me in the maternity hospital 2 weeks earlier than planned, stimulated it several times, but I still gave birth right on time, even 2 days later. My daughter is now 11 years old.

http://www.woman.ru/health/Pregnancy/thread/3918784/

I had intrauterine fetal death at 32 weeks, the reason was placental hypoplasia. My friend's child died at 40 weeks for the same reason. During pregnancy, ultrasound did not notice anything :(

https://eva.ru/static/forums/53/2008_1/1210371.html

Deviations from the normal values of the thickness of the placenta, its premature or late maturation - this is not a reason to panic. If an ultrasound scan reveals hyper- or hypoplasia, a discrepancy between the degree of maturation of the child's place and the gestational age, you should consult with the gynecologist who is leading the pregnancy and follow his advice. It is impossible to neglect common sense in such a situation, because serious consequences are possible for both the child and the expectant mother. But in most cases, women with similar problems become happy mothers.