Regulations 

Early aging of the placenta 34 weeks. How to diagnose a disease. Aging of the placenta during pregnancy: causes

The appearance of echographic signs of maturity placental tissue earlier than gestational age, for which such changes are physiological. Clinically it does not manifest itself in any way, it is diagnosed only when routine screening... When making a diagnosis, ultrasound data is used. The study is complemented by dopplerography placental blood flow, CTG, fetometry, fetal phonocardiography. Treatment involves the treatment of the underlying disease and the appointment of drugs that improve blood circulation between the pregnant woman and the child - antiplatelet agents, vasodilators, essential phospholipids, amino acid complexes.

Diagnostics

Treatment of premature maturation of the placenta

The main medical tasks in the management of a pregnant woman with PSP are the correction of the disorders that caused the pathology, the normalization of blood circulation in the uteroplacental system, the choice the best way and time of delivery. The tactics of managing the patient at the prenatal stage is determined by the period at which it was diagnosed premature aging:

  • Early detection of PSP... Detection of metabolic-dystrophic changes in the placental tissue at 20-24 weeks is an indication for examination in a specialized department of pregnancy pathology. In such cases, starting from the 26th week of gestation, dopplometric monitoring of blood flow is performed at least 1 time per week, fetal movements are counted daily. Urgent delivery in case of critical violations of blood flow in the umbilical cord, CTG signs of fetal hypoxia, arrest of its growth, a sharp decrease in volume amniotic fluid, the appearance of other signs of a threat to the child can be performed even for a period of 31-33 weeks.
  • Revealing PSP inIIItrimester... According to the research results, when the process of premature aging of the placenta is detected at 32-34 and, especially, 35-37 weeks of gestational age, the probability of a pathological course of pregnancy is significantly reduced. However, for the timely detection of complications, it is necessary to ensure regular ultrasound and specialist supervision. The preferred method of delivery is vaginal delivery. Only in those cases when PSP is combined with a significant delay in fetal development, a caesarean section is indicated for the prevention of acute distress syndrome in a child.

Regardless of the timing of the detection of premature maturation of the placenta tissue, an obstetrician-gynecologist or a specialized specialist actively treats the underlying genital or extragenital disease using antibiotics, hormone therapy, immune correctors, cardiovascular and other medications. In parallel with the correction of the leading disorder, drugs are prescribed to improve the blood supply to the fetus - vasodilators, antiplatelet agents, amino acid complexes, essential phospholipids. Drug therapy complemented by non-drug methods- rational physical activity, diet correction, normalization of sleep and rest.

Forecast and prevention

Timely screening and correct medical tactics can reduce the risks of fetoplacental insufficiency during aging of the placenta, slow down this process and prolong pregnancy to a safe time for the birth of a child. Primary prevention involves planning pregnancy for patients with genital and extragenital diseases, protected sex to protect against specific infections, justified prescription of invasive gynecological procedures, quitting smoking, alcohol and drug use. During gestation for normal development placenta, it is important to take care of protection from possible infection ARVI and others infectious diseases maintaining the level of hemoglobin sufficient motor activity and a rational diet. Secondary prevention is aimed at early diagnosis disorders, includes timely registration with an antenatal clinic, regular passage scheduled examinations and ultrasound.

Carrying a child is not always cloudless. Sometimes this process is complicated by the occurrence of various pathological conditions, requiring close attention, adequate correction, and sometimes the adoption of urgent medical measures. That's why future mom should be very attentive to her well-being, systematically visit a doctor and go through all necessary research... After all, only a timely examination can reveal premature aging of the placenta at 30, 31, 32, 33, 34, 35, 36 weeks.

The placenta is essentially an embryonic organ. It performs many functions - it protects the fetus from infectious lesions, produces a number of necessary hormones, ensures the delivery of oxygen and various nutrients... All kinds of violations in her activities can harm both the baby and the expectant mother.

The formed placenta looks like a disk-like organ. Its diameter is approximately two hundred millimeters, and its weight is about half a kilogram. By the time of its formation, this organ has a thickness of thirty to forty millimeters. The thickness of the placenta corresponds approximately to the term + - 4 mm. The placenta is exposed natural process aging, but in some cases it occurs pathologically quickly.

Why does aging of the placenta occur at 30 and earlier weeks?

Early aging of this organ can be caused by certain individual characteristics the maternal organism, as well as pathological influence directly on the placenta.

Sometimes premature aging of a child's place occurs when severe toxicosis(gestosis), which developed in the second half of gestation. It can be provoked by the aggressive influence of toxic substances, the presence of Rh-conflict and various injuries of the uterus. TO possible reasons this violation also includes smoking, taking alcoholic beverages, not enough correct diet, the presence in the mother of chronic ailments of the kidneys, heart, liver and blood vessels.

Sometimes premature aging of the placenta is observed when multiple pregnancy, if there is a history of abortion and difficult childbirth... It can be caused by the presence of endocrine diseases, placenta previa or placenta previa partial detachment, as well as the development of infectious lesions in the uterine cavity.

How to recognize premature aging of the placenta at 30 - 36 weeks?

Early aging of the placenta occurs completely unnoticed by a pregnant woman. Sometimes on similar phenomenon indicates a sharp decrease in intrauterine activity of a growing fetus, or vice versa - excessive activity... Usually, a similar pathology is diagnosed during a planned ultrasound scan, which shows a decrease in the volume and area of ​​a child's place, which makes it possible to judge its inconsistency with the timing of development.

To confirm the diagnosis, doctors perform Doppler ultrasound, it shows the presence of abnormalities in the uteroplacental blood flow. In addition, doctors can perform cardiotocography, biochemical or general research blood.

Many doctors are sure that the permissible norm is the first and second degree of maturity of the placenta over a period of more than twenty-seven weeks of pregnancy, and the third degree of maturity over a period of more than thirty-two weeks.

Why is early aging of the placenta dangerous at 30 - 36 weeks of gestation?

In fact, premature aging of the placenta does not always indicate the presence of any serious problems for a child. If, during a routine ultrasound, doctors detect early aging of the placenta, they will conduct a series of studies to find out how the child is feeling.

After all, if the placenta is aging especially actively, a delay may occur. intrauterine development baby caused by a lack of nutrients. In this case, the baby may also encounter hypoxia (lack of oxygen) varying degrees severity. Therefore, with the active aging of the placenta and a strong threat of hypoxia, doctors may insist on an early delivery to save the child.

But, as practice shows, even pronounced aging of the placenta does not always indicate the suffering of the child. Nevertheless, the baby's condition must be monitored.

Is Premature Aging of the Placenta Treated?

Therapy early aging the placenta can be carried out in an inpatient department only under the supervision of qualified doctors. The expectant mother is given a set of measures that are designed to normalize blood flow and support the vital functions of the fetus. The therapy helps to cope with the cause of the aging of the placenta. For example, if doctors find bacterial, protozoal, or viral infections, they use various medicines to eliminate them.

To avoid hypoxia ( oxygen starvation) in a baby, apply Various types droppers, in order to normalize blood flow, are usually used vitamin remedies, essential phospholipids, zufilin, aspirin, actovegin, courantil, etc.

It should be noted that the detection of premature aging of the placenta for a period longer than thirty-two weeks, most often allows the expectant mother to successfully reach the pregnancy and give birth to completely healthy baby... However, a pregnant woman needs regular medical supervision and ultrasound control.

The key to a successful pregnancy and normal development of the fetus in the womb is normal functioning internal organs expectant mother and the absence of any pathologies. The same applies to the placenta - the organ responsible for the supply of oxygen and nutrients to the fetus. The people also call this organ a "children's place". If by certain reasons the placenta does not cope with its functions, then doctors talk about its failure or early maturation. What kind of threat can this pose to the baby?

Reasons for the early maturation of a child's place at 31-36 weeks

Normally, the placenta has 3 degrees of maturity and the fourth is zero. Until the 30th week of pregnancy, zero organ maturity is optimal, which means that the placenta copes with its functions and the pregnancy develops normally. As a rule, when screening a pregnant woman at 31-36 weeks, she is given 1 maturity of the placenta, which is also the norm. If at this time “ baby place"Has a second or even third degree of maturity, this indicates that the body is not coping with its functions and there are a number of reasons for this. These reasons most often include:

  • conducting wrong image life - smoking, drinking alcohol, coffee abuse;
  • frequent stress;
  • lack of sleep and significant physical or emotional stress;
  • self admission drugs, in particular antibiotics or analgesics;
  • transferred viral infections and other diseases during pregnancy.

Dangerous consequences of early aging of a child's place at 31-36 weeks

It is the placenta that is a kind of "mediator" between the mother's body and the body of the unborn baby, therefore it is extremely important that this organ copes with its duties before the birth itself - this will ensure the birth of a healthy baby. At a period of 31-36 weeks, there is an improvement in the cerebral convolutions in the fetus, and with early maturation of the "child's place" at this time, the child receives an insufficient amount oxygen, which can lead to negative consequences:

  • premature birth;
  • , as a result of which death may occur;
  • mental retardation and physical development against the background of insufficient blood supply to the placenta and the transfer of oxygen and beneficial nutrients to the fetus;
  • infection of the fetus, since the placenta can no longer fully protect the child and "filter" substances that enter the uterus.

Aging of the placenta: treatment at 31, 32, 33, 34, 35, 36 weeks

If the early maturation of a child's place is detected on an ultrasound scan, a woman should be under the constant supervision of doctors. Now antenatal clinic will have to visit much more often, and, perhaps, even go to the hospital for a while. You should not refuse hospitalization if the gynecologist insists so, because every expectant mother is interested in having a healthy baby on time.

Doctors can in no way restore the original functions of the placenta during its early maturation, however, their actions are aimed at resuming optimal blood flow in the vessels of the organ and maintaining the condition of the fetus in the uterus. For this, the patient is prescribed:

  • intravenous administration of a glucose solution with vitamins to feed the fetus;
  • antispasmodics - to relax the blood vessels and provide better access to nutrients and oxygen to the fetus;
  • if necessary, prescribe drugs used for respiratory failure.

In addition to drug maintenance therapy, a woman should be excluded nervous stress, try to rest more and breathe fresh air.

Aging childbirth at 31, 32, 33, 34, 35, 36 weeks

To assess the degree of risk to the fetus with early maturation of the placenta at 31, 32, 33, 34, 35, 36 weeks of pregnancy, a woman, in addition to an ultrasound scan, is performed special studies- and . If the development of the fetus does not correspond to its gestational age and lags behind by 2 or more weeks, then the woman in mandatory sent for treatment in a hospital. With the progression of pathology from the side of the child's seat and clear signs of fetal hypoxia, doctors may offer the patient a cesarean section earlier due date- this will save the life of the baby and leave him in the conditions of the intensive care unit.

Irina Levchenko, obstetrician-gynecologist, specially for the site site

Alena asks:

What is the danger of early maturation of the placenta?

Early maturation of the placenta is also called premature maturation, or aging. The state of early maturation of the placenta is determined by ultrasound data. That is, the diagnosis " early maturation placenta "is placed solely on the basis of ultrasound data.

Currently, depending on the structural features of the placenta, there are four degrees of maturity - 0, 1, 2 and 3. Each degree of maturity of the placenta is normally observed on a certain period pregnancy. Compliance with the degree of maturity and gestational age meets the following criteria:

  • Zero maturity (0) is typical for pregnancy before the 30th week;

  • The first degree of maturity (1) is characteristic of pregnancy from the 27th to the 34th week of pregnancy;

  • The second degree of maturity (2) is characteristic of pregnancy from the 34th to the 39th week of pregnancy;

  • The third degree of maturity (3) is typical for pregnancy from the 37th to the 40th week of pregnancy.
If the degree of maturity of the placenta is higher than it should be for this specific date pregnancy, the diagnosis of "early maturation of the placenta" is made. Currently, the syndrome of early maturation of the placenta is placed when the following inconsistencies in the timing of pregnancy and degrees of maturity appear:
  • First degree of maturity of the placenta (1) before the 27th week of pregnancy;

  • The second degree of maturity of the placenta (2) before the 32nd week of pregnancy;

  • The third degree of maturity of the placenta (3) before the 36th week of pregnancy.
When such a discrepancy between the degrees of maturity and the timing of pregnancy is revealed, then the ultrasound report indicates "early maturation of the placenta."

However, even if a woman is diagnosed with this, there is no need to panic. Remember that the syndrome of early maturation of the placenta does not indicate pathology, since it is established exclusively on ultrasound data in the absence of any reliable clinical symptoms. The presence of this syndrome speaks only of high risk development of placental insufficiency. In such a situation, it is necessary to undergo a course of treatment aimed at normalizing blood flow in the mother-placenta-fetus system, and to monitor the child's condition according to cardiotocography (CTG) data, vascular Doppler measurements, etc.

Earlier maturation of the placenta does not threaten either the mother or the fetus, if fetoplacental insufficiency does not develop. If the syndrome of early maturation of the placenta is not monitored and left without proper treatment, then it can lead to grave consequences such as:

  • Intrauterine fetal hypoxia (lack of oxygen);

  • Fetal hypotrophy (lack of mass in a child);

  • Violation of the blood supply to the fetus;

  • Early rupture of amniotic fluid;


  • Premature birth;


  • Intrauterine fetal death;

  • Disruption of the normal development of the fetus and the birth of a child with deformities.
Thus, early maturation of the placenta can threaten with very serious consequences for the health of the child, since as a result of this pathology, the normal blood supply is disrupted, and, consequently, nutrition and respiration of the fetus. If there is a slight discrepancy between the degrees of maturity of the placenta and the timing of pregnancy, then there is nothing to worry about. Most likely in in this case early maturation of the placenta does not threaten anything, but is a feature of a pregnant woman. If the aging of the placenta began earlier than the 36th week of pregnancy, and its growth was noted earlier than the 30th week, then it is necessary to undergo a course of treatment and carefully monitor the state of the uteroplacental blood flow.
Find out more on this topic:
  • Doppler ultrasound during pregnancy is a study of the blood flow and vessels of the fetus, placenta, uterus and uterine arteries. Indicators of the norm by weeks, decoding of the results.
  • Anemia during pregnancy. Diagnostics, treatment and prevention
  • Anemia during pregnancy. Types, causes, symptoms and signs
  • Pregnancy calculators. Calculation of the gestational age. Pregnancy calendar by week. How to calculate the expected due date?
  • Hemorrhoids - causes, symptoms, signs, varieties. Treatment: surgery to remove hemorrhoids, effective remedies (suppositories, ointments, tablets), folk remedies, how to treat at home

Premature maturation the placenta is a common problem for expectant mothers. This pathology is determined when ultrasound examination in the second, but more often the third trimester of pregnancy. In essence, it means that the "child seat" loses its functionality.

The placenta during pregnancy plays important role... Indeed, it largely depends on how well the child will enter the body. nutrients and oxygen. Subject to the normal lifestyle and nutrition of the mother. And it is understandable when a child suffers in utero from a mother who smokes, uses alcohol and drugs. But after all, premature aging of the placenta is also put on healthy, responsibly approaching the health of their children, women who do not differ in such bad habits. Why there is such an injustice, and what other reasons exist for the premature maturation of the placenta - every woman needs to know about this.

Provoke this process may various infections... These are viral infections, sexually transmitted diseases, as well as infections that directly affect the genitals. These include herpes type II (genital), for example. Unfortunately, you cannot see the signs of premature maturation of the placenta on your own. Try to protect yourself from any infections, do not visit hospitals and clinics, as well as places with a large crowd of people, unnecessarily. In most cases, infection directly to the child does not threaten anything, since the placenta is a real protective barrier. However, premature maturation of the placenta at 32, 33, 34 weeks, and sometimes more early dates- these are practically inevitable consequences in this case.

The condition of the placenta may worsen due to intake medicines, and even vitamins. That is why you should not take various medications "for prevention", especially if your doctor has not recommended them.

Why is premature maturation of the placenta dangerous for a child? The fact that he does not receive enough food and oxygen. With the so-called placental insufficiency, which occurs in the case of rapid "wear" of the placenta, a woman's belly grows slowly, as the child is delayed in development. Often, on ultrasound in children, developmental delay is determined, calculated approximate weight the fetus is below normal.

However, not in all cases, this diagnosis turns into problems for the baby. And the premature maturation of the placenta, treatment during pregnancy requires only if there is evidence that something is wrong. Otherwise, taking medications will only "hit" the placenta even more. You can find out how a child is feeling with the help of Doppler ultrasound, the same ultrasound, but which also looks at the blood flow in the "mother-placenta-fetus" system. The same study is prescribed for women suffering from gestosis and, separately, hypertension, with polyhydramnios and oligohydramnios, post-term pregnancy, kidney diseases, of cardio-vascular system etc. Also informative is cardiotocography, with the help of this study the fetal heart rate is recorded.

If there are negative changes, doctors decide on either hospitalization with supervision or an emergency caesarean section if the child is severely behind in development, there are signs acute hypoxia. Drug treatment as such, there is no premature maturation of the placenta. There is no way to "update" it. Therefore, every pregnant woman, and especially one in whom the degree of maturation of the placenta "overtakes" the norm, should quit bad habits and visit more fresh air, that is, take care of your health itself.