What threatens the low location of the placenta. The concept of low placentation during pregnancy: what does it mean and what threatens such an arrangement of the placenta
The placenta is a unique embryonic organ that forms in the early stages of the gestational period and, by about the middle of pregnancy, begins to serve as a source of nutrients for the fetus. For the safe bearing of the baby and bringing it into the world at the most optimal time, the specific location of the placenta is extremely important: the norm for different periods of pregnancy is somewhat different here.
The norms for the location of the placenta will say little to unprepared patients - they are rather set for obstetricians and gynecologists and other specialists who are pregnant and choose the optimal tactics of obstetric care for each case when the time comes for this. Of course, specific and final decisions in this regard should be made directly during the act of childbirth, but a qualified doctor can make some predictions in this regard even in the middle or late stages of the gestational period of his patient. Last but not least, the location and height of the placenta will affect this choice: these two indicators will mainly affect how natural the birth of any pregnant woman will be - or the child will have to be removed from her womb by caesarean section.
The most successful for a lady "in position" - as well as her future crumbs - is the location of the placenta along the posterior uterine wall, and the closer to the bottom of the main female organ it is placed, the better. In such a case, the chance of raising it higher as the uterus grows is very large - and this entails a decrease in the risk of damage to the placental, and its detachment and other pathologies. A similar relative stability of the course of pregnancy is created in terms of the development of the placenta due to the fact that its tissues in such a presentation are provided with sufficient stability for their normal functioning. Accordingly, the baby will also receive the normal nutrition necessary for its growth, development and preparation for extrauterine existence, which will come just a few months later.
It is unlikely that at least one doctor will undertake to predict exactly where the placenta will be located in each particular woman, since the mechanism of this phenomenon has not yet been fully understood; but it is known that its attachment usually does not occur at the sites of damage to the endometrium - the inner uterine layer.
The location of the placenta on the other wall of the uterus - the anterior - is more risky in terms of avoiding premature birth and other similar options for pathologies of pregnant women. In this case, it is highly desirable that the placenta initially attach as close as possible to the uterine fundus, since, according to experts, there is a chance that as the fetus grows, this embryonic organ will even slide down (this is impossible with posterior wall implantation).
However, the most critical from the point of view of the normal course of the gestational period in the later stages and the choice of medical tactics at the time of childbirth will be not so much localization as the height of the placenta. It is determined as a result of an ultrasound examination, and according to several ultrasounds performed at various stages of pregnancy, doctors monitor the dynamics of this indicator. At a later date - i.e. in the third trimester, already about 29-32 weeks - any location of the lower edge of the placenta at a distance of less than 7 centimeters from the edge of the internal os of the uterine cervix is considered low. When these indicators are generally measured by a couple of centimeters, we can talk about partial placenta previa, and if closer to the 35-37-week period it does not shift higher, this will serve as a signal to doctors that this pregnant woman should not be allowed to natural childbirth. Then the lady "in position" will have to put up with a planned caesarean, because when the pregnancy is considered to be actually full-term, immediately before the birth, the placenta does not rise, and the operation becomes the only chance for a successful birth of the baby.
The low location of the placenta, and especially the situation when it partially or completely covers the cervix, is dangerous in childbirth because it causes bleeding, as well as hypoxia of the baby being born: after all, when the placental tissue exfoliates, it will lose oxygen.
Thus, in the later stages, and specifically in the third trimester, of the gestational period, the norms for the location of the placenta are such that any position below 7 cm relative to the cervical os is considered low and requires close observation by doctors.
A huge number of women face the diagnosis of "low placenta". Very often this makes them panic, looking for the causes of this condition and suitable medicines. But is the low placenta so dangerous and what is it? We need to figure it out.
After conception, the fertilized egg travels through the fallopian tubes to the uterus, where it attaches itself, where the placenta is formed. Normally, the egg is attached to the bottom of the uterus, but sometimes it falls below and is fixed on the wall or even near the pharynx itself. If the placenta is located near the cervix, we can talk about a low placenta, but if it covers the pharynx - about presentation.
Differences between a low placenta and a normal one (Video)
The placenta or the so-called child's place is a temporary organ that appears in a woman only during pregnancy. It is necessary to communicate the child's body with the mother's body and provide it with all the necessary substances. It is from the placenta that the child receives nutrients and oxygen, and decay products are excreted through it.
One of the tasks of the placenta is to prevent an immunological conflict between mother and child. At the same time, it secretes hormones necessary for both organisms.
Outwardly, the placenta looks like a disc attached to the wall of the uterus. Its diameter is about 15 centimeters, and its weight is about half a kilogram. From the side of the fetus and from the side of the uterus, the placenta is covered with special plates, between which there are many blood vessels.
The place of attachment of the placenta is of great importance. Normally, it is attached to the bottom of the uterus or next to it. In this place there are many blood vessels that create favorable conditions for the formation of optimal uteroplacental blood flow and nutrition of the embryo. But sometimes the placenta attaches below the optimal level, perhaps even in the lower segment of the uterus - this phenomenon is called a low placenta. When presenting, it is attached at the very bottom and covers the pharynx.
There are three common types of placenta previa:
- with partial presentation, the placenta partially covers the cervix of the uterus;
- with full presentation, the placenta lies across the internal os and completely covers it, separating the uterus and cervical canal;
- Cervical placentation is a rare situation when the placenta is attached in the isthmus and cervix.
The stronger the placenta overlaps the cervix, the more dangerous the situation for the mother and child.
What is the danger?
Everyone knows that a low placenta is dangerous. But what is the danger? The low placenta is, in fact, under the baby. As the pregnancy progresses, the baby grows, its weight increases, and with it the pressure on the placenta. The movements of the baby become more active, which leads to shocks on the placenta. In addition, the pressure on her is increased by too active movements of the woman. And strong pressure on the placenta can lead to bleeding.
In the bottom of the uterus, where the placenta usually attaches, there are many more blood vessels, so there are more opportunities for feeding the fetus. Incorrect attachment can threaten with a lack of oxygen and nutrients.
Very dangerous placenta previa during childbirth. In this position, a caesarean section is usually recommended to prevent premature placental abruption and severe bleeding. That is why women with a low location of the placenta in the LCD are watched especially closely. Proper management of pregnancy and childbirth, as well as the correct behavior of the woman herself, minimizes all risks.
Features of the course of pregnancy
Low attachment of the placenta can complicate the course of pregnancy, as it significantly increases the likelihood of placental abruption. During pregnancy, its lower segment grows and may increase, which is fraught with displacement of the fetus. In this case, the placenta remains in its place. This can lead to the appearance of detachment. This condition is undoubtedly dangerous, but in most cases it is not at all fatal.
It must be understood that any pregnancy requires caution and a decrease in the intensity of physical activity. A pregnancy with a low placental attachment requires doubly caution, as the likelihood of detachment and bleeding is high. When attaching the placenta at a distance of several centimeters from the internal os of the uterus, it is necessary to exclude not only strong physical exertion, but also the lifting of any objects heavier than 3-5 kg, as this can stimulate the tension of the abdominal wall. Among the forms of physical activity, leisurely walks in the fresh air can be recommended.
If the placenta blocks the internal os, the restrictions will be even greater. It is necessary to exclude not only physical work, but also sexual contacts, as well as any stress. It is important to monitor your well-being and secretions. If blood appears in them, you should immediately go to the hospital.
But you should not panic. If at a planned ultrasound at 19-20 weeks they say that there is a low attachment of the placenta without overlapping the internal pharynx, then you need to calm down and wait, following all the doctor's recommendations. In most cases, before 30-35 weeks, the placenta rises. This does not mean that she crawls over the uterus - the place of her attachment remains the same, just the uterus is stretched, and this place may be higher than it was.
Features of childbirth with low placentation and presentation
Low insertion of the placenta without occlusion of the internal uterine os is not a problem in childbirth. You can give birth naturally and there are usually no differences from other births. Problems arise if the placenta blocks the pharynx. Why is that?
Normally, during childbirth, the baby continues to feed through the umbilical cord and placenta until it comes out and begins to breathe on its own, but even after that, the connection with the placenta remains. A child comes out of the mother's womb, and the child's place still remains in the uterus. After the baby is born, the placenta comes out of the mother's body. It is no longer needed, so there is a painless and harmless process of its exfoliation.
The location of the placenta after childbirth
If the placenta is between the baby and the pharynx, then during the opening of the cervix, it can exfoliate or come off in advance, which will lead to bleeding. It turns out a situation when the child cannot exit due to the fact that the placenta blocks the exit and does not allow the cervix to open. And the opening of the CMM leads to severe bleeding, which is fraught with the death of the child and mother. Therefore, with placenta previa, a planned caesarean section is performed. With a properly performed operation, the risks for mother and child are minimal.
The most dangerous situation is cervical placentation or cervical pregnancy. Fortunately, such a pathology is extremely rare, since the only correct way to save a woman's life in this situation is to remove the uterus along with pregnancy. Any attempt to remove the fetus from the uterus leads to severe bleeding, which is too strong a threat.
Ways of prevention and treatment
Although low attachment of the placenta is called a pathology, in fact it is rather a feature. To date, doctors do not have an exact answer why the placenta is attached in the wrong place, so there can be no talk of any prevention. If the gynecologist says that the placenta is fixed lower than it should be, then there is no need to be nervous, you just need to accept this as a fact and as a guide to optimizing your lifestyle.
One of the possible reasons for improper attachment of the placenta, doctors call the presence of scars or other damage in the place of its normal localization, so it is worth treating all diseases on time and trying to avoid unnecessary surgical procedures, such as abortion.
As for treatment, there is not much to advise here either. The fact is that there are no procedures that raise the placenta, as well as drugs.. You need to understand that it is where it is. Often, pregnant women are advised to lie with their legs up - supposedly this will help the placenta rise. Now let's think about it, is it that we will hang upside down, our ears will drop? No, and the placenta will not move anywhere. The only way to raise it is to wait until the uterus grows and the place where the placenta is attached is higher than it was.
Very often, women with a low placenta are advised to lie down "for preservation." Considering that there is no cure for this disease, the only purpose of such “preservation” is to control the woman and prevent her from harming herself. If you are sure that you can optimize your lifestyle and get to the hospital immediately when you appear, hospitalization is not necessary.
The bottom of the uterus is located ... at the top. It is there, closer to the bottom (that is, from above) that the placenta should be attached. But this does not always happen, and in about 15% of cases, expectant mothers will find out during a routine ultrasound examination about the low location of the placenta.
What is the danger and what can be done?
Low location of the placenta - where is it?
Usually, they talk about low placentation when 5.5-6 cm remains from the cervix to the edge of the placenta. The doctor sees this result even at a planned ultrasound at 12 weeks and makes a note about this in the map of the expectant mother. For such a short period, this does not matter, because the placenta grows and moves until the 36th week of pregnancy.
Why is a low placenta dangerous?
Doctors have two reasons for concern.
Poorer blood supply to the lower part of the uterus compared to the upper. The worse the blood supply to the placenta, the less nutrients the baby receives.
The pressure that a growing fetus exerts on the placenta - after all, no one has canceled the force of gravity! The squeezed placenta not only does not fulfill its functions to the full, but can also exfoliate, which will become a direct threat to pregnancy.
” But, as we have already emphasized, before 22-24 weeks, all this is of no fundamental importance.
Migration of the low placenta
During pregnancy, the placenta moves, and this is not surprising.
Firstly, it is a living organ, in which some parts can die off, and some can grow.
Secondly, it must meet the nutritional needs of the child, and therefore increase in size as the baby grows.
Thirdly, it is attached to the wall of the uterus that changes in size, and its position changes along with its stretching.
You can predict the movement of the placenta based on the place of its attachment, which the doctor notes during the first ultrasound.
” The most favorable location is on the back wall of the uterus, which is closer to the spine. It stretches less during pregnancy and, most likely, by the middle of the term, the placenta will have time to rise to a safe height.
The least favorable location is from below and in front - it is this area of \u200b\u200bthe uterus that stretches the most, and the placenta simply may not have time to "crawl" higher.
Why is the placenta attached so low?
The reason, in fact, is one - damage to the endometrium of the uterus in those places where the placenta should normally be attached. But it can be caused by a variety of circumstances. Among them:
scars after caesarean section or other operations on the body of the uterus;
tissue damage after abortion or removal of neoplasms;
changes in the endometrium after infectious diseases;
large neoplasms (for example, uterine fibroids), which in themselves do not prevent pregnancy, but "occupy the best places";
malformations of the body of the uterus (for example, saddle or bicornuate uterus);
multiple pregnancy (twins can have , and in the second case one of them is often attached too low).
It is clear that you cannot fix the shape of the uterus or the scar after the operation, but the one who is warned is already armed! Now you know that you should not miss a planned ultrasound at the 12th week of pregnancy.
Low placentation at the 12th week of pregnancy. What's next?
Nothing! For a short period, even not the most successful location of the placenta does not affect the course of pregnancy. Listen to the doctor's recommendations (they may relate to limiting physical activity and additional intake of a complex of vitamins and microelements), carefully monitor your well-being, immediately contact a antenatal clinic for spotting and pain in the lower abdomen ( however, this should be done at any time and at any position of the placenta).
” And don't miss your next ultrasound - it's usually scheduled in 10 weeks!
Low placentation at 22 weeks pregnant. What's next?
Most likely, during the next examination, the doctor states that the placenta has already migrated along the wall of the uterus and you can no longer be afraid of the course of your pregnancy. If the placenta is still located at the very pharynx of the uterus, then, alas, some measures will have to be taken.
Limit physical activity. Even special sets of exercises for pregnant women can hurt you now, not to mention running, jumping, lifting weights ...
Refuse intimacy, in any case, from its traditional forms with deep penetration. Do not once again disturb the area of \u200b\u200bthe uterus to which the placenta is attached.
Try to rest more, if you can lie down - lie down ( Do you remember that gravity is now working against you?) Place a small pillow under your feet while you sleep.
” But the most important rule - do not worry! The chances that the situation will change by the 36th week of pregnancy are very high!
Low placentation at 36 weeks gestation. Childbirth with a low location of the placenta
” If you are unlucky and the placenta is still at the very edge of the cervix (recall, the critical figure is 5.5 cm), then most likely you will have planned hospitalization and a cesarean section.
Many women are set on natural childbirth and worry that "everything went wrong." But in this case, surgical intervention is fully justified: a bulky placenta prevents the baby from “moving to the exit”, which seriously delays and complicates childbirth, and in addition (and this is the most dangerous) it can exfoliate ahead of time. Until the baby is born and takes its first breath, the placenta and umbilical cord are also its respiratory organs, without them hypoxia quickly sets in, the baby literally “suffocates” even in the womb. A tragic situation requiring emergency intervention, and the outcome can be much worse than with a planned operation!
Finally, with the borderline position of the placenta - the same 5.5-6 centimeters, when natural childbirth is also possible, but there is still a risk of an unfavorable development of the situation, the doctor can pierce the fetal bladder at the very beginning of childbirth.
” When the amniotic fluid is poured out, the baby's head quickly descends to the cervix of the uterus and, as it were, presses and pushes the placenta away.
However, such a solution is possible only if the baby is correctly positioned; low placentation and - unambiguous indications for operative delivery.
Remember, no matter how your pregnancy proceeds, the main thing is the health of mother and baby. Modern obstetrics can handle the most difficult situations, the main thing is to remain calm and follow the recommendations of your attending physician!
Prepared by Anna Pervushina
The placenta is an organ that will nourish the baby, supply it with oxygen, and serve as a kind of filter. It is designed to protect the baby from toxins, viruses and bacteria that can enter through the blood. The normal and full development of the baby directly depends on the position of this organ and its condition.
Low placentation during pregnancy is the location of the child's place close to the internal pharynx of the cervix. This pathology occurs in a quarter of pregnant women. And the older the woman, the higher the risk of a low position of the placenta. Women over the age of 35 are at risk in the first place - it is they who often face such a pathology.
Quite often, patients confuse the placenta, which is fixed too low, and the prolapse (prolapse) of the uterus. Prolapse in this case is a pathological condition associated with a change (downward displacement) in the position of the fundus of the uterus and its cervix. It has nothing to do with the attachment of a child's place.
Place of formation
A child's place is formed at the site of the introduction of the embryo into the wall of the uterus. It is believed that the most favorable is the fixation of the fetal egg on the back wall of the uterus closer to its bottom. The implantation of the embryo on the anterior wall is also considered the norm.
It is the back wall of the uterus, in the segment adjacent to its bottom, that is the most favorable place for feeding the placenta, and hence the fetus. This is considered so for two reasons:
- Due to the most intensive blood circulation in this place.
- The closer to the bottom of the uterus the child's place is attached, the less the myometrium will stretch. Consequently, the slower the placental tissues will stretch.
- This also means that this position negates the threat of detachment.
To avoid misunderstandings, it should be said that the bottom of the uterus is called its upper part, located on the opposite side of the internal pharynx.
What are the stages of the formation of the placenta:
- The active process occurs at 5-6 weeks of gestation.
- By 7-10 weeks, the fetus switches to the placental blood supply.
- By 14–16 weeks, this process is completed.
During these periods, it is important to confirm the well-being of this organ, its blood supply and the place of fixation:
- The low location of the placenta during pregnancy is diagnosed as a result of ultrasound screening. This can happen at the first mandatory screening at 11, 12 or 13 weeks.
- During pregnancy, week 20 (more precisely, week 20-24) is the time of the second screening, when this pathology can be diagnosed.
- At the third screening (30-34 weeks), if the situation does not change for the better, the woman will be offered hospitalization and delivery by caesarean section for a period of 37-38 weeks.
In the case of placental abruption, operative delivery may be recommended at an earlier date.
Placentation
The very word "placentation" sounds strange. But in fact, everything is simple - it only indicates the place of fixation of the placenta. What does low placentation mean during pregnancy? By this they mean that the child's place has formed too close to the exit, that is, to the pharynx of the uterus. Close is less than 6 centimeters.
In the second trimester of pregnancy, a significantly larger percentage of pregnant women encounter this diagnosis after ultrasound than in the third trimester. This is explained by such a concept as placental migration.
Of course, the placenta migrates conditionally. In fact, the walls of the pregnant uterus stretch as the fetus grows and develops, and the placenta "moves away" from the pharynx. At the same time, she does not change the place of her education.
If in the second trimester the placenta is low along the back wall of the uterus, this is considered a relatively good location. And in most cases, the situation improves by childbirth.
Causes of pathology
The reasons for the development of this pathology may be different. It is reliably known that the embryo cannot be fixed in the damaged endometrium:
- Thinned after scraping.
- Affected by adhesions.
- Affected by fibroids.
- In the presence of scars after surgery.
- If you have any birth defects.
Therefore, sometimes the embryo is fixed in places that are not the most suitable for this. That is, the placenta during pregnancy is not formed at the bottom of the uterus, but close to its pharynx or completely blocking (partially or completely) the “exit” from the uterus. The latter condition is called presentation and refers to a more severe type of pathology than just a low location of the placenta.
Women at risk for low placental fixation include:
- After 35 years.
- Many gave birth.
- Previously undergone uterine surgery.
- With a large number of abortions or self-abortions in history.
- With multiple pregnancy.
- Often ill with infectious diseases, sexually transmitted diseases, or having such diseases in a chronic form and neglecting treatment.
- Having congenital pathologies of the development of the uterus, which led to a change in its structure or a violation of the structure of the myometrium or endometrium.
- Suffering from endometriosis.
All of these factors lead to the fact that changes in the endometrial layer accumulate, it becomes either too thin or thickens. The embryo "chooses" the least altered part of the mucous layer, even if it is in the immediate vicinity of the pharynx.
Symptoms
Low attachment of the placenta rarely manifests itself in any way. It is usually detected by ultrasound during mandatory screening at 12-13 weeks or later. If such a trouble as low placentation during pregnancy is combined with placental abruption, then:
- A woman may feel discomfort in the lower abdomen, pulling back pain.
- There is an admixture of blood in her secretions.
- In addition to the symptoms described, it is believed that pregnant women with low placental attachment are characterized by hypotension and the development of late preeclampsia.
The cause of detachment and bleeding in this case is too fast "migration". The uterus during pregnancy is actively growing, each fiber of its myometrium is stretched. The pregnant organ is most susceptible to stretching in the pharynx. An inelastic placenta does not have time to adapt to such conditions, ruptures occur (separation of the placenta from the endometrium). Places of ruptures bleed. This explains the presence of blood in the vaginal mucus.
The period at which a woman begins to bleed depends on the position of the placenta. Most often, an admixture of blood is found in a woman for a period from 28 to 32 weeks. It is explained by the fact that during this period the myometrium is most actively preparing for labor.
In one case out of five, bleeding begins at an earlier date (between weeks 16 and 28). There may be earlier bleeding at 10-13 weeks - it all depends on many other factors.
Consequences
The low location of the child's place in itself is not a threatening factor for the development of the child. Although it is believed that in the later stages (at 32–36 weeks), this position of the placenta can threaten the fetus with hypoxia. This is justified by the fact that the blood supply in the lower part of the uterus is worse than in the area of its bottom, and with the course of pregnancy, the pressure on its lower part, including the placenta, increases.
Due to this location of the child's place, the supply of oxygen to the fetus is reduced. Therefore, women with a similar diagnosis are under the vigilant supervision of an obstetrician leading a pregnancy. Ultrasound examination in this case may be prescribed more often than normal (between screening periods). For example, at 18-19 weeks.
Low placentation during pregnancy in most cases is not a reason for a caesarean section. The threat is fraught with complications that this position of this important organ entails.
Threats to mother
As it has already become clear, the main threat is placental abruption (separation of part of it from the uterine wall). What does this mean for a girl?
- With small separations, the process proceeds painlessly, and only spotting can alert the expectant mother. However, it should be noted that placental abruption is not always accompanied by bleeding - blood can accumulate in the uterine cavity.
- Sometimes a large fragment of the placenta exfoliates, which is accompanied by discomfort and heavy bleeding. This condition requires immediate hospitalization.
With minimal separation of the placenta, the woman should be constantly under the supervision of a specialist, because the process is prone to repetition. The number of separations increases, which entails a threat to the development of the baby.
For a mother, such a condition is fraught with the fact that blood during detachment is not removed from the uterine cavity, but accumulates in it, impregnating all its layers, penetrating through the walls of the uterus into the peritoneum. The uterus of Kuveler is formed. This condition is called uteroplacental apoplexy. It threatens the life of the pregnant woman herself, and requires an immediate caesarean section in order to save the woman's life. Unfortunately, in this case, the uterus must be removed.
Threats to the fetus
Low placentation and placental abruption also poses a threat to the unborn child. And first of all, because the separated part of the placenta will no longer be able to take part in the process of nutrition and protection of the fetus. The consequences depend on the time frame.
- If the embryo is small, then the consequences will be minimal.
- If the period is long enough, then the development of the fetus may slow down, hypoxia will be noticeable and lead to serious consequences.
- Total detachment entails the death of the fetus.
When identifying a low fixation of a child's place, one should not panic. But if a specialist recommends hospitalization, it is not worth refusing.
Diagnostics
Little can be said about the diagnosis of this condition. There are no special methods and methods for determining the position of the placenta. Most often, such a diagnosis is made at a period of 20 weeks during a routine ultrasound screening examination. After that, the woman on this item is taken under observation.
The low location of the placenta at an earlier date (at 12–13 weeks) is determined quite often. But if the first screening reveals that it is not critical, treatment is usually not required at such an early stage. Most women find out at their next screening that the position of their placenta has changed for the better.
Differentiate during diagnostic procedures low placentation with the following pathologies:
- The threat of miscarriage and premature birth. In this case, if the low position of the placenta led to abruption, symptoms characteristic of abortion (bleeding, pain) may be observed.
- Presentation (full / partial) of the placenta. It can be determined by internal palpation. In this case, the specialist clearly palpates the tissues of the placenta, completely or partially covering the cervix of the uterus. In the case of a placenta close to the pharynx, only small fragments of placental tissues can be palpated.
Constant monitoring of the state of the placenta and fetus, a course of medications and bed rest will help to avoid irreparable consequences.
Treatment and prevention
Drug treatment is usually used if the low position of the placenta entails its detachment. How to raise the placenta during pregnancy? It is not possible to change the place of implantation of the embryo. But if you follow these recommendations, starting from 12 weeks of pregnancy (or from the moment the pathology is diagnosed), then you can give birth to a healthy baby.
If the diagnosis is made at 13 weeks, the obstetrician will recommend:
- Wear a bandage.
- Give up aerobics (even light) and any sports activities, replacing it with leisurely walks.
- Avoid climbing stairs.
- Don't lift weights.
- Eat well, drink vitamin drinks.
- Refuse sexual contact.
- Minimize travel in transport (sudden movements can cause detachment).
- Sneeze and cough gently and while lying or sitting.
- Avoid sudden movements (not only jumping, but also raising your arms up).
- Do not sit in a chair with your legs crossed.
- Avoid stress.
With a low-lying placenta for a period of 12-13 weeks, if you follow these recommendations, by the 30th week the situation usually returns to normal. But if this does not happen, there is no need to panic. Sometimes an ultrasound diagnostician informs the woman just before the birth that the position of the placenta allows natural childbirth.
The detection of low placentation during pregnancy at 21 weeks is also not a reason to panic. All of these recommendations will help maintain the normal state of a woman. If bleeding begins, then in this case it is necessary to go to the hospital and undergo a course of drug therapy.
For treatment, different groups of drugs are used:
- Light sedatives (Valerian).
- Hemostatics (Tranexam) to prevent bleeding during detachment.
- Antibiotics (III generation cephalosporins, for example, Cedex, Ceftebuten), to prevent the development of infection in the formation of placental hematomas.
- Metabolites (Actovegin) for the prevention of insufficiency in the uterus-placenta system.
Other remedies may be prescribed at the discretion of the doctor.
The placenta is an organ that appears only during pregnancy, which connects the organisms of the mother and the embryo. Through the placenta, vitamins, nutrients and oxygen come from the mother's body to the child. Through the placenta, toxins and decay products are released from the fetus. The organ completes its formation at the 16th week of pregnancy, but continues to increase until the 36th week, as the need for oxygen and nutrition of the actively developing embryo is constantly increasing. The placenta, like any organ, can develop with pathologies. A common deviation is the low location of the placenta.
How is the placenta formed?
Before conception, in the middle days of the menstrual cycle, a corpus luteum is formed in the ovary of a woman - a gland that regulates the synthesis of progesterone, helping the endometrium to prepare for the introduction of an egg that supports pregnancy. A temporary gland is formed from a follicle from which a mature egg has entered the fallopian tube.
Further, the existence of the corpus luteum is determined by whether fertilization has occurred or not. The unfertilized egg leaves the body with menstrual blood, and the corpus luteum slowly shrinks until it disappears completely. If conception has occurred, then the corpus luteum continues to exist for about four months, until the placenta is fully formed.
But how and why is the placenta formed? The organ begins to develop when the fetal egg attaches to the endometrium. The implanted egg breaks into two structures: the embryo itself is formed from one cluster of cells, and the placenta is formed from the second. Interestingly, the placenta develops from the male part of the egg's genetic material.
The formation of the placenta is completed by the 16th week of pregnancy. A fully formed organ begins the synthesis of progesterone, replacing the corpus luteum. Also, the placenta is a reliable gateway between the mother's body and the embryo. It prevents the penetration of toxins, medicine particles and other harmful compounds into the child's body. Metabolism between mother and fetus is also carried out with the help of the placenta. Therefore, the placenta is one of the most important organs for the normal course of pregnancy.
What is a low placenta during pregnancy
For those who have not encountered such a problem, it is difficult to understand what "low placenta previa" is. Despite this, most women give birth on their own, without endangering the child and themselves.
The embryo, which enters the uterine cavity through the fallopian tube, is attached as close as possible to the uterine fundus, pressing against the walls of the organ. Over time, a placenta appears around the embryo.
Low location of the placenta - the distance from the placenta to the uterine outlet is less than 6 cm.
In medical practice, there is another concept that you should know. We are talking about placenta previa, which is a placenta strongly lowered to the bottom of the uterus, blocking the exit.
Types of location of the placenta
The placenta should normally be located on the back wall of the uterus, not far from the bottom. But keep in mind that the uterus is a reverse structure, so its bottom is on top. But the ideal placenta is not located in all cases. Sometimes the placenta is placed on the anterior wall of the uterus, which is not dangerous.
But the low placenta previa is dangerous. The low-lying placenta is strongly compressed by the embryo, therefore, it can be injured or exfoliate due to the slightest external influence. And in the later months of pregnancy, a moving and pushing baby often touches the placenta and squeezes the umbilical cord.
The low location of the placenta is also bad due to the fact that the lower part of the uterus is not saturated with blood as actively as its bottom. As a result, the embryo develops hypoxia - oxygen starvation.
If the low placenta during pregnancy is located on the back of the uterus, then the problem can correct itself: the placenta will move to a higher place. The front wall is intensively stretched, the placenta attached to it is also able to move, but not up, but to the lower section, blocking the cervix. But the most dangerous pathology in pregnant women is complete or incomplete placenta previa.
Causes of a low placenta
A variety of factors provoke a low location of the placenta. Often the causes of pathology are injuries of the mucous membranes of the uterus, which appeared after inflammatory reactions, infectious diseases, miscarriages and surgical abortions. Sometimes a fertilized egg cannot attach to the upper portion of the uterus if the woman has previously had uterine surgery or a caesarean section.
The placenta can be located low if the uterus is improperly developed or underdeveloped, has a pathological form. Sometimes low placenta previa is noted when carrying several fetuses.
Rarely there are primiparas with low diligence, often it occurs after the second or each subsequent birth. All the fault of the changes that have occurred with the genitals. The more these changes, the more problematic the pregnancy is. Also, a low placenta during pregnancy is formed due to the following factors:
- the age of the woman in labor is over 30 years;
- separation of the placenta in previous births was performed by doctors;
- multiple pregnancy;
- cauterization erosion, abortion, caesarean;
- benign neoplasms;
- genital infantilism;
- inflammation of the pelvic organs;
- problems with the work of the kidneys and liver, intoxication.
Symptoms of a low placenta
Usually, low placenta previa does not show any symptoms. In rare cases, there is a pulling pain in the lower abdomen, bleeding opens. But these are signs of not just low placement, but already detachment of the placenta.
It is possible to find out whether there is a low location of the placenta only through ultrasound monitoring. Therefore, the passage of ultrasound is an important and mandatory procedure for pregnant women.
The formed placenta, which does not overlap the internal uterine os, does not cause discomfort to the expectant mother. About such as low placenta previa, the pregnant woman learns only at the last examination.
In 1 out of 10 women in labor, this condition can adversely affect pregnancy, there is a sharp deterioration in well-being, there are:
- bloody issues;
- pain in the lower abdomen;
- low pressure.
Treatment of low placentation
A low placenta during pregnancy is not treated with medications. Usually, one can only hope that the placenta will move to the optimal place on its own. This is an expected and quite probable outcome.
At 19-20 weeks, pregnant women undergo a planned ultrasound, which confirms or refutes the low location of the placenta. With the growth of the uterus, the placenta rises higher, so in many cases, the placenta takes the correct position closer to childbirth.
Low placenta previa at 20 weeks is not yet a verdict. The pregnant woman learns about this fact only on ultrasound, without feeling the symbolizing symptoms.
In many future mothers, the placenta gradually rises into the upper part of the uterus over time. But not everyone is so lucky. In some women in labor, the diagnosis of a low location of the placenta persists until the very birth.
What to do when diagnosed with a low placenta during pregnancy? The first step is to abandon intimate relationships and minimize physical activity. A woman should not carry weights, play sports, strain her stomach.
If bleeding occurs, you should immediately consult a doctor. While the pregnancy lasts, the doctor carefully monitors the condition of the patient's placenta. The expectant mother should attend all ultrasounds prescribed by the doctor in a timely manner. In most cases, in the third trimester of pregnancy, low placenta previa disappears on its own.
Childbirth with a low placenta
The low location of the placenta is a dangerous condition for a pregnant woman. But how can pathology affect childbirth? The degree of danger depends on where exactly the placenta is located. Many women diagnosed with low placenta previa give birth naturally.
If the placenta is placed near the opening of the uterus, then the amniotic sac will most likely need to be punctured. In this situation, the baby presses the placenta against the uterus with its head. With an incorrect location of the fetus in the uterus or with placenta previa, the expectant mother is required to have a caesarean section.
The location of the placenta less than 5 cm from the internal os is considered a signal for a caesarean section.
If at 20 weeks the ultrasound shows a low location of the placenta, then doctors recommend wearing a bandage.
Doctors say that up to 38 weeks this fact is not considered a pathological condition, however, with a low location of the placenta, it is possible, even necessary, to fulfill a number of requirements:
- observe hygiene;
- visit a doctor in a timely manner, take tests, do an ultrasound;
- rest more, do not take long walks;
- don't bend over.
Even if you have mild pain in the lower abdomen and spotting, it is important to go to the hospital as soon as possible.