During fertilization, the fusion of sperm and egg produces a zygote that has a supply of nutrients for a short period of time. After 11-12 days, the embryo is attached to the wall of the uterus, and from that moment it receives all the necessary substances from the mother. This is facilitated by the formation of the placenta ("children's place") - an organ that is the junction of the blood flow of the fetus and the woman.
Normally, this organ acquires its final structure by the 12th week of pregnancy and retains it until at least 37 weeks. But sometimes there is premature aging of the placenta - a pathology in which the "children's place" loses its physiological structure ahead of time, due to which there is a violation of the supply of nutrients to the fetus.
The role of the placenta
The placenta is the main element that preserves pregnancy and supports the development of the fetus. It performs several important functions, the first of which is respiratory. In the intrauterine period, the fetus does not breathe on its own with the help of the lungs, so gas exchange occurs due to the connection of the vessels of the fetus and mother in the placenta. Thanks to this organ, the child's blood is enriched with oxygen and carbon dioxide is removed from it.The second function of the placenta is trophic or nutritional. It enriches the blood of the fetus with essential substances: proteins, fats, carbohydrates, vitamins, ions.
The third function of the organ is immune. The placenta is permeable to some maternal antibodies, protecting the fetus from pathogens. At the same time, the "children's place" delays the antibodies produced in response to the child's foreign genome, which can cause rejection reactions.
The fourth function of the organ is endocrine. The placenta synthesizes its own hormones (hCG, progesterone, etc.), which supports the course of pregnancy and induces labor.
The fifth function of the "children's place" is protective. The body is able to destroy substances that are unsafe for the fetus.
The last function of the placenta is a barrier. It prevents the entry of microorganisms to the child.
Early maturation of the placenta during pregnancy leads to a decrease in the performance of the listed functions of the organ. The presence of this pathology impairs gas exchange and nutrition of the fetus.
Structure and functions of the placenta (17 minutes):
Stages of pathology
To determine the degree of aging of the placenta, doctors use ultrasound diagnostics. With the help of it, the structure, condition of the organ and the thickness of its walls are visualized, which are compared with the gestational age. Premature maturation of the placenta is classified into 4 stages:0 stage. It is characterized by the normal structure of the body, in which it fully performs all its functions. Normally corresponds to 20-30 weeks of pregnancy.
I degree. It has a second name - the phase of active growth. At this time, the placenta performs its functions well, but degenerative processes begin in it. Normally, this period begins at 27-31 weeks and lasts until 32-33 weeks.
II degree. It is called the maturity phase. By this time, rather strong structural changes occur in the placenta, its walls become thicker, and gas exchange decreases. Mature "baby place" is diagnosed normally from 34 to 39 weeks of pregnancy.
III degree. This phase is called "aging". The placenta is preparing for the upcoming birth, with a physiological course, this period begins after the 37th week of pregnancy.
If structural changes in the "children's place" do not correspond to the gestational age, the doctor diagnoses "premature aging of the placenta."
Causes of pathology
It is not always possible for doctors to identify the exact etiological factor in premature maturation of the placenta. A certain role in this pathology is played by the lifestyle of the mother and concomitant diseases. Sometimes the early maturation of the "children's place" can provoke violations of the integrity of the epithelial cover in the uterus.In a recently published study, researchers from the University of Texas Medical Branch at Galveston proved that premature maturation of the placenta can be caused by oxidative stress in the body. Environmental toxins and polluted air are an integral part of normal life. However, pregnant women should avoid other factors that lead to oxidative stress: smoking and alcohol consumption, a high body mass index, poor diet, and infections.
"This is the first study to prove that oxidative stress causes placental aging and preterm birth," says Dr. Ramkumar Menon, assistant professor of obstetrics and gynecology at the University of Texas Medical Branch and lead researcher on the study. “More than 15 million pregnancies worldwide end in preterm birth, but with the information we have received, we will be able to reduce the risk of this pathology.”
The main reasons for the development of early maturation of the placenta include:
- curettage of the uterus before pregnancy;
- chronic renal and heart failure;
- sexually transmitted infections (chlamydia, syphilis, etc.);
- diabetes mellitus; congenital anomalies in the development of the uterus and its appendages;
- spontaneous miscarriages in history;
- late toxicosis of pregnant women; mechanical injuries;
- severe labor activity in history;
- smoking, alcoholism, drug addiction;
- severe degree of atherosclerosis;
- bearing several children at the same time;
- increased amount of amniotic fluid;
- obesity or underweight.
Signs and symptoms
There are no objective symptomatic signs of the development of this pathology. Premature aging of the placenta can only be diagnosed by a specialist using ultrasound diagnostics. However, observing the movements of the fetus, the expectant mother is able to suspect deviations during pregnancy.Increased or slower movements of the child may be a symptom of hypoxia - oxygen starvation of the fetus. This pathology occurs due to premature aging of the placenta stage II-III. If the mother-to-be notices unusual fetal activity, she should seek medical attention and undergo an ultrasound examination.
Danger
The most dangerous options for the course of premature maturation of the placenta are grade 2 at 32 weeks and earlier, or grade 3 before 37 weeks of pregnancy. Lighter forms of pathology in the absence of progression of the process do not lead to serious consequences. Usually, the 1st degree of premature maturation of the placenta does not affect the development of the fetus, or causes a slight growth retardation - malnutrition.In severe cases, premature aging of the placenta is dangerous for the development of fetal hypoxia. The unborn child receives little oxygen, harmful metabolic products accumulate in his organs, and adequate cell respiration does not occur. Sometimes this pathology threatens with a strong lag in the growth and development of the fetus.
Attention! To prevent the development of premature aging of the placenta of a future mother, it is recommended to prevent abortions, treat urogenital diseases in a timely manner, and lead a healthy lifestyle during childbearing.
The third degree of premature aging of a child's place can lead to even more serious pathologies. Due to a strong decrease in circulatory processes, amniotic fluid may come out, placental abruption, which will lead to premature birth. In rare cases, intrauterine fetal death is observed.
Diagnostics
Detection of early aging of the placenta is possible only with the help of instrumental diagnostic methods. Most often, this pathology can be detected on a routine ultrasound examination. Therefore, pregnant women should not miss examinations by an obstetrician-gynecologist. A specialist using an ultrasound sensor sees structural changes in the placenta and thickening of its walls.As additional diagnostic methods, the doctor may use Doppler ultrasound. This ultrasound method helps to visualize placental blood flow. With it, you can assess the degree of supply of oxygen to the fetus. Dopplerography is a method by which a doctor is able to observe the condition of the fetus and monitor the quality of the treatment provided.
To monitor the vital activity of the fetus, doctors prescribe cardiotocography. This diagnostic method shows the heartbeats and movements of the unborn child, their relationship. Based on the results of CTG, a specialist can assess the degree of hypoxia of the baby. Sometimes, as a way of additional diagnostics, a woman is assigned a general and biochemical blood test.
Treatment
If the placenta is “older” by less than 1 week from normal, the woman can be treated on an outpatient basis. When doctors diagnose a more serious degree of pathology, the expectant mother should be immediately hospitalized in a highly specialized hospital.When diagnosing this pathology of the expectant mother, recommendations regarding lifestyle should be followed. A pregnant woman needs to spend a lot of time outdoors, avoid stress, strong physical exertion.
future mother it is recommended to review your diet, exclude from it fried, salted, smoked and semi-finished products. She should also add as many fresh vegetables and fruits, lean meats, poultry, fish, cereals, and dairy products to her diet as possible.
Drug treatment of premature aging of the placenta follows from the causes of the disease. If urogenital infections are detected, the woman should be given appropriate antibiotic therapy.
To improve metabolic processes in the body of the fetus of the expectant mother, it is recommended to take regeneration stimulants (Actovegin). To suppress thrombus formation and expansion of placental vessels, doctors prescribe antispasmodics and vasodilators (Aspirin, Eufillin).
With the effectiveness of drug treatment, natural delivery is possible under the special supervision of specialists. If doctors observe the progression of aging of the placenta, it is recommended to perform a caesarean section.
The placenta is a special organ that arises and grows in the uterine cavity during pregnancy, the main task of which is the correct connection of the blood supply systems of the fetus and matter. In the body of the placenta, biochemical processes are performed that are responsible for the normal development of pregnancy, for the production of special hormones that provide the fetus with oxygen, and also protect it from the influence of harmful factors. After the birth of a child, the child's place dies off and separates 30-50 minutes after birth.
The degree of maturity of the placenta at different stages of pregnancy
Like any organ, the placenta has its own "age", that is, it is born, develops and matures, and then ages and after childbirth - dies. This is a normal physiological process, however, early, premature maturation or aging of the placenta poses a threat to the health and life of the baby.
Currently, in obstetric and gynecological practice, four stages of placental maturation are differentiated, and each of them normally corresponds to a certain period of pregnancy.
However, there are so-called transitional stages, when signs of adjacent degrees of maturity may appear, which is associated with a different rate of development of the fetus and placenta, which is carried out from its marginal sections to the center.
- 0 - zero degree of maturity (according to the classification of Grannum P.A. 1979) can be diagnosed up to the 30th week;
- 0 - I degree (transitional period) is typical for 29, 30 weeks;
- I - the first degree of maturity is observed at 30 - 32 weeks;
- I - II (transitional period) is diagnosed at 32 - 34 weeks;
- II - the second degree of maturity corresponds to 34 - 40 weeks;
- II - III (transitional period) can last from 35 to 40;
- III - the third degree of maturity is diagnosed at 37 - 38 weeks to 40.
With the correct course of pregnancy, the growth of the placenta is completed by 36-37 weeks. After that, the thickness of the body of the child's place decreases or no longer changes. The ultrasound method of research (ultrasound) allows you to determine the thickness of the child's place and the degree of its development, which is directly related to the state of the chorionic membrane (the chorionic membrane surrounding the fetus and lining the fruiting surface of the placenta), the parenchyma (the villous outer fetal membrane of the embryo) and the basal layer (connective tissue lining of the uterus).
Changes in the structure of the placenta at different stages of pregnancy
At 0 degree of development of the placenta, its structure is homogeneous. The chorionic membrane is flat and smooth, without undulations. The basal layer is not defined.
If the zero degree of maturity changes to degree I before reaching the 27th week, this indicates the premature development of the placenta. As a rule, this condition occurs in the presence of negative factors: viral diseases such as rubella, chickenpox, suffered during pregnancy, smoking, drinking alcohol and drugs.
During the first degree At maturity, placental growth stops, and the body of the placental substance becomes thicker, and individual hyperechoic zones can be found in it, which are clearly visible on ultrasound, the chorionic plate becomes uneven. If at this time the doctor sets the II degree of maturity, this may be a sign of possible developmental disorders. In this case, it is required to take medications that activate blood flow in the vessels of the child's place.
At the II degree of maturity (35-39 weeks), during ultrasound, multiple echo-positive small inclusions are observed, the roughness of the chorionic plate increases, but its depressions do not reach the basal layer. In the basal layer itself there are small echogenic zones located linearly (the so-called basal “dotted line”). This stage of pregnancy is the most calm and stable. And even if in the middle of this period a III degree of maturity is determined in a pregnant woman, this does not often become a cause for alarm.
Grade III is usually observed at 37-38 weeks, when the placenta reaches the final phase in its development and corresponds to the duration of a normal full-term pregnancy. This period is characterized by biological aging of the placenta, the structure of which becomes lobar, and the depressions of the chorionic membrane reach the basal layer. This stage requires a detailed analysis of any inconsistencies observed in the body of the placenta, since even minor deviations from normal development can be signs of threatening complications. If the diagnosis at the III degree of development indicates fetal hypoxia, then the management of childbirth is often recommended, with the use of surgical intervention (caesarean section).
Premature aging of the placenta
Premature aging of the placenta is ascertained in cases where the II degree manifests itself before 32 weeks, and III - before 36 weeks. This is not yet evidence of the pathology of pregnancy, but requires mandatory control of the movement of blood in the vessels of the uterus and the child's place.
In the case of premature maturation of the child's place, a special protein settles on the villi, which is released from the blood circulating between them, and prevents their participation in the metabolic processes of the uterine and placental blood flow. At this stage, by the end of 39-40 weeks, a decrease in the thickness of the placental membrane from 25 to 6 microns is recorded. In the tissues of the placenta, dystrophic changes are observed, lime salts are deposited in certain areas.
If the degree of maturation does not correspond to the gestational age, for example, when it should be I according to the weeks of pregnancy, but they state II, or at the 33rd week they find the III degree, then a natural question arises: What is the danger?
The placenta, as one of the most important links in a single biological system that unites the fetus, the umbilical cord and the mother's body, works on many life problems:
- Provides oxygen to fetal tissue cells and removes carbon dioxide from the blood;
- Delivers nutrients to cells and removes metabolic products;
- It is a barrier and a filter that protects the embryo from the negative effects of harmful substances that enter the mother's body: drugs, toxins, bacteria;
- Produces hormones necessary for the proper development of pregnancy.
Therefore, premature aging or death of areas of the child's place negatively affects these functions. Deterioration of blood flow in the vessels of the uterine-placental system with a discrepancy between the maturity of the placenta and the established weeks of pregnancy is dangerous for the development of placental insufficiency, leading to hypoxia and fetal hypotrophy, and in the worst case, intrauterine death.
Causes of premature aging of the placenta.
The most common reasons:
- Nicotine, alcohol and narcotic substances that poison the cells of a child's place.
- Diabetes mellitus, thyroid disease.
- Hypertension in pregnancy.
- Late toxicosis (gestosis).
- Negative rhesus blood in the mother.
- Previa and early detachment of the placenta.
- Multiple pregnancy.
- endocrine disorders.
- Multiple pregnancy.
- intrauterine infections.
Late maturation of the placenta, causes and consequences
Such a diagnosis in the practice of pregnancy and childbirth is less common than the definition of premature maturation of the placenta. The main reasons for this status of a children's place are:
- primary and secondary diabetes mellitus in a pregnant woman;
- negative Rh factor leading to Rh conflict;
- chronic diseases of the expectant mother;
- smoking during pregnancy;
- alcohol consumption;
- fetal malformations.
With a delay in the development of the placenta and its late maturation, we can say that it does not fulfill its mandatory functions - providing the baby with oxygen and the nutrients necessary for its proper development. In addition, carbon dioxide and metabolic products are retained in the body of the fetus, which contributes to its intoxication and leads to developmental delays.
The prognosis for the established diagnosis of "late maturation of the placenta" in most cases is unfavorable without qualified medical treatment in a hospital setting. Otherwise, there is a high risk of stillbirth and mental retardation in the fetus.
Thus, the maturation of the placenta, its development, aging and death are natural processes, but the syndrome of premature aging and late maturation requires special attention. Modern methods for studying blood flow in the fetal-placental system have shown that an extended analysis of its circulation allows the attending physician to make an accurate diagnosis.
And this makes it possible to prescribe the most effective treatment, choosing the optimal tactics for managing pregnancy and obstetrics in order to achieve their favorable completion and the birth of a healthy child.
The placenta is an important organ that provides the fetus with nutrients and protects against most harmful agents.
The formation of the placenta (children's place) begins from the moment of penetration of the chorionic villi into the endometrium (approximately 3-4 weeks of pregnancy).
Further, the active growth of tissues and the vascular bed begins, a full-fledged placenta is formed. And then the reverse process takes place: deformation and blockage of blood vessels, the death of tissue fragments, which is called "aging of the placenta."
If for some reason the placenta ages before the fetal maturation, the diagnosis is “premature aging of the placenta”.
Doctors make a decision depending on the duration of pregnancy and the readiness of the unborn baby: premature birth, or carrying out pregnancy on an outpatient basis or under round-the-clock supervision of doctors in a hospital.
During pregnancy, the placenta goes through several stages of development.
During the first trimester, the placenta grows and develops, and from 10-12 weeks it is already formed and begins to fulfill its protective functions.
It is with the activity of the placenta that the weakening at the end of the first trimester is associated.
By the end of pregnancy, tissue cells and blood vessels of the child's place are gradually deformed and die, this process is called "placental aging".
This usually happens by 37-38 weeks, when all the organs and systems of the fetus have matured. But it happens that the placenta begins to die at an earlier date. This is the reason for the hospitalization of a woman. Pregnancy can be saved with medication.
The most reliable method for diagnosing the maturity of the placenta is ultrasound and Dopplerography (blood flow measurement).
In accordance with the ultrasound data, the specialist’s conclusion will indicate the degree of maturity of the placenta, it is classified as follows:
- 0 degree.
Normally, the zero degree persists until about 30 weeks.
This is a period of active work of the placenta, freshly formed tissues reliably protect the baby from harmful external toxins, metabolic products are effectively filtered (they are excreted by the mother's excretory system).
The blood supply to the vessels is good, the fetus receives the necessary nutrients.
- 1 degree
The first degree of placental maturity is observed from about 27 to 34 weeks. Continued active growth of the placenta, at this stage it reaches its final size.
- 2 degree.
It falls on 34-38 weeks. It is characterized by the normal functioning of the mature placenta. By the end of the term, some vascular changes are possible, but they do not have a significant effect on blood flow. The surface of the placenta becomes more dense and bumpy.
- 3 degree.
The placenta reaches its maximum maturity in the last weeks of pregnancy (37-40).
This period is associated with the natural wear and tear of tissues and blood vessels. There are signs of salt deposition and changes in blood flow.
But if examinations show that the fetus has a normal heart rate, growth and physical activity correspond to the gestational age, then you should not worry.
If the changes are diagnosed at earlier stages (for example, maturation to stage 1 before 30 weeks or a sharp transition to stage 3 with fetal growth retardation), they speak of premature aging of the placenta.
If chronic diseases of the mother are a contraindication to taking any of these drugs, the obstetrician-gynecologist, together with a specialized specialist, will select an individual therapy that is safe for the expectant mother and baby;
- Taking vitamins.
Vitamins A, and C, they will provide antioxidant protection and normalize the transport function of the placenta;
- Decreased tone of the uterus.
The decrease also improves placental blood supply. For this purpose, Ginipral is usually used in obstetric practice (if the mother has no contraindications!)
In the case of placental aging at an early stage (for example, the transition to stage 1 before 30 weeks), as a result of a set of measures taken, compensatory restoration of blood vessels is possible.
And in the future, pregnancy will develop according to the timing. After the control examination ( and ), the woman is discharged under observation at home.
The frightening diagnosis of "premature aging of the placenta" may be the result of bad habits, an untreated infection, or chronic diseases of the mother. Most causes are treatable or correctable.
Supportive care in a hospital setting will help restore blood flow and provide the fetus with conditions for normal further development.
Despite the fact that pregnancy is considered a magical period, women are advised to remain calm and carefully monitor their own body and, at the first unusual and unpleasant symptoms, seek help and advice from specialists.
placenta - the most important and unique organ that exists only during pregnancy. It acts as a link between the mother and the fetus, delivering all the necessary nutrients to it.
Premature aging of the placenta symptoms and causes
The state of the placenta is monitored by a doctor of ultrasound diagnostics and, in case of any deviations from the norm, diagnoses “premature maturation of the placenta”. We will consider how dangerous this is a little later, but for now let's talk about the reasons that can provoke such a phenomenon.
Most often, it is difficult to establish the exact cause that led to the development of this disease (each case is studied and considered individually), although doctors name several of the most common points. Among them:
uncontrolled intake of various medicines, which include biologically active additives and vitamins consumed by expectant mothers without consulting a specialist;
- viral diseases (influenza, acute respiratory infections, acute respiratory viral infections, etc.);
- smoking;
- drinking alcoholic beverages during pregnancy;
- taking illegal drugs, etc.
What to do?
Unfortunately, it will not work to restore the placenta, so the desire of women with the help of drugs to “return everything to its place”, alas, is not feasible. So doctors first of all assess the condition of the fetus and if, due to premature aging of this unique organ, there is a threat to its normal development, the expectant mother is hospitalized. In the hospital, she usually glucose preparations are introduced, some drugs that are prescribed for respiratory failure, as well as drugs that reduce the tone of the uterus.
In the case when the condition of the fetus is very difficult and the above measures do not bring the desired result, a caesarean section can be performed before the scheduled date of birth. In this case, a premature baby is born.
Why is premature aging of the placenta dangerous?
As we have already said, the placenta is a unique organ that is formed during pregnancy and performs protective and nutritional functions. With it, the baby receives the necessary nutrients and feels protected from the threats of the outside world. But as soon as the mother succumbs to temptations and returns to the wrong lifestyle, engage in self-medication during pregnancy or not visit a specialist on time (with planned ultrasounds, the doctor will definitely notice the first signs of aging of the placenta and recommends that the woman take action), as the condition of the placenta worsens and premature aging begins.
Effects
This is fraught with the development of pathologies in the crumbs, since he will not receive the trace elements he needs, as well as the birth of a premature baby, since an emergency caesarean section is performed in difficult situations.
Read also
If intrauterine infection did not lead to termination of pregnancy and the baby was born safely, the following symptoms should make parents worry:
- early jaundice;
- rash of a different nature;
- respiratory function disorders;
- cardiovascular insufficiency;
- neurological disorders;
- high body temperature in the first day of life;
- inflammatory (eg, conjunctivitis) and degenerative (eg, optic nerve atrophy) eye diseases.
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Premature aging of the placenta is a threatening condition. Any pregnant woman can face it. Why the "children's place" begins to lose its functions ahead of time and what to do with these, we will tell in this article.
How does the "children's place" mature?
"Children's place", or placenta, is a temporary organ needed by a woman and a child only during pregnancy. It has a spongy structure, one side fits snugly against the wall of the uterus, from where it draws maternal blood supplies, and the other is connected to the fetus through the umbilical cord. The placenta performs protective functions, preventing the mixing of the blood of mother and baby. It also acts as an intermediary in gas exchange and nutrition: through the placenta through a vein in the structure of the umbilical cord, the baby receives fresh blood with oxygen and vitamins, and through two arteries inside the umbilical cord, the child's waste products are returned to the placenta: urea, carbon dioxide, creatinine. The placenta produces important hormones for pregnancy and subsequent breastfeeding.
A week after ovulation, the fertilized egg enters the uterine cavity and its main task is to implant. This helps the chorionic membrane, which "grows" into the maternal endometrium. At the site of attachment, a chorion is formed, which gradually transforms into a placenta. The formation of a "children's place" is completed by the 14-16th week of pregnancy. The young placenta takes its final form by the 20th week. Until the middle of pregnancy, the "children's place" grows and expands. After that - only slightly adds in thickness.
The closer to childbirth, the less functional the placenta: it develops its resources, begins to age. First, its membranes become wavy, then blotches of deposits of calcium salts appear in the placenta, then these blotches become more extensive - the spongy placenta becomes more dense, begins to become thinner. All these processes fit into four degrees of maturity.
If the degrees succeed each other on time, this does not pose any danger. If the placenta "extinguishes" too quickly, they talk about its premature aging.
Norms and deviations
A young and full of strength placenta has a zero degree of maturity. This means that the resources of the "children's place" are not exhausted - the baby receives everything necessary for its development. Normally, the zero degree of maturity is recorded before the 30th week of pregnancy.
The first degree of maturity of the placenta speaks of the changes that have begun: the growth of the network of blood vessels and tissues has stopped, the membrane becomes wavy. But the "children's place" performs its functions properly - the baby is comfortable, and everything is enough. The first degree normally corresponds to a period of 30-34 weeks of pregnancy.
The second degree of maturity describes active regressive processes in the "children's place": a fragmentary thinning of the placenta may appear, its structure becomes denser, and calcium salt deposits appear. If the 2nd degree is set in the appropriate time frame, you don’t have to worry - the placenta copes with its tasks without harming the baby. The second degree will not be considered pathological if the gestational age is already 35–38 weeks.
The third degree is a mature or old placenta. The structure, which previously resembled a fairly even cake, becomes lobed: lobes are defined, the membrane is uneven, salt deposits are clearly distinguishable. Usually, the 3rd degree is fixed immediately before the birth: in the last couple of weeks, and sometimes just a few days before the birth.
If the doctor sets an intermediate degree, for example, 0-1 or 1-2, then the ultrasound showed signs of the transition from one stage of development of the "children's place" to another, but the transition itself has not yet been completed. With transitional degrees, the most incomprehensible moments and misunderstandings usually arise. To make it easier to understand what is normal and what is not, you should know that 0–1 degree at a period of 27–28 weeks of pregnancy is not a pathology, but a variant of the norm.
After 30 weeks, the doctor can diagnose both the first and transitional (0–1) degrees. But the 1-2 degree at 32 weeks is a clear pathology, since there is still about a month before the transition to the second degree. The onset of the 3rd degree of maturity before 38 weeks is also an alarming and dangerous situation, in which, most likely, a decision will be made on early delivery.
The greater the time gap between the norm and the real state of the placenta, the more dangerous the consequences can be.
What is dangerous?
Since nature has assigned important functions to the placenta for protection, nutrition, oxygen supply, as well as hormonal support for the body of a pregnant woman, any changes in the structure of the placenta ahead of time can lead to serious complications. When aging comes on time, it is physiological: the loss of some functions of the placenta, their decrease is compensated by the organisms of the mother and fetus. This does not harm the child, since the normal extinction of the function proceeds quite smoothly.
If early maturation is observed, then the baby receives insufficient oxygen, the placenta copes worse with the removal of its waste products, it lacks nutrients. In addition, the placenta copes worse with protective functions. The most common consequence of premature puberty for a child is hypoxia.
Against the background of oxygen deficiency, the baby's brain and nervous system suffer. Prolonged hypoxia can lead to the death of a child in utero. Often, it is intrauterine hypoxia that causes the fetus to lag behind in development, gross violations of the activity of the central nervous system.
Children who suffered from hypoxia in the mother's womb are more painful, they may experience various neurological abnormalities, as well as dysfunctions of the musculoskeletal system. In addition, such children study worse, disability is not excluded.
Lack of nutrients leads to a delay in intrauterine development of the baby. It is diagnosed during pregnancy. Height, weight, length of the limbs of the fetus lag behind the normal values characteristic of a particular period of pregnancy. Often, a delay in physical development is accompanied by brain and metabolic disorders, which after birth is determined in the form of lags in mental and mental development. Against the background of starvation, various defects of the internal organs and the skeletal system of the baby can develop.
The slow removal of fetal waste products by an early ripened placenta creates a threat of intoxication, death of the child. And a decrease in the barrier functions of the "children's place" can lead to infection of the crumbs with dangerous viruses that can easily penetrate the bloodstream to the baby. Intrauterine infection is a condition that is regarded as a threat to the life of the child.
What caused?
The placenta matures ahead of schedule for a variety of reasons. Most often, doctors are faced with such a phenomenon as premature aging of the placenta in women who, while carrying a baby, continue to smoke or cannot deny themselves the pleasure of taking alcoholic beverages. In women who console themselves with the hope that "light" cigarettes are not dangerous, and red wine is useful, such a pathology after 30 weeks of pregnancy is quite common.
However, the absence of bad habits during pregnancy and before it does not guarantee that there will be no problems with the placenta. The maturation of the "children's place" ahead of time may be a consequence of a viral infectious disease, for example, SARS or influenza in the early stages, as well as sexually transmitted infections.
In pregnant women with Rh-negative blood, provided that they carry a baby with a positive Rh factor, an Rh conflict may develop, in which the placenta begins to suffer almost at the stage of formation. Its early maturation is often a consequence of those immune processes that take place during a conflict in the body of a future mother.
If a woman had diabetes before pregnancy or she acquired gestational diabetes while carrying a baby, the likelihood that the placenta will age quickly is much higher.
With such ailments, placental hyperplasia (an increase in its thickness) is usually observed, which almost always leads to an early loss of its functions. Early aging of the "children's place" is also found in women who have had several abortions: the thinned endometrium in this case cannot ensure the normal development of the placenta. In this case, it is thinner initially, and ages much faster.
Chronic diseases of the expectant mother, especially if they concern the kidneys, liver, thyroid gland, heart and blood vessels, as well as blood clotting disorders increase the likelihood of premature maturation of the "children's place".
Many medications can negatively affect the rate of maturation of the placenta, which is why expectant mothers are strongly discouraged from taking any medication unless it is approved by their doctor. The contact of the expectant mother with toxic substances, varnishes and paints, solvents, bleaches and other chemicals is also destructive to placental tissues and blood vessels. Working in a hazardous and hazardous industry increases the likelihood of negative changes in the rate of maturation of the placenta.
Premature aging of the placenta is more often observed in women who live in large cities with unfavorable environmental conditions than in women who live in a village or small town where there are no large city-forming industrial enterprises. And also pathology, according to the observations of doctors, is inherited - from mother to daughter.
Preeclampsia (late toxicosis) quite often leads to the aging of the "children's place" ahead of schedule. Dangerous from the point of view of the likelihood of developing a pathological condition and drops in blood pressure in a future mother, hypertension. If a pregnant woman at any stage of pregnancy experienced even minor placental abruptions or there is a previa "children's place", the risk of early maturation is several times higher than in women who do not have such problems during pregnancy.
When carrying twins or triplets, the risk of early maturation is higher than with a singleton pregnancy. And in women with hormonal problems, placental anomalies almost always occur to one degree or another, including the old placenta at inappropriate gestation periods.
Symptoms and signs, diagnosis
There is no way to feel the degree of maturity of the placenta, as well as to determine its thickness and other parameters on your own. The accelerated maturation of the "children's place" proceeds completely without symptoms. That is why it is important to regularly visit a doctor, undergo all the examinations required by the deadline, take tests and do an ultrasound scan. The earlier an anomaly is detected, the more favorable the doctors' forecasts for the upcoming treatment will be.
Signs of premature aging of the placenta at a later date, when the consequences of placental insufficiency are already manifesting, are mainly felt as a change in the baby's motor activity. An increase in activity indicates the initial stage of hypoxia: the movements of the baby become sharp, they can cause severe pain to the pregnant woman. So the baby tries to massage the placenta with its arms and legs, trying to get more oxygen.
Protracted hypoxia is manifested by the opposite signs - the baby almost stops moving. It enters a mode of saving oxygen and nutrients, trying to spend as little energy as possible. A complete cessation of movement may be a sign of the death of the baby.
Only a doctor can establish the fact of hypoxia, intrauterine growth retardation, intoxication and other unfavorable conditions. That is why it is so important not to miss visits to the antenatal clinic.
When the behavior of the baby changes, the woman is prescribed a study of the placenta and the characteristics of the uteroplacental blood flow for ultrasound, ultrasound, and CTG is also performed. Cardiotocography, which can be performed from the 28-29th week of pregnancy, can give a fairly accurate answer to the question of whether the baby has changes in the condition.
The degree of maturity of the placenta is determined by ultrasound, starting from the 20th week of pregnancy. At earlier periods, neither the thickness of the "children's place" nor its characteristics of maturity have a diagnostic value.
Treatment
Despite the fact that the consequences can be quite serious, a woman should not panic: premature aging of the placenta is always more favorable than its pathological immaturity. With early detection of pathology, doctors can help the baby and his mother. Treatment is usually carried out in a hospital setting.
The choice of tactics of action depends on the term. If premature maturation of the placenta is detected at 31-35 weeks of gestation, then doctors are trying to do everything possible to preserve it and prolong it, because the baby at this time is not yet ready to be born. The woman is monitored in the hospital, they provide the necessary therapy, they do CTG every day to find out if the baby's condition and well-being have changed. Once every few days, an ultrasound is done to control the processes occurring in the placental structures.
If the gestational age is more than 36 weeks, then with a high degree of probability, doctors will decide on early delivery: stimulation of labor or a caesarean section. Although, if the degree of deviation from the norm is small, they can put it on preservation and try to support the baby inside the mother's womb with medication for at least two more weeks so that he has time to gain weight.
In the standard treatment regimen, there are antispasmodic drugs ("Papaver", "No-shpa") to reduce the contractility of the smooth muscles of the uterus. To improve blood flow in the mother-placenta-fetus system, Curantil, Actovegin are used both in tablets and in the form of intravenous drip injections. To compensate for the nutritional deficiency of the baby, vitamin preparations are used. If fetal hypoxia is suspected, oxygen cocktails are recommended to a woman.
If infectious diseases have become the cause of premature maturation of the "children's place", in parallel with the standard scheme, the woman is prescribed appropriate treatment with antiviral or antibacterial drugs. With late toxicosis, diuretics are prescribed to reduce swelling, and means to lower blood pressure if the expectant mother has hypertension.
If systematic observations of the baby indicate the slightest negative changes in his condition, the preservation therapy is canceled and an emergency delivery is performed. This is necessary in order to save the child's life.
You should give up smoking, alcohol, uncontrolled medication in advance - antibiotics, anticonvulsants, hormonal drugs, including contraceptives, are especially dangerous.
If a woman is being treated with such means or is being protected with oral hormonal contraceptives, before conceiving a baby, you should consult a doctor and pass the necessary tests to avoid problems in the future.
From the first weeks of pregnancy, it is important to monitor your diet, avoid contact with toxic substances, radioactive radiation, and not work on the night shift, since lack of sleep leads to hormonal imbalance. If bleeding occurs at any time, you should consult a doctor to exclude placental abruption, and receive the necessary treatment if it occurs.
A woman should breathe fresh air, walk, if the weather permits, sleep with an open window. The more oxygen she receives herself, the more she will be able to give it to her baby through the placental blood flow. Viral infections should also be avoided by carrying out the correct and timely prevention of influenza and SARS, especially during periods of mass morbidity.
During pregnancy, you should not change your sexual partner: any introduced infection can cause damage to the placenta.
About premature maturation of the placenta, see the following video.