Even the most emotionally balanced women slightly lose their ability to reason sensibly during pregnancy - the hormonal background, which varies greatly during pregnancy, is “taken care of”.
Maternal instinct makes a woman anxious for no apparent reason, and if the leading doctor announced the diagnosis of "low placentation during pregnancy," some individuals generally panic.
And completely in vain: this condition does not apply to pathological conditions and can change over the course of pregnancy.
According to the WHO, 99% of pregnant women with low placentation, determined in the middle (or near the end) of pregnancy, successfully give birth on their own. But in one percent of cases, this condition is really dangerous. How not to get into this group?
Low placentation during pregnancy - what is it?
The placenta is a kind of "fortress" for the child, which provides him with maximum physical and immune protection, satiety, health and full development. Formed in the wall of the uterus, the placenta is a thickened part of the embryonic membranes and an extensive network of blood vessels in it.
The weight of the placenta can reach one and a half kilograms. As a rule, it is deployed at the bottom of the uterus and begins to develop after the introduction of a fertilized egg into the uterine wall. To fix the egg and the formation of the placenta, the zone of the best blood supply to the uterus is selected, most often next to the blood vessel at the base of the epithelium.
The end of the formation of the placenta occurs at 12-16 weeks and is directly related to the end of the toxicosis of pregnant women.
Attachment of the placenta to the walls or the bottom of the uterus is considered normal if the child's place is located 5-6 centimeters from the uterus. In the case of low placentation during pregnancy, the introduction of the egg falls dangerously close to the pharynx, and can cause complications. The doctor monitors the condition of the placenta during pregnancy in order to see the presentation on time, on which the method of delivery depends.
As pregnancy develops, the uterus increases, while the implantation site remains in place. It is due to an increase in uterine tissue that the "placenta" migrates further from the internal pharynx, up to a normal distance of 5-6 centimeters.
Symptoms of low placentation
A properly formed placenta, which does not completely overlap the internal uterine pharynx, may not let the pregnant woman know about herself: low placentation during pregnancy is often noticed only on the last ultrasound.
But in certain cases, the described condition leads to the threat of miscarriage, and a pregnant woman appears:
• spotting spotting;
• aching regular pain in the lower abdomen and lower back;
• fetal hypoxia;
• reduced blood pressure of the pregnant woman.
Low placentation during pregnancy: causes
Women with the first pregnancy are practically not found with a low placenta, since the more changes occurred with the condition of the genitals, the higher the risk of an undesirable pregnancy.
To the end, the causes of this condition have not been studied to this day. The formation of the placenta in the cervical region is considered by many to be even normal. But there are conditions that contribute to deviations from the norm in the development of the placenta.
Causes of low placentation during pregnancy:
• the age of a pregnant woman over 30;
• second or more births;
• manual separation of the placenta in previous births;
• dystrophic and atrophic processes in the endometrium - uterine scars, damage to the endometrial mucosa after cesarean, abortion or cauterization of erosion;
• immaturity of the blastocyst;
• anatomical structural features of the reproductive organs (septum in the cavity, bending, uterine underdevelopment);
• pathology of the villous chorion (more often in women with impaired ovarian function or genital infantilism) - endometrial restructuring does not occur on time;
• congenital or acquired physical abnormalities;
• pathology of the cervix uteri - endocervicitis, erosion, ismocervical insufficiency;
• inflammatory processes in the pelvic organs;
• benign neoplasms, polyps;
• abortive or other surgical interventions in the functioning of the reproductive organs;
• multiple pregnancy;
• infectious diseases;
• chronic ailments (cardiovascular, kidney and liver diseases, intoxication), which provoke circulatory disorders in the area of reproductive organs.
Separately, it must be said about benign neoplasms. The likelihood of low placentation during pregnancy in this case increases. If the doctor found in the genitals polyps, fibroids and other neoplasms during the planning of your pregnancy, and suggests surgery, it is certainly better to agree.
Damaged endometrium after surgery and inflammatory diseases in the uterus suggests that it is advisable to wait at least a year with pregnancy.
The effect of low placentation on pregnancy, complications
The larger the fetus becomes, the more it presses on the uterine cavity. The vessels of the placenta are compressed, the blood flow in the uterus and placenta is disturbed. These processes can lead to fetal hypoxia (lack of oxygen) and intrauterine growth retardation. Pregnant at this time experiences weakness, low blood pressure, anemia may develop.
The more terrible consequences of low placentation during pregnancy are much less common. It can cause placental abruption with impaired blood supply, which develops acute hypoxia and even fetal death. In this case, bleeding forces doctors to perform operative delivery.
Low placentation during pregnancy: diagnosis
By the end of the third trimester, chorion is transformed as a result of gestation into a placenta consisting of blood vessels. This is the time of the first ultrasound examination, genetic pathologies of the fetus and malformations are revealed. It is an ultrasound that allows you to quickly and safely identify problems with the placenta.
At the first ultrasound scan at 12-16 weeks, 80% of pregnant women are diagnosed with low placentation. Confirm the diagnosis at 22-25 and 30-35 weeks. Normally, near the end of pregnancy, the child's place is shifted, and by the time of birth is in a normal position.
If bleeding occurs and ultrasound is not possible, the cervix is examined with the help of mirrors to find part of the placenta in the cervical canal. The method is quite dangerous and is used only in extreme cases in the presence of an operating room.
Low placentation during pregnancy: what to do
Medical practice shows that the vast majority of pregnant women with low placentation initially at the end of the term comes to birth with a normal state of the uterus and placenta. This is due to the constant modification of the lower segment of the uterus, which often increases and higher raises the child's place. Usually such women give birth on their own.
Only 5% of women with such a diagnosis have low pricing at 32 weeks of gestation. By week 37, only a third of the remaining ones retain this state. By the date of birth, not more than one percent of pregnant women has a placenta located closer than 2 centimeters to the internal pharynx of the uterus. These pregnant women are diagnosed with placenta previa and a cesarean section is performed.
The risk of bleeding in natural births in pregnant women, when the placenta is located further than 2 centimeters from the internal pharynx of the uterus, is not higher than with a normal placenta.
Although low precentration during pregnancy is not a pathological condition until 38 weeks, women with this diagnosis are recommended in the last stages:
• walk less, do not neglect rest;
• in a supine position, place legs on a hill;
• Do not crouch or bend low;
• do not miss scheduled examinations by a leading doctor, observe the schedule of ultrasound and tests;
• monitor vaginal discharge.
If the lower abdomen began to disturb and spotting appeared, then you must immediately tell the doctor if the pregnant woman is in the hospital, or call an ambulance and go to the department of pathology of pregnant women.
Can I fly in an airplane at low placentation
If you need to travel, pregnant women with this condition have strong fears, especially if you need to fly on an airplane, where there are strong changes in pressure and overload. A doctor’s consultation is mandatory, and if he gives the go-ahead for a flight at low placentation, then you can safely go on a trip. As a rule, almost nothing is forbidden to a woman until the middle of her pregnancy, therefore, until 20 weeks there is no risk of miscarriage or bleeding. Naturally, the shorter the flight, the better, and you should not take heavy baggage with you.
Low placentation during pregnancy: what can not be done
Following some rules of behavior, a pregnant woman can reduce to zero the risk of complications with low placentation.
These requirements include:
1. Minimization of physical activity: running, brisk walking, active sports and sex life - it is better to refrain from this.
2. Elimination of sudden movements and vibration - drive less in any means of transport (especially in public).
3. Taking medications prescribed by your doctor.
4. Observation of vaginal discharge, and in case of bleeding, immediately take a horizontal position and call an ambulance (the speed of these actions affects the outcome of pregnancy and the preservation of fetal life).
Low placentation
The method of delivery in this case is chosen only by the doctor. He can decide to puncture the fetal egg, then the placenta will be fixed by the head of the fetus. Such births are most often performed in operating rooms in order to have a cesarean section if the fetus is located in the wrong position for delivery (legs forward).
Low placentation during pregnancy at 37-38 weeks forces doctors to recommend a woman hospitalization in the pathological department of pregnant women, where she will be under constant supervision.
By the time of birth, the placenta can "move" to an acceptable distance - then natural birth is possible.
However, during childbirth, the uterine muscles contract and it decreases in volume, while the placenta remains the original size.
As a result, the blood vessels connecting the low placenta to the walls of the uterus are very tense, even their rupture and premature detachment of the placenta is possible.
The fetus will not receive enough oxygen, and the brain may be damaged.
To prevent such complications, doctors decide to do a cesarean if the situation with low placentation has not changed by 38 weeks.
