Early maturation of the placenta. Premature aging of the placenta: causes, treatment, prognosis

All vital organs are formed in a person long before birth. And it seems that it does not happen that any organ suddenly appears in a person during his life. However, it is possible. A similar organ is the placenta, which is formed in women during pregnancy.

Children's place

Placenta is a medical term. People call it a children's place. So, the placenta is an organ that forms during pregnancy. It is through it that the baby receives oxygen and all the necessary nutrients. The placenta allows you to remove waste products from the baby and carbon dioxide. It is endowed with the most important function - it protects the baby from reactions immune system mothers and various infections.

If we consider the placenta from a scientific point of view, then it is a small disk (20 cm in diameter) weighing about 5 kg and approximately 3 cm thick. One side of it is directed towards the fetus (it is from this side that the umbilical cord departs), and the second, consisting of villi, attached to the uterus.

The placenta itself contains arteries and veins through which blood is exchanged between the mother and the unborn baby.

What's happened

Aging of the placenta during pregnancy is a fairly common diagnosis that doctors make to expectant mothers. This diagnosis is made on the basis of an ultrasound scan and has important For normal development fetus

The placenta goes through 4 stages of maturation:

Zero, which is typical for pregnancy up to 30 weeks;

The first, which lasts from the 30th to;

The second, which corresponds to pregnancy from the 34th to the 37th week;

The third, characteristic of that is, from the 37th week until the moment of birth.

Depending on the stage, the placenta changes and has characteristic features. Aging of the placenta during pregnancy is a decrease in the functionality of this organ. This does not mean at all that the placenta, which, for example, has a second degree of maturity, ceases to perform its functions. This body simply gradually reduces the scope of its capabilities.

In this regard, the identification of such pathology in later pregnancy should not cause serious concern. It is much worse when aging of the placenta during pregnancy is detected in the first or second trimester.

Learn more about the stages of placenta aging

The age of the placenta is the most important indicator that informs about intrauterine development and fetal formation. It happens that the outcome of pregnancy depends on this indicator.

As already mentioned, there are 4 stages of placental maturation.

Starting from the 12th week of pregnancy, an organ such as the placenta begins to form and actively grow. Every week it gets denser. In the period from the 12th to the 30th week of pregnancy, the degree of maturation of this organ is normally zero. During the specified period, the structure children's place is smooth and uniform. In the zero stage, the placenta fully performs all the functions assigned to it: it actively saturates the fetus with oxygen and nutrients, removes carbon dioxide and waste products of the unborn baby.

Stage one

The normal course of pregnancy in the period from the 30th to the 34th week corresponds to the first stage of maturation of the child's place. It is characterized by the fact that it is during this period that the first signs of aging begin to appear on the placenta. They are expressed by the appearance of small irregularities and inclusions. At the same time, this organ does not lose its functions: the placenta continues to actively help the baby develop, grow and eat.

Sometimes this period is called the period of placental development, since it is during this period that the fetus is actively growing and developing.

Second stage

The second stage of maturation (aging) is characteristic of the pregnancy period from the 34th to the 37th week of pregnancy. Ultrasound examination of the placenta during the specified period shows the appearance large quantities inclusions, changes in the relief of a given organ. gradually begins to decrease, which leads to a decrease in its functional tasks.

However, for the period from the 34th to the 37th weeks of pregnancy, the placenta performs all the necessary functions: the baby receives the amount of nutrients that it needs for proper development and growth.

Final stage

The third (final) stage of maturation is observed at 36 weeks of pregnancy. The aging of the placenta is reaching the “finish line.” The functioning of the child's seat is significantly reduced, and natural aging occurs. This stage is typical for full-term pregnancy and indicates that the fetus is ripe and the mother’s body is ready for childbirth. Externally, the placenta at this stage has many inclusions and deposits of salts. Its structure is very heterogeneous; large waves are visible on the placenta, the depth of which in some places reaches the basal layer.

Any deviation from these norms is considered a pathology and requires systematic monitoring and treatment. However, placentas are not a death sentence at all. Timely detection of this deviation will help stabilize the condition of the fetus and bring the expectant mother to a successful birth.

Aging of the placenta during pregnancy: causes

You can see a photo of the organ in the article. The placenta, like any other organ, wears out due to excessive stress. There are many factors that cause aging of the placenta during pregnancy. The causes of this pathology most often come down to the following:

Infectious or endocrine diseases of the expectant mother, the presence of pathologies of the circulatory system, as well as diseases of the kidneys and urinary system;

Rh conflict between mother and fetus;

Excess (or insufficient) weight of the woman in labor;

Drinking alcohol and smoking;

Presence of abortion or difficult previous births;

Toxicosis;

Poor nutrition;

Chronic diseases of the heart, lungs, arterial hypertension;

Multiple pregnancy.

As you can see, there are a huge number of reasons why premature aging of the placenta occurs during pregnancy. This and chronic diseases, and acquired viral and infectious diseases, as well as improper behavior of the mother during pregnancy.

It is worth remembering that a diagnosis such as premature aging of the placenta is made in cases where the second degree of maturity is diagnosed at up to 32 weeks or the third at up to 36 weeks.

How to find out and understand?

You can only find out by doing an ultrasound. Since this pathology occurs without any symptoms, it is impossible to independently understand that the placenta is not coping with its functions.

The development of this pathology can also be determined using an optical cardiac monitor. It shows the fetal heart rate and its changes.

However, despite the fact that there are no visible symptoms, you can still suspect that something is going wrong by the behavior of the fetus.

Symptoms

Thus, aging of the placenta during pregnancy has the following symptoms:

The fetus's heart rate increases. This occurs as a result of oxygen starvation and lack of nutrients. This symptom indicates that the placenta is not coping with its functions;

Due to oxygen starvation, the expectant mother may feel sharp tremors in the abdomen (starting from the second trimester): the baby begins to actively move, kick and push with arms and legs;

Due to a lack of nutrients, the fetus may stop moving and moving altogether.

These symptoms in most cases indicate premature maturation of the child's place.

Consequences

What can happen if placenta aging during pregnancy is established? This pathology has the most negative consequences for the child.

In the early stages (in the first trimester), such a diagnosis, as a rule, leads to a miscarriage or so-called frozen pregnancy.

In the second trimester of pregnancy, the appearance of this pathology can lead to a delay in physical or mental development future baby, as well as the birth of a child with reduced body weight. In addition, premature aging of the placenta can cause the death of brain cells.

However, most often such a diagnosis is made in the third trimester of pregnancy. IN in this case Doctors recommend using methods of artificially inducing labor. With the help of droppers, special gels and injections, you can speed up the onset labor activity and give birth to a healthy baby 3-4 weeks earlier than the preliminary due date.

Treatment

So, the expectant mother was diagnosed with “premature aging of the placenta during pregnancy.” Treatment in this case will be carried out in a hospital setting. In most cases, doctors will use medications to eliminate the resulting pathology.

It is worth knowing that it is impossible to cure this pathology. In this regard, treatment will be aimed at helping the unborn baby.

Depending on the reason for the untimely growth of the placenta, a pregnant woman may be prescribed IVs or injections. If the cause of this diagnosis is an infectious disease of the mother, she will be offered a course of treatment with medications depending on the type of infectious agent.

Most often, droppers and injections are prescribed that can prevent the development of hypoxia in the fetus. Such drugs include Actovegin, Curantil, as well as essential phospholipids and other medications.

These drugs are also used to reduce the tone of the uterus and improve blood circulation. The baby's respiratory failure can be restored with glucose medications.

However, there are situations in which treatment by medication doesn't make sense. In such cases, premature delivery is used, which is performed by caesarean section. As a rule, such emergency measures are typical when aging of the placenta is detected at 34 weeks of pregnancy and at later stages.

Doctors resort to such emergency measures in cases where it is reliably established that intrauterine development is more dangerous for the child than premature birth.

Preventive measures

A set of preventive measures that can help you avoid premature aging The placenta is quite simple. A pregnant woman is advised to give up any bad habits, be it smoking, drinking alcohol, and especially drugs. The expectant mother should avoid stressful situations, physical activity and spend as much time as possible on fresh air.

Important preventive measure is also a systematic visit to a gynecologist. After all, timely detection of pathology will help to take appropriate measures in time and avoid unpleasant consequences.

You should not refuse to visit a day hospital: you should remember that the condition of the fetus during early maturation of the placenta directly depends on medical supervision, qualified and adequate medical care.

Instead of a conclusion

Pregnancy is often accompanied by the appearance of various pathologies and abnormalities. One of the most common diagnoses made to expectant mothers is premature aging of the placenta during pregnancy. The causes and consequences of this pathology can be completely different: this and wrong image mother's life, and the presence infectious diseases, and even congenital diseases.

So, we talked about what aging of the placenta is during pregnancy. The consequences of early organ maturation depend on the period of their appearance and detection. However, a timely visit to a gynecologist, compliance with all doctor’s instructions, as well as healthy image life can reduce the likelihood of the occurrence of this deviation.

It is worth knowing that in most cases, when diagnosed with “premature aging of the placenta,” doctors manage to stabilize the condition of the fetus and expectant mothers give birth to absolutely healthy and full-fledged children.

Premature ripening of the placenta is a common problem for expectant mothers. This pathology is determined by ultrasound examination in the second, but more often the third trimester of pregnancy. Essentially this means that the “children’s place” loses its functionality.

The placenta plays an important role during pregnancy. After all, it largely determines how well nutrients and oxygen will enter the child’s body. Provided the mother has a normal lifestyle and nutrition. And it is understandable when a child of a smoking, alcohol and drug-using mother suffers in utero. But premature aging of the placenta is also diagnosed by healthy women who are responsible for the health of their children and who do not have such bad habits. Why such injustice occurs, and what other reasons exist for premature ripening of the placenta - every woman needs to know about this.

Various infections can provoke this process. This and viral infections, sexually transmitted diseases, as well as infections that directly affect the genitals. These include herpes type II (genital), for example. Unfortunately, you will not be able to see the signs of premature ripening of the placenta on your own. Try to protect yourself from any infections; do not unnecessarily visit hospitals and clinics, as well as places with large crowds of people. In most cases, infections do not directly threaten the child, since the placenta is a real protective barrier. However, premature ripening of the placenta at 32, 33, 34 weeks, and sometimes at earlier stages, is an almost inevitable consequence in this case.

The condition of the placenta can worsen due to taking medications, and even vitamins. That is why you should not take various medications “for prevention,” especially if they were not recommended to you by a doctor.

How dangerous is premature ripening of the placenta for a child? Because he will not receive enough food and oxygen. With the so-called fetoplacental insufficiency, which occurs in the case of rapid “wear and tear” of the placenta, a woman’s stomach grows slowly, as the child is delayed in development. Often, ultrasound in children reveals developmental delay, calculated approximate weight the fetus is below normal.

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

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

The placenta is an organ that ensures normal growth and development of the fetus. The maturation of the placenta has four stages. From the beginning of pregnancy to the thirtieth week, the formation process occurs. Until the thirty-second week it grows. The maturation stage lasts from the thirty-fourth to the thirty-sixth week, and starting from the thirty-seventh week of pregnancy, aging of the placenta occurs. After childbirth, this organ comes out as an afterbirth.

The degree of maturity of the placenta is determined using ultrasound examination.

What does premature ripening of the placenta mean?

The processes of maturation and aging, which occur slightly ahead of schedule, may be associated with individual characteristics body and do not pose any threat to the fetus and mother.

If the degree of maturity of the placenta exceeds the gestational age by a significant gap, this means that the woman is likely to have premature aging of the placenta. This diagnosis should be taken with responsibility, since rapid maturation of the placenta impairs its functionality, and the baby will not be able to fully receive oxygen and nutrients from the mother’s body. During aging, the exchange surface area decreases, and salt may be deposited in some areas.

What is dangerous about premature maturation of the placenta is hypoxia and malnutrition of the fetus. This pathology can cause disruption of the baby’s blood supply. Premature aging of the placenta threatens placental abruption and untimely rupture amniotic fluid and miscarriage. This pathology can cause abnormalities in brain development, and in some cases even miscarriage. To avoid these pathologies, it is necessary to undergo a course of treatment on time and be constantly under the supervision of a doctor.

Causes of premature ripening of the placenta

This pathology can be caused by several factors:

• deviation from the normal body weight of a pregnant woman, this can be either overweight or thin;
• disruption of the structure of the walls of the uterus and its nutrition - these changes can occur due to previous abortions or a history of difficult childbirth;
• damage to the uterus as a result of mechanical stress;
• diseases endocrine system, liver, urinary system;
• pathologies of the circulatory system;
• chronic diseases, infectious diseases;
• smoking;
• long-term late gestosis;
• toxicosis high degree gravity.

Typically, there are no signs of premature aging of the placenta. This process can only be determined using ultrasound. During the study, the density of the placenta is measured and the data obtained are compared with the gestational age. Data on its thickness and accumulation of calcium salts are also studied.

Treatment of premature placental maturation

Treatment of such pathology begins after receiving confirmatory results of a comprehensive examination. First of all, risk factors are eliminated and complex drug therapy is used to improve placental function and prevent fetal hypoxia. By using medications it is quite possible to restore the functioning of the fetal circulatory system and the supply of nutrients.

In some cases, hospitalization is necessary. After the completed course of treatment, ultrasound and CTG are repeated. For birth healthy child labor often begins ahead of schedule. In this case, labor is induced with medication.

Knowing what premature ripening of the placenta means and what its consequences are, the expectant mother should be attentive to herself, follow the doctor’s recommendations and not self-medicate.

Igor Polyakov

13.05.2015 | 576

Premature ripening of the placenta is not at all a dangerous situation if this problem is identified in time, and gestation is nearing completion.

In general, the discrepancy between the degree of maturity of the placenta and the gestational age is an unpleasant condition for mother and baby.

Causes of premature aging of the placenta

Accelerated maturation of a child's place in most cases is a compensatory reaction: the body of a pregnant woman, for various reasons, at some point loses the ability to work fully, providing for both itself and the fetus. It is from this time that the child’s place accelerates the completion of the natural development cycle.

The main causative factors for this condition are:

• impaired blood flow between mother and fetus due to gestosis and high blood pressure;
• vascular problems associated with both varicose veins, and with blood clotting disorders;
• hormonal imbalance due to decompensation of endocrine diseases (hypothyroidism, diabetes mellitus);
• chronic kidney problems that negatively alter the functioning of the excretory system;
• any traumatic injury to the uterus in the past, affecting normal placentation;
• the appearance of group or Rh antibodies in the blood of a pregnant woman, which indicates an immunological conflict and the risk of fetal suffering;
• any infectious diseases (ARVI, hepatitis, herpes) that provoke disturbances in the placenta;
• multiple births, polyhydramnios, large fetus.

In fact, early aging of the placenta is a signal indicating some kind of trouble in the female body, due to which continued gestation is undesirable long time. Premature maturation of the child's place almost always means premature birth.

Early maturation of the placenta - what to do?

Typically, a doctor identifies a problem with the baby's place by conducting an ultrasound examination after 30 weeks of pregnancy. Having assessed the thickness, size, and structure of the placenta, the specialist will indicate in the diagnosis the degree of maturity that does not correspond to the term.

The period at which the problem was discovered is of great importance for the tactics of pregnancy management in a woman with premature maturation of the placenta. Most often, placental disorders occur closer to 36 weeks.

If the pregnancy is close to the end of gestation, then regular monitoring of the child’s condition using cardiotocography (CTG) is necessary without the use of any therapeutic techniques. At 30-34 weeks of pregnancy, in addition to CTG, it is necessary to monitor the state of blood flow in the placenta using Doppler ultrasound. Good effect Medicines prescribed by your doctor that affect placental blood flow will help.

A pregnant woman needs to monitor the movements of the fetus daily in order to notice a decrease in the baby’s activity in time. If necessary, the doctor will recommend repeating the ultrasound after 2 weeks to assess the child’s condition.

Is it possible to prevent premature ripening of a child's place?

The best prevention of premature aging of a child’s place is the prevention of pregnancy complications and timely treatment of diseases in expectant mother. This is especially true when:

• increased blood pressure in a woman;
• difficulty maintaining blood sugar levels;
• serious kidney diseases and Rhesus conflict.

If premature maturation of the placenta has already occurred during pregnancy, then you need to carefully monitor intrauterine condition baby and prepare for the fact that the birth will occur ahead of schedule.

The baby feels completely safe in the womb. The placenta, which forms by the end of the third month, protects the fetus from harmful substances or negative impacts like a barrier. Gradually it goes through four stages of development and leaves female body after delivery in the form of an afterbirth. But it may happen that the normal mechanism of placental maturation fails and the organ ages too quickly. What are the features of placenta maturation at 32 weeks of pregnancy? And what are the reasons for her premature aging?

The correct formation of a natural barrier occurs in four stages:

• from 8–10 days of pregnancy, the laying of the placenta begins, its first cell is born, gradually growing to a whole organ. This entire process takes 28 weeks until the thirtieth week of pregnancy;
• on average, from the thirtieth to the thirty-third week of gestation, an increase in the parameters of the placenta occurs;
• Over the next four weeks, the organ matures and is finally formed. This stage lasts until week 37;
• the final stage is aging of the placenta. At this time, she is fully developed and is preparing to be born with the baby.

Only an ultrasound specialist can determine at what stage of maturation the organ is after the 20th week of pregnancy. If premature ripening is detected, consultation with several doctors is necessary to clarify the diagnosis.

Normal placental thickness by week

Normally, at 32 weeks of pregnancy, the placenta reaches the second level of maturity. Its thickness is determined by its widest area. It is this parameter that shows what the condition of the organ is and whether it performs its functions well.

The thickness of the placenta in millimeters should approximately coincide with the gestational age in weeks. So, at 32 weeks of pregnancy, the optimal thickness of the organ is 32 mm. But a slight fluctuation in this indicator does not give cause for panic. At week 20, the normal thickness of the placenta is from 16.7 mm to 28.6 mm. At the fortieth week - from 26.7 mm to 45 mm. If a woman has a deviation from the norm, but it falls within the acceptable range, then after additional tests a conclusion is made about the individual development of this organ.

The parameters of the pregnant woman herself are also of great importance. A miniature young lady has much smaller dimensions in everything, including the thickness of the placenta, than an obese lady.

The placenta is the link between mother and baby in the womb. It is thanks to her that the fetus can breathe and eat. The placenta maintains normal blood flow in the small body. This continues until his organs and systems are unable to perform vital functions.

Functions of the placenta:

A strong discrepancy with natural timing can lead to serious complications for the woman and child or even death. At 32 weeks of pregnancy, without proper attention to this condition, its consequences are quite noticeable.

What are the causes of premature aging of the placenta?

After an ultrasound examination, a woman may be diagnosed with “premature ripening of the placenta.” There may be several reasons for this:

• alcohol addiction and smoking (due to nicotine addiction, certain areas of the placenta die without the possibility of recovery);
• severe underweight or excess body weight;
• toxicosis or gestosis in protracted stages (vomiting and severe swelling);
• Rh conflict between mother and fetus;
• sexually transmitted diseases;
• dysfunction of the circulatory system (poor coagulation);
• failure of the endocrine system (diabetes mellitus);
• diseases of the liver and genitourinary system;
• mechanical damage to the uterine cavity and genital organs;
• the pregnant woman has a history of interrupted pregnancies and difficult childbirths;
• placenta previa;
• multiple pregnancy;
• placental abruption;
• genetic predisposition.

What is the danger of premature ripening of the placenta?

This pathology can cause as a complication:

• Development of fetoplacental insufficiency or oxygen starvation.
• Delay physical development fetus
• Placental abruption.
• There is also a risk of disruption of the blood flow system in individual parts of the placenta.
• Too rapid aging of the placenta can provoke early onset of labor or termination of pregnancy at a short term.

How is premature ripening of the placenta diagnosed and what is done when it is detected?

Only a doctor can diagnose the condition of premature aging of the placenta using an ultrasound examination. This does not affect the woman’s well-being and does not appear externally. If the specialist suspects something is wrong with the ultrasound, then an urgent CTG procedure (cardiotocography) is prescribed, where the fetal heartbeat is listened to, its tone and clarity are assessed, and the baby’s activity is analyzed. Using these indicators, the specialist determines whether the fetus suffers from a lack of oxygen.

It makes sense to prescribe CTG in late pregnancy, when the baby’s heart muscle is fully formed. Both ultrasound and CTG are necessary and absolutely safe procedures for mother and baby.

If at the 32nd week of pregnancy a pregnant woman is diagnosed with significant aging of the placenta, she is urgently hospitalized in the pathology department of the maternity hospital. There the woman is examined, laboratory assistants take the necessary tests, and specialists examine the fetus. The purpose of these activities is to find out whether the maturation of the organ somehow affects the child, whether he feels nutrient deficiency and oxygen starvation.

To diagnose the functions of the placenta, the following are used:

• laboratory tests for the level of placental hormones;
• analysis of enzyme activity in plasma;
• listening with a simple gynecological stethoscope or CTG procedure;
• Dopplerometry (control of blood supply in the vessels of the uterus and umbilical cord).

If the placenta has stopped supplying the fetus with useful microelements from the mother, then the woman is prescribed medications that stimulate the functioning of the placenta. But therapy must be prescribed by a doctor. Self-medication is simply unacceptable here. After a course of drugs, the pregnant woman is sent for repeated studies.

Possible prescription of drugs:

• antibacterial agents;
• vitamin complexes, minerals and iron-containing preparations;
• drugs that stimulate the uteroplacental blood flow, namely Curantil, Actoverin.

If acute fetal hypoxia is detected, a decision is made on urgent surgery. C-section. Labor is also artificially induced when a child is found to have severe developmental delays.

If at 32 weeks of pregnancy the deviation from the norm is insignificant, then treatment is not prescribed. But it is important to understand at what speed the placenta will mature. To do this, the woman is monitored more carefully and additional examinations are carried out throughout the remaining period of gestation.

Doctors advise a woman to eliminate all risk factors:

• stabilization of body weight, proper diet;
• getting rid of cigarettes (according to studies, the overwhelming percentage of women who were diagnosed with early placental maturity were smokers);
• taking medications to reduce the child's exposure to harmful toxins;
• treatment late gestosis and swelling;
• therapy against infectious diseases and diseases transmitted through sexual intercourse;
• walks in the fresh air for three or four hours a day;
• introduction balanced diet nutrition, including dairy products, vegetables, fruits, grains, wholemeal bread, dried fruits;
• elimination possible sources infections;
• elimination of physical activity;
• protection from emotional and stressful situations;
• timely and long rest, sleep at least ten hours;
• It is recommended that pregnant women sleep on the left side.

The placenta is a rather complex mechanism that takes on enormous functionality in the body of a woman carrying a baby. Like any impressive system, it tends to fail for a variety of reasons. As a preventive measure, a pregnant woman should take care of herself and the baby and do everything possible to avoid premature aging of the placenta. To do this, the first thing you should do is give up bad habits and take care of your health.