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Chorionic presentation. The predominant localization of the chorion is posterior

During fetal development, a woman's body experiences many changes. First of all, the amount of hormones released changes. At the same time, some changes occur in the pregnant woman’s uterus. Most women don't even know about them. During development, the fetus receives all the elements necessary for development through the mother’s blood. This happens due to the activities of temporary internal organs that appear during pregnancy. One of these organs is the chorion, which appears almost immediately after conception. The chorion is a set of outgrowths located around the fetus. These growths constantly increase in size and begin to penetrate the lining of the uterus. And after a while it turns into a child's placenta. It is the chorion that allows blood to circulate through the placenta and can penetrate the walls of the uterus.
The chorion is an organ that allows the embryo to develop normally. After all, only with its help can the fetus exist and not die. The chorion is formed approximately seven days after the conception process. The presence of this membrane is detected only through an ultrasound examination, since this is simply impossible to do during a routine examination.
Several types of Chorion can be distinguished, changing during different periods of pregnancy. If the period is short (up to forty-five days), then this shell will have a circular shape. In this case, it is still impossible to see the embryo itself, but only its shell. In later stages of pregnancy, it may have a circular or villous form.

Particularly important for the normal development of the fetus is the place of attachment of the chorion to the uterus, or its localization. In medicine, the term chorionic presentation is used. In this case, the chorion is located in the lower part of the uterus, near the transition of the uterus to the cervix. This attachment of the chorion is very dangerous, as it can lead to severe bleeding during childbirth. And during pregnancy it can even lead to miscarriage. Most doctors perform a caesarean section in this situation. Because natural degeneration may be completely impossible.
Chorionic presentation is a pathology, but there are no ways to eliminate it yet. But it can disappear on its own. After all, the chorion, like the placenta itself, migrates very often. This is what happens in most pregnant women. However, in some women the chorion remains in one place all the time, which leads to difficulties during childbirth. If it completely covers the cervix, then a caesarean section is mandatory. But if it is located more than five centimeters above the cervical canal, then perhaps the doctor will allow the woman to give birth independently.
Bleeding can often occur in this position. But to prevent this from happening, you should completely abandon physical exercise, sudden movements and lifting heavy objects. You should also completely avoid sexual intercourse.
Anterior localization of the chorion
One of the types of chorion presentation is its localization on the anterior wall of the uterus. In this case, it passes from the anterior wall into the cervix. This localization is not dangerous, because in this case the uterus remains almost completely open. There is no need to worry too much when making this diagnosis. But it is very important that the chorion is localized several centimeters above the internal pharynx. Also, in this position of the chorion, its growth occurs much faster.
But even with this arrangement of the chorion, some complications can occur. Indeed, in this case, the placenta grows and develops on the wall of the uterus that is located closer to the mother’s abdomen. Then the fetus can be located behind the placenta, through which the baby’s heartbeat and movements can be heard very faintly. Also, a caesarean section with this diagnosis is much more difficult. Well, besides, after preliminary birth, the placenta can adhere to the muscular layer of the uterus.
Posterior localization of the chorion
Very often, when undergoing an ultrasound scan, pregnant women find out that their chorion is located on the back wall of the uterus. This situation can be called classic. After all, the attachment of the chorion to the posterior wall of the uterus with simultaneous capture of the side walls is natural. This position, unlike the anterior localization of the chorion, is not pathological.
Posterior localization of the chorion is normal and is not a deviation from the norm. But it has its effect on a woman’s body. After all, the growth rate of a pregnant woman’s belly depends on this. In the case of a posterior attachment, the abdomen is usually small. Whereas with anterior localization, the abdomen becomes quite enlarged, already in the first stages of pregnancy. In the future, the chorion can move upward. And this is a common occurrence, because this is how it should happen.
So, a pregnant woman does not have to worry about anything. You just have to stick to the regime and constantly be under the supervision of a doctor, following all his instructions. And the chorion itself will rise up, and thus the problem of complicating pregnancy will disappear by itself. And the pregnancy itself in this case will end with a successful birth.
But there is still a danger that with posterior localization of the chorion, the placenta can completely block the entrance to the uterus. In this case, constant monitoring of the pregnant woman is needed. And it is best for her to be in the hospital, even if she has no complaints and feels quite normal. If the uterus is blocked by the placenta, there is always a risk of bleeding, and this can be very severe and repeated frequently. In addition, it can begin without any preliminary symptoms.
During pregnancy, women are subject to many tests. One of them is ultrasound. During such an examination, the doctor must examine both the chorion itself and its location. In this case, the presence of detachments in the membrane and its size are always taken into account, and all possible problems are diagnosed. Therefore, any problems associated with this organ are detected in the very early stages of pregnancy and can be treated immediately. So you should always follow all the doctor’s instructions, and your pregnancy will end happily.

The chorion is a structure that includes the outer membrane of the embryo called the serosa. It is the precursor of the placenta, which is formed by 12-14 weeks of pregnancy. The chorion consists of many villi that perform nutritional, respiratory, excretory and protective functions.

Initially, the villi completely cover the chorion, but from the 5th week of gestation they begin to grow on the side of the fetus and die off on the opposite side. Normally, the outer membrane of the fetus develops at the bottom of the uterus and extends onto its anterior, posterior and side walls. Chorionic presentation is a pathology in which this structure is not located in a physiological place.

Diagnosis

The first screening during pregnancy, carried out at 11-14 weeks of gestation, includes an ultrasound examination. During an ultrasound, the doctor measures the length of the embryo, studies its structure, and checks for the presence of markers of chromosomal abnormalities. One of the stages of this examination is examination of the chorion.

The most appropriate time for an ultrasound examination of the chorionic villus is the 13th week of pregnancy. At this stage, the formed villi are clearly visible; the doctor can accurately determine the position of the future placenta - the connecting link between the mother and the fetus.

According to statistics, in 90% of cases the chorion is visualized in a physiological place - at the bottom of the uterus. But sometimes this structure is located lower, which is a deviation and causes complications. However, when diagnosing chorionic presentation, the expectant mother should not worry too much, since the placenta can change its position after the 1st trimester of pregnancy. This phenomenon is due to the fact that over time the uterus increases in size and pulls up the fetal membrane.

Usually, the incorrect position of the placenta does not show itself in any way; the expectant mother does not have any symptoms. But sometimes, in the presence of chorionic previa, a woman may experience brown discharge on her underwear or sanitary pad. In very rare cases, the abnormal location of the membranes manifests itself as uterine bleeding. The listed symptoms occur against the background of irritants - fitness classes, during stress, etc.

Types of presentation

To assess the position of the chorion, doctors focus on its position relative to the os (the place where the uterus meets the cervix). If it is more than 3 centimeters away from this anatomical landmark, then the placenta develops normally. In other cases, the following classification is used:

1. Central complete chorion presentation.

It is characterized by the fact that the fetal membrane completely covers the internal os of the uterus. This type of presentation is the most unfavorable.

2. Central incomplete chorion presentation.

Sometimes it is called partial. This presentation is characterized by the fact that the chorion touches up to two-thirds of the uterine pharynx. Has a better prognosis.

3. Regional presentation of the chorion.

It is a variation of the previous one, but some doctors distinguish it into a separate category. With this type of pathology, the placenta develops, affecting less than one third of the uterine os. Regional presentation of the chorion at 12 weeks is a relatively favorable option for the fetus, since in half of the cases the membrane will take a physiological position after a certain period of time.

4. Low chorion presentation.

With this type of abnormal position, the placenta is formed outside the uterine os, but it is located at a distance of 3 or less centimeters from it. Low presentation is a fairly favorable diagnosis; in 90% of cases, by the end of pregnancy, the membrane occupies a normal place in the organ cavity.

Some experts distinguish anterior and posterior chorionic presentation, when the structure is formed on the anterior or posterior wall of the uterus, respectively, but is located at a distance of more than 3 centimeters from the pharynx. These conditions of the membrane are absolutely normal; over time, the placenta will move to the bottom of the organ.

An accessible explanation about “Placenta Previa” by obstetrician-gynecologist S.M. Dyakova:

Causes

It is not always possible for a doctor to determine the cause of abnormal development of the chorion in the uterine cavity in a particular patient. The main cause of the pathology is a violation of the structure of the walls of the organ, due to which the embryo cannot attach to a physiological place. Damage to the uterine mucosa is a consequence of curettage, abortion, replacement with connective tissue due to infection. Sometimes congenital anomalies of the organ structure occur.

Predisposing factors for chorionic presentation also include:

  • chronic diseases of the heart, liver, kidneys in the stage of decompensation;
  • age more than 36 years and less than 18 years;
  • chromosomal abnormalities of the embryo;
  • history of difficult childbirth;
  • history of caesarean section;
  • uterine fibroids;
  • polyps of the cervical canal;
  • bearing twins;
  • endometriosis;
  • repeat pregnancy;
  • menstrual irregularities due to hormonal pathology.

Consequences

The most common complication of the anomaly is uterine bleeding. Its type depends on the type of pathology. With central placenta previa, blood may appear in the early stages of pregnancy, starting from 8-. With more favorable positions of the chorion, red discharge is observed later, sometimes it does not occur at all.

Uterine bleeding during chorionic presentation is provoked by physical exertion, emotional stress and other irritants. Their peculiarity is the fact that they are not accompanied by other symptoms - abdominal pain, nausea, etc. Thanks to this, bleeding due to the abnormal location of the placenta can be distinguished from spontaneous abortion.

Red discharge does not have any pattern; it can appear at any time of the day, at different intervals. Sometimes they are very scanty in the form of a “daub”; with a central position of the placenta, a woman may observe profuse scarlet bleeding.

Attention! Chorionic presentation is not always a sign of severe pathology; in many cases, over time, the placenta takes a physiological position in the uterine cavity on its own.


The main negative consequence of bleeding, in addition to discomfort, is the development of anemia - a reduction in the amount of hemoglobin and red blood cells per unit volume of blood. Because of this complication, the expectant mother suffers; she is worried about shortness of breath, dizziness, weakness, confusion, and fainting. Anemia also affects the child; he receives less oxygen, which can lead to intrauterine growth retardation and development.

The most dangerous complication of placenta previa is. Miscarriage and premature birth occur due to increased uterine tone, when the organ begins to spontaneously contract. During a spontaneous abortion, a woman notices red or brown discharge from the vagina, which is accompanied by cramping pain in the lower abdomen.

Abnormal location of the placenta often leads to malpresentation of the fetus - the position in which the unborn baby finds itself in the last weeks of pregnancy. This phenomenon is observed in 50-70% of pregnant women with the above diagnosis. The most unfavorable options are the transverse and oblique position of the baby, in which case a caesarean section is necessary. With a breech presentation of the fetus, delivery tactics depend on the qualifications of the doctor and the type of pathology.

Placental abruption

The placenta, fully formed after the 1st trimester of pregnancy, is the site of communication between the blood flow of the mother and the fetus. With its pathologies, the nutrition and protection of the unborn child are disrupted, which can cause deviations in its development, and sometimes lead to death. Sometimes women diagnosed with placenta previa experience abruption.

Placental abruption is usually associated with the death of the vessels that feed it. The pathology is accompanied by bleeding, abdominal pain, deterioration of health, increased heart rate, pallor, and dizziness. If a woman felt fetal movements before the complication developed, when placental abruption occurs, the baby’s movements stop or sharply increase in frequency.

Doctors distinguish three degrees of placental abruption. In the first case, the area of ​​organ damage is less than one third, the child experiences oxygen starvation, but his life is not in serious danger. The second degree is characterized by the fact that the placenta is exfoliated by half, the fetus is in a state of severe hypoxia. With more severe lesions, intrauterine death of the child from suffocation is observed.

If you seek medical help in a timely manner for partial placental abruption, doctors are able to prolong pregnancy. If treatment measures do not end in success, and the child’s age exceeds 22 weeks and he is alive, specialists can perform an emergency caesarean section.

Treatment

With placenta previa, only symptomatic treatment is possible; at the moment, doctors cannot change the abnormal position of the fetal membranes. Low and marginal presentation of the chorion at week 13 does not require any measures; in most cases, the organ will independently take the correct position.

If after a few weeks the position of the placenta does not change, but the woman does not have bleeding, she is advised to avoid physical and emotional stress, refuse intimacy, sleep more than 8 hours a day, and get plenty of rest. Also, the expectant mother should follow a diet rich in vitamins and microelements, especially iron. It is recommended to include more fresh vegetables and fruits, lean meat, fish, and cereals in your diet.

In case of central placenta previa, as well as in the presence of bleeding, hospital treatment is recommended for the woman. In addition to bed rest and a balanced diet, the expectant mother is prescribed medications to support pregnancy.

To prevent placental abruption, progestin drugs are used - Duphaston, Utrozhestan. Their therapeutic effect is based on reducing the tone of the uterus. The woman is prescribed iron supplements that reduce the loss of hemoglobin - Ferrum-Lek. If bleeding develops, the expectant mother is given hemostatic agents - sodium etamsylate.

Also, the expectant mother is prescribed multivitamin complexes aimed at improving metabolism. If there are mental disorders, doctors recommend taking sedatives - Valerian, Motherwort. In case of persistent bleeding that is not amenable to drug treatment, the question of emergency delivery is raised.

During pregnancy and examination, women may encounter the expression chorion along the posterior wall.” What does this mean, when does it occur during pregnancy, is this condition dangerous and what can be done about it, what does marginal presentation mean, we will tell you in this article.

What is chorion?

Chorion is one of the membranes that makes up the baby’s placenta during pregnancy. There are 3 shells in total - allanotis, aminion and chorion. During pregnancy and the formation of an embryo, a placenta is created, which attaches to the wall of the uterus. It turns out that the chorion along the back wall of the uterus is a type of attachment.

In its normal state, the placenta is attached to the fundus of the uterus or its body at the posterior wall, adjacent to the sides. There are varieties when the placenta is attached low, either to the anterior wall of the uterus, or to its lower segment, when the pharynx partially or completely blocks the cervical canal.

Reasons for location on the rear wall

It turns out that chorion along the posterior wall is a common situation that does not cause concern. This term is one of the types of placenta attachment, which will be indicated to you on your card after the ultrasound.

The chorion attached to the back affects the size of the tummy - it will be small compared to the front wall - the belly will be large and noticeable even in the first trimester. The chorion tends to migrate inside the body of the uterus, so that in one trimester it can be attached to the back wall, and at 12-13 weeks - already to the front. Anterior or posterior localization is detected by a doctor using ultrasound at 12-13 weeks.

But you should know that the norm for the location of the chorion is if it is located above the internal pharynx by more than 3 cm, it should not be low. Another scenario is considered a deviation - it could be a marginal presentation, incomplete, central.

Placenta previa

Simultaneously with the diagnosis of chorion on the posterior or anterior wall, pregnant women at 12-13 weeks have the opportunity to see chorion or placenta previa in their chart. This term means: the placenta is located non-standardly - it is attached not to the uterus itself, but to its lower segment.

The first trimester may also be marked by the fact that you can also encounter complete or partial closure of the pharynx of the cervical canal, but as the baby grows at 12-13 weeks, the chorion moves and the pharynx becomes open again. But this may not happen in every case.

Low

Low presentation means that the fertilized egg has attached below the cervix. This happens very rarely - in about 5 cases out of 100, and is determined by ultrasound. The first and second trimester may be characterized by this position, but almost always subsequently the chorion assumes a normal position due to the growth of the uterus and the extension of the placenta.

Along the back and front wall

Posterior presentation is considered the most common option and is not considered abnormal. This is a predominantly harmless pathology. The placenta in this embodiment can capture the walls from the side. Anterior presentation is considered less rare, without going beyond the norm. Anterior presentation is characterized by the fact that the placenta migrates more quickly to its normal state.

When the placenta does not rise at 12-13 weeks, but the localization of the pharynx is not blocked, then pregnant women are prescribed timely examinations and complete rest without stress.

Partial

Partial presentation during pregnancy is characterized by overlap of the cervix up to 60 percent. One of the cases of this option at 12-13 weeks is marginal presentation, when the percentage of overlap is no more than 30. Such presentation is dangerous due to the threat of miscarriage, bleeding and fetal hypoxia. To treat this deviation, complete rest and sedatives are used, treatment is carried out at home, and examinations are carried out regularly in the hospital.

Complete

Complete presentation during pregnancy is otherwise called central, when the pharynx is completely blocked. Having discovered such a pathology, already at 12-13 weeks the pregnant woman will be put on preservation due to the risk of bleeding and loss of the child. There is even a threat to the mother's life, so hospitalization is mandatory. With this scenario, a cesarean section is most often indicated, and adverse outcomes occur in only 5 cases out of 100.

Why does presentation occur?

Causes of breech presentation during pregnancy may include:

  1. deviation from the norm in the condition of the internal walls of the uterus and the inability of the embryo to attach to them;
  2. previous abortions or infectious diseases;
  3. uterine deformation due to myomectomy;
  4. diseases of the cardiac system, liver and kidneys that cause stagnation;
  5. second birth of a woman after 35 years;
  6. predominant anomaly of the ovum;
  7. the placenta is too dense.

Despite all the threats, all of the above pathologies can be successfully treated with careful examination and monitoring by doctors. Therefore, when you see a diagnosis of anterior or posterior placenta, whose localization confuses the doctor, do not be alarmed, trust the doctors, and you can give birth to a healthy child!

During pregnancy, the unborn baby is in dire need of various nutrients and oxygen, which he receives from the mother’s blood. For the exchange of substances between the organisms of mother and child, nature came up with unique organs: the chorion and the placenta.

The chorion (the outer embryonic membrane surrounding the embryo) is formed early in pregnancy. If you look at it from the inside, you can see many elongated vessels of the membrane that surrounds the baby, penetrating into the walls of the uterus.

As pregnancy progresses, the size of the outgrowths of the embryonic membrane increases and gradually turns into villi, the thickness of which increases and through which metabolism occurs.

Somewhere from the 13th week, the chorion gradually turns into the placenta, which will be responsible for the viability of the baby until the end of pregnancy.

The localization (attachment) of the chorion is very important for a normal, healthy pregnancy. The first ultrasound gives an idea of ​​where in the uterus it is located. If, according to the results of the study, the conclusion says that the chorion is on the anterior wall of the uterus, then this is considered normal and is not a cause for concern. Millions of women with a similar diagnosis walk quietly throughout their pregnancies and give birth to beautiful babies.

In the same way, you should not worry when the chorion is along the back wall of the uterus. This is not a pathology and cannot cause miscarriage or spontaneous abortion. Therefore, if the doctor conducting the ultrasound examination writes a similar wording in the conclusion, then there is no need to worry, much less worry.

In the first trimester of pregnancy, very often after an ultrasound in the conclusion you can read the diagnosis: low location of the chorion. This indicates that the embryo is attached to the lower wall of the uterus, at a distance of no more than 3 cm from the cervix.

Low attachment does not mean that there is a risk of pregnancy. As a rule, along with the growth of the uterus, the chorion gradually rises up, never migrating down. As a result, its location is significantly different from what it was originally.

In practice, 3 types of presentations are defined:

Regional presentation of the chorion - only one edge touches the cervix, without completely covering it.

Partial - only partially covers the internal os of the uterus

Complete - localization occurs in the lower part of the uterus and the transition to the cervix is ​​completely blocked.

The most dangerous diagnoses are: complete or partial placenta previa. Marginal attachment, as a rule, is curable and does not cause arbitrary termination of pregnancy.

Another threat in the first trimester may be chorionic detachment. This pathology is often the cause of miscarriage or the onset of spontaneous abortion. Fortunately, such situations occur only in 6% of pregnancies and are not hopeless. To prevent the detachment from continuing, doctors recommend that the expectant mother rest completely, rest in bed, and take medications containing progesterone.

Treatment is carried out in a hospital, but in some cases, the woman is allowed to stay at home, subject to strict bed rest and following all the doctor’s recommendations. The patient is tested for hormones (progesterone, thyroid hormones, estradiol) and smears for infectious diseases. Based on the examination data, the gynecologist makes a decision on treatment methods.

Recovery depends on how large the area of ​​detachment is affected, as well as on the reasons that caused it. In any case, there is always a chance to save the pregnancy; the main thing is to consult a doctor in time.

In general, women who are in an “interesting situation” always have a lot of questions after undergoing an ultrasound examination. For example, very often in the conclusion the doctor writes: anterior localization or predominantly posterior localization of the chorion. Such diagnoses are the norm and do not require additional measures to maintain pregnancy.

Despite the fact that all three trimesters may proceed well, sometimes the doctor decides on the need for additional examinations. One of such examinations may be a chorionic villus biopsy. This procedure determines pathologies of fetal development in the early stages of development, then abortion becomes the best solution if the analysis is not favorable.

It is believed that with the help of a biopsy, you can find out all the possible pathologies of the unborn baby, and there are up to 3800 of them. Therefore, if a gynecologist insists on conducting such a study, then there are significant reasons for this.

In general, waiting for a miracle and the birth of a baby is the best time for a woman, this is the time of birth and gestation of a new life, and there is nothing more beautiful than feeling your special destiny.

To explain what chorion is and how the course of pregnancy depends on it, let’s give it a definition. The chorion is a membrane that makes up the placental barrier complex together with the allantois and aminion and plays a critical role in the metabolism of the fetus. The classic option is to attach the placenta in the area of ​​the fundus of the uterus or body along the back wall with a slight grip on the sides. Also, the placenta can be fixed on the anterior wall of the uterus or in the lower segment, while partially or completely covering the opening of the cervical canal.

Features of chorion attachment

The chorion along the back wall of the uterus is not a deviation, but simply a type of attachment. Thus, if after an ultrasound examination the diagnosis indicates a predominant posterior localization of the chorion or localization of the chorion along the posterior wall, this should not frighten the expectant mother.

The only thing that affects the place of attachment of the chorion - along the back wall, front or side - is how quickly your tummy will be visible. If the localization of the chorion is posterior, the tummy will be relatively small and neat, but if it is anterior, it can be visible already at a short period of time. Although the placenta can migrate during pregnancy, and at the next ultrasound the fetus may “change its place of residence.”

Chorion low on the posterior wall

Often on ultrasound, women hear that the chorion is localized on the posterior wall of the uterus. As we have already explained, this is the most common option and is the norm. Anterior, posterior and lateral attachment is considered normal if the chorion is located above the internal pharynx by more than 3 centimeters. Also, expectant mothers should not worry if chorionic presentation is detected; in this case, it is necessary to follow all the doctor’s instructions and the pregnancy will lead to a successful delivery. It is necessary to pay attention - if the placenta completely covers the internal os, in this case the pregnant woman should be observed in a hospital, even if she feels great and has nothing to worry about. With this arrangement, there is a high risk of severe systematic bleeding, which begins suddenly, painlessly and asymptomatically. Inpatient stay and proper preservation will ensure the health of the future baby, who will be born in this case thanks to a caesarean section.

As you can see, a pregnant woman should not worry if the chorion is located on the back wall of the uterus or if on the front. In any case, first of all, you need to follow the regime and wait for your baby in a calm environment.

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At the 27th week of pregnancy, the child is already large enough and developed enough to withstand a meeting with the outside world in the event of premature birth and with the help of doctors. The baby is already showing his character with all his might - and by his behavior in the stomach, the mother can understand what he will be like after birth. Read the article for more details about the fruit.

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Location of the placenta along the anterior wall of the uterus

The main thing is how the placenta functions. But you still have 21 weeks, as the pregnancy grows, the uterus grows, and the distance between the edge of the placenta and the internal os may change, they say that the placenta “migrates”. The placenta is on the anterior wall and is attached high.

The placenta is an important organ whose main purpose is to connect the blood circulation of mother and child during pregnancy. The first signs of the placenta appear at the very beginning of the period, but this organ acquires its final appearance only by the 16th week.

The back wall and the place closer to its bottom are best supplied with blood. Therefore, it is not surprising that these places in the uterus are the most favorable for the attachment of a child’s place. This does not mean that women who were diagnosed with a placenta along the anterior wall of the uterus during pregnancy need urgent treatment!

18-22 weeks), because the placenta in this location acts as a pillow that reduces sensitivity. Imagine (for greater clarity, use the pictures above) that the placenta is attached to the posterior wall of the uterus, very low to the internal os (read about low-lying placenta).


The first weeks of pregnancy for the expectant mother are probably one of the most difficult periods throughout the entire period of bearing a child. At this time there are several “critical periods” in the life of the future little man; his mother is mentally and physically rebuilt for a successful pregnancy. Unfortunately, this period does not always pass without complications and problems, so routine ultrasound examinations should be carried out. A woman’s first ultrasound is scheduled for the end of the first trimester, and it is at this time that this pathology is most often detected.

How dangerous is chorionic presentation at 12 weeks, and how to prevent complications?

Chorionic presentation during pregnancy - what does it mean?:

The chorion is a special organ that provides communication between the body of the mother and her unborn child. In fact, this is an early stage of the development of the placenta, therefore the term “chorion” is used only during the first three months of gestation, after which the word “placenta” is already used. One surface of the chorion faces the fetus, and the other is attached to the wall of the uterus. And it is precisely when the location of the chorion is atypical that various disorders can occur.

As you know, the uterus communicates with the vagina and external genitalia through the cervix, inside which there is a special cervical canal. The internal opening of this canal, which breaks off into the uterus, is called the os of the cervical canal. The chorion or placenta is normally attached to the bottom or lateral surfaces of the uterus and does not overlap the pharynx in any way. But in some cases they can partially or completely close the internal opening of the cervical canal - it is in this situation that a disorder called "Chorion presentation"

Types of presentation:

The closure of the cervical canal by the chorion does not have to be complete, therefore there are several types of presentation that characterize the complexity of this condition:

Partial chorion presentation. In such a situation, the developing placenta covers at least two-thirds of the lumen of the cervical canal.

Regional chorionic presentation . This is a variation and, one might say, an easier version of partial presentation, since only one third of the lumen of the pharynx is covered.

Central chorion presentation. In this case, the lumen of the pharynx of the cervical canal is completely closed by the future placenta, which significantly complicates the course of pregnancy and poses a threat to both the unborn child and the life of the mother.

Low location of the chorion . The forming placenta can be located next to the opening of the cervix, but does not block it. If it is attached near the edge of the pharynx closer than three centimeters, then it is said to be low. This is not dangerous, but poses a potential threat to pregnancy.

Chorionic presentation at week 12 can be in any of these forms.

As pregnancy progresses, the growing uterus can pull back the placenta, so central presentation can turn into partial and marginal, and then disappear completely. According to obstetricians, more than 90% of cases of one or another chorionic presentation completely disappear over time, so if you were diagnosed with it in the first weeks of pregnancy, this is not a reason to panic. But you will have to monitor your condition and not neglect examinations by a specialist.

Causes of presentation:

Why exactly the developing placenta is attached in such dangerous proximity to the pharynx of the cervical canal is completely unknown. However, several main factors have been noted that contribute to a greater likelihood of developing this pregnancy complication. Especially often, various variants of chorionic presentation develop in women who have had in the past or currently have the following diseases and conditions:

Inflammatory lesions of the uterus, abortions, especially using the curettage method, surgical interventions for fibroids or cesarean section. All these factors are united by one consequence - after this, scars and adhesions can be left on the inner surface of the uterus, which make it difficult for the chorion to attach to the “right” place.

Diseases of the liver, kidneys or heart. It would seem, how can these conditions affect the position of the fetus and its placenta in the uterus? But with pathologies of these organs, blood stagnation may occur in the pelvic area, which contributes to lower attachment of the chorion.

Multiple births in the past. If you are pregnant not for the first time, then your chances of improper attachment of the chorion significantly increase. Most physiologists see the reasons for this phenomenon in the fact that after each pregnancy, in the area of ​​the uterus where the placenta was attached, the structure of the endometrium changes. Therefore, at the next conception, the chorion can no longer attach there. Over time, such places on the inner surface of the uterus become less and less, which leads to the attachment of the placenta in the danger zone.

Uterine deformities, acquired (for example, after surgical interventions) or congenital in nature, can also lead to chorion presentation.

Is chorionic presentation dangerous?:

Most pregnant women are frightened by such a conclusion from the first ultrasound examination. Although in fact, chorionic presentation during pregnancy of 10-13 weeks is observed in approximately 5% of cases, that is, in every twentieth woman. In later stages, this condition becomes increasingly rare, observed before childbirth in no more than 0.5% of women in labor. The main reason for this is that the growing uterus is able to “pull” the chorion attachment point from the cervical canal to a safer area. Therefore, according to pediatricians, chorion presentation during the first trimester can be regarded as a feature of the course of pregnancy, but not a complication.

Difficulties begin if the presentation continues to persist after the third month of pregnancy. Being dangerously close to the pharynx of the cervical canal, the placenta can be easily injured, which leads to bleeding of varying degrees. With marginal or partial presentation, the first spotting occurs closer to the sixth month. They are practically painless, and blood may be released in thin streaks in the discharge, or give the impression of menstruation. Central presentation can manifest itself with such symptoms as early as the second or third month. In fact, this is the main consequence and danger of chorion presentation, which entails a number of disruptions to the course of pregnancy and the health of the mother and her unborn child:

The constant loss of small amounts of blood leads to anemia in a pregnant woman. You may experience weakness, dizziness, and your skin becomes pale. In case of severe bleeding, blood pressure may decrease, vision may become dark, and you may even lose consciousness.

Disruption of connections between the uterus and placenta also leads to malnutrition of the unborn baby. Its development slows down, and against the background of reduced oxygen delivery (due to a damaged placenta and anemia in the mother), intrauterine fetal hypoxia occurs.

If the mother’s blood loss reaches significant levels, this can lead to miscarriage, intrauterine fetal death and a number of other terrible consequences.

In addition to the problems described, presentation is often complicated by incorrect positioning of the fetus, which leads to difficulties during the birth process. Therefore, if such a condition is diagnosed in you in the sixth month or later, then you need to mentally prepare yourself for the fact that you may have to have a caesarean section rather than give birth on your own.

Treatment of chorionic presentation:

Unfortunately, at the moment, doctors do not yet know how to correct such a condition as chorionic presentation, so all treatment comes down to preventing complications and eliminating their consequences. As a rule, if there is a central presentation in the fourth month, they prefer to place the girl in the position in a hospital for preservation. The same is done with partial forms of presentation, if they are complicated by bleeding, hypertonicity of the uterus and other factors that may threaten termination of pregnancy. In a hospital setting you will be provided with the following treatment:

To begin with, strict bed rest and limitation of physical activity, which is one of the most important factors in the prevention of bleeding during placenta previa. In addition, you will need to avoid emotional stress, as this can also lead to negative consequences.

Regular examination by a doctor and diagnostic ultrasound examinations. Being under 24-hour medical supervision, you greatly reduce the risk of sudden complications, since they will be identified and corrected as soon as possible. Most deplorable and even tragic situations with chorion presentation are caused by delayed medical intervention.

Maintenance treatment, which includes all the vitamins necessary for the pregnant body.

Proper and regular nutrition, which normalizes the functioning of the gastrointestinal tract. If you have diarrhea or constipation, you may strain your abdominal muscles, which increases pressure in the pelvis and can trigger bleeding.

If you develop anemia due to bleeding, it can be treated in a hospital setting by taking iron supplements, including those given by injection.

Treatment is also prescribed to eliminate other factors that threaten the course of pregnancy - for example, antispasmodics for uterine hypertonicity.

In case of partial chorionic presentation, which does not manifest itself with severe symptoms, you do not have to go to the preservation, but you need to take certain precautions to prevent possible complications. These primarily include:

Exercise stress. Leisurely walks and walking around the house is the maximum for a girl in such a situation. Lifting heavy objects, walking up stairs, and running are strictly contraindicated.

It is necessary to completely avoid sexual contact. During pregnancy, in principle, sexual intercourse is not prohibited at almost any stage, but during presentation it can cause severe bleeding.

Mental stress or stress affects the pregnant body no better than lifting weights. Therefore, they also need to be excluded, and even with sedentary and predominantly mental work, it will be time for you to go on maternity leave.

Also, as with preservation, it is necessary to eat properly so as not to cause changes in stool and at the same time provide the body with all the necessary nutrients. You also need to agree with your doctor on the choice of a vitamin complex, which will be very useful in such a situation.

And most importantly, if you have been diagnosed with chorion previa and at some point you notice the release of even a small amount of blood in the absence of pain, weakness and other symptoms, then you need to urgently consult a doctor. And if the bleeding is accompanied by pain in the lower back and lower abdomen, palpitations, weakness or fainting, then you need to call an ambulance as soon as possible, as you risk losing your child.

Often, during the first ultrasound, a pregnant woman learns: “The attachment of the chorion is along the back wall of the uterus!” Naturally, not everyone immediately understands what we are talking about. Let's tell you what doctors mean when they say this phrase.

Definition

The chorion is the membrane that is part of the placental barrier complex (along with the aminion and allantois) and at the same time plays an extremely important role in the metabolic processes of the fetus. During development, the chorion develops into the placenta, which is attached to the fundus or body of the uterus. Normally, the attachment goes along the back wall, including the side walls. This is a classic option. There are other options for attachment - along the anterior wall of the uterus, in its lower segment, while completely or partially blocking the entrance to the cervical canal. The latter, and then the placenta, is considered pathological and is called chorion previa (placenta).

Chorion along the posterior wall of the uterus - deviation or normal?

If the diagnosis after an ultrasound examination indicates that the predominant localization of the chorion is along the posterior wall, this is not a death sentence at all, but a normal phenomenon and is considered within normal limits. The place where the chorion attaches can affect how quickly a woman's abdomen grows. With posterior attachment, the woman’s belly will remain relatively small (despite the fact that with anterior attachment, the belly becomes noticeable already at a short period of time). The next ultrasound examination during pregnancy will show that the chorion has changed its habitat - it has migrated upward, and this is how it should be.

In all cases, mom should not worry. You just need to follow the regimen and all the doctor’s recommendations. The chorion will move upward, the threat of pregnancy complications will go away by itself, and the pregnancy will be resolved by a successful birth.

One has only to pay attention to the case when the placenta completely or partially blocks the entrance to the cervix (internal os): in this case, monitoring the condition of the pregnant woman is necessary, so it is best to stay in the hospital, even in the absence of complaints, since with this location of the placenta there is a risk of bleeding, which can be severe and regular. Bleeding may begin suddenly, without prior symptoms. Therefore, it is better to play it safe and go to the hospital, which will ensure minimal risk of further development of pregnancy.