Cause premature aging of the placenta. Causes and consequences of premature aging of the placenta
Premature aging of the placenta is a pathological condition that occurs during pregnancy. Briefly about what the placenta is. This is an organ that exists only in the female body during pregnancy. The placenta is the link between mother and child.
Her story begins from the moment the fertilized egg attaches to the wall of the uterus (this happens within 2 weeks after fertilization).
From this moment on, the child and mother have a joint circulatory system, through which the growing body receives all the necessary substances and removes the products of its vital activity.
Thus, the nutrition and respiration of the fetus is carried out. In addition, the placenta performs a barrier and protective function - only substances that have passed the hematoplacental barrier and immune complexes from the mother's blood come to the child.
But - you should not rely on this function of the placenta in everything: many toxic substances and pathogens freely pass the hematoplacental barrier.
The placenta goes through a number of stages in its development. Since the beginning of its formation, it has been actively working, carrying out the above functions and producing hormones to maintain the hormonal status of pregnancy. Over time, "reverse development" begins in the placenta. Normally, placenta grows up to 35-37 weeks of pregnancy, after this period the placenta may not change or become thinner.
Each period of pregnancy has its own ultrasound picture of the state of the placenta - the degree of maturity.
Premature aging of the placenta is a condition in which an ultrasound scan detects a degree of maturity of the placenta that does not correspond to the gestational age. The examination takes into account the thickness of the placenta, the state of blood circulation in it, and some other factors.
In the normal course of pregnancy, the maturation of the placenta proceeds as follows:
-1 degree - 27-34 weeks of pregnancy;
-2 degree - 32-39 weeks of pregnancy;
-3 degree - starting from the 36th week.
Thus, premature aging of the placenta is diagnosed in cases where the second degree of maturity appears in less than 32 weeks, and the third - less than 36 weeks.
This condition poses a certain threat to the course of pregnancy and the development of the child, but modern means of drug correction can avoid complications.
Premature aging of the placenta can develop under the influence of many factors:
- diseases of the endocrine system,
- other chronic diseases of the mother,
-smoking,
- Rhesus conflict,
- gestoses, etc.
When such a pathology is detected, one should not panic: about a third of pregnant women have the described condition and this does not prevent them from giving birth to a healthy baby normally. Listen to the recommendations of the gynecologist observing you and follow all the appointments.
The placenta is a unique temporary embryonic organ that begins to form after conception and is rejected by the body during labor. Aging of the placenta during pregnancy poses a threat in case of inhibition of its functions before certain dates. Therefore, it is important to control the state of the "children's place" throughout the entire period of gestation.
What is premature aging of the placenta during pregnancy
The formation of the fetal membrane takes a certain period of time - the entire first and part of the second trimesters. Throughout the entire nine-month period, the "children's place" develops, new vessels appear, the walls become thicker.The functional ability of this internal organ is unique, it allows you to supply the developing fetus with nutrients, oxygen, and also protects the child from various infections and harmful bacteria.
There are normal indicators:
- 27-30 weeks - zero degree;
- 28-34 weeks - the first stage, active growth occurs;
- 35-38 weeks - the second degree, characterized by a period of maturity;
- From the 37th week, the natural extinction of the "children's place" begins.
Causes of aging of the placenta during pregnancy
The rapid aging of the placenta during pregnancy most often occurs due to the individual characteristics of the female body. Additionally, there are risk factors that affect the premature extinction of the functionality of the embryonic membrane:- bad habits - smoking and alcohol abuse;
- toxicosis, which began at a later date;
- not rational nutrition;
- different Rh factor in the fetus and the expectant mother;
- inflammatory reactions in the uterine cavity;
- previous difficult childbirth or interruption of gestation (abortion);
- diseases caused by a chronic course;
- thyroid disease;
- intoxication with various drugs;
- conception of more than one fetus.
Aging of the placenta during pregnancy: consequences for the child
The danger to the baby directly depends on the stage at which the process begins. The old placenta of the 1st degree during pregnancy threatens the child with the occurrence of malformations and a lack of incoming oxygen.If the "children's place" in its development does not reach the norm for 34-36 weeks, then this will not be a cause for particular concern, for the reason that the second degree is determined by stability and does not cause serious violations.
At the third stage, the pathology is the most dangerous, despite the fact that at this stage the process implies a natural extinction.
A strong deviation from normal values indicates the need for treatment. The child does not receive enough nutrients, there is a threat of hypoxia. Placental insufficiency, in rare cases, can be seen in the special behavior of the baby inside the womb - too mobile or, conversely, slow.
How to prevent aging of the placenta during pregnancy
First of all, a complete diagnosis of the body is carried out in order to establish the cause of placental insufficiency. In a hospital, drug therapy is prescribed, which is aimed at reducing or completely eliminating the factors that affect the formation of pathology.To exclude oxygen starvation and normalize the umbilical blood flow of the baby, directional droppers are prescribed. An auxiliary method is the intake of vitamin complexes to improve the metabolism and nutrition of the baby.
Complete peace, lack of stress, rational nutrition and daily walks in the fresh air will become the basis for such a diagnosis.
The placenta is an embryonic organ, the main functions of which are protection against infections, the production of necessary hormones, and the delivery of oxygen and nutrients to the fetus. Any violations associated with the placenta will adversely affect the condition of the expectant mother and child, to a greater or lesser extent. The formed placenta is a disk-shaped organ, the diameter of which is approximately 200 mm, and the weight is about 0.5-0.6 kg. At the same time, the thickness of the walls of the placenta at this time reaches approximately 30-40 mm. Like any other organ of the human body, the placenta is subject to aging and this is a normal process, but in some cases, premature aging can occur.
Causes and consequences of premature aging of the placenta
Early aging of the child's place may be due to the individual characteristics of the organism of the expectant mother, as well as due to the pathological effect on her placenta. These pathologies include:
- severe toxicosis (gestosis), which appears in the second half of the pregnancy;
- impact on the body of toxic substances;
- uterine injury;
- smoking;
- chronic diseases of the kidneys, heart, liver, blood vessels;
- multiple pregnancy;
- wrong diet;
- abortions;
- endocrine diseases;
- previous difficult childbirth;
- or her;
- alcohol abuse;
- development of infections in the uterine cavity.
The result of the above pathologies may be the development of placental insufficiency in the expectant mother, which will subsequently negatively affect the blood supply to the child. A minor violation, as a rule, is compensated by the characteristics of the body of a pregnant woman, however, with a more serious circulatory pathology, there is an insufficient supply of oxygen and nutrients to the baby. Under such circumstances, the fetus begins to lose weight, there is a violation of the development of all its organs, which can result in difficult childbirth, underdevelopment of the fetus, and more serious consequences. Do not be alarmed, because this only happens if this diagnosis is left without attention and treatment is not carried out.
Signs and Diagnosis
Early aging of the embryonic organ is always asymptomatic for the woman in labor, and the only thing that can indicate the presence of this disease is a sharp decline in the intrauterine activity of the fetus or, conversely, the child will behave too actively. As a rule, this pathology will be detected on a planned ultrasound. An ultrasound examination may show a decrease in the area and volume of the placenta, which shows a discrepancy between its terms of development. To confirm the diagnosis, additional studies are usually prescribed, such as ultrasound dopplerography (allows you to get information about). Additionally, additional cardiotocography, biochemical and general blood tests can be performed.
Treatment
Treatment of placental aging is carried out exclusively in a hospital under the close supervision of medical professionals. In addition to complex measures to normalize blood flow and maintain the life of the fetus, treatment is prescribed to eliminate the cause of premature aging of the placenta. So, when bacterial, protozoal or viral infections are detected, various medications or injections are prescribed to combat them. To prevent oxygen starvation of a child, several types of droppers are prescribed, and vitamin therapy is used to normalize blood flow and essential phospholipids, zufilin, aspirin, actovegin, chimes, etc. are prescribed.
As a rule, the treatment of premature aging of the child's place is limited only to medicinal methods, however, in rare, more severe cases, premature delivery can be performed. But at the same time, doctors will be 100% sure that the development of the fetus outside the womb will bring more benefits than the presence of possible negative consequences from.
Recent studies have shown that if premature aging (stage 3) was detected at a period of more than 32 weeks, then the likelihood of a favorable outcome is the same as in a healthy pregnancy. Naturally, this requires consultation with doctors and regular ultrasound.
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.
To understand the meaning of the term "old placenta", it is necessary to know the features of the functioning of this organ. Firstly, the placenta is a unique organ, the lifespan of which is limited to only nine months. During these nine months, the placenta goes through all stages of life - birth, growth, development, maturity, aging and death. The death of the placenta occurs after the birth of a child, when it separates from the walls of the uterus and comes out after the fetus. This means that by the time of birth, the placenta should already be "aging".
Often, doctors use the simple term "old" to describe the functional insufficiency of the placenta and the changes that have occurred in its structure. This refers precisely to the premature aging of the placenta, which can lead to fetal hypoxia, premature birth, the threat of miscarriage, etc.
In principle, the aging of the placenta is a normal physiological process, if it occurs in due time. For example, an old placenta with a degree of maturity of 2 or 3 at 40 weeks of gestation is the norm. But if the placenta becomes old ahead of schedule, then it is necessary to undergo a course of treatment aimed at normalizing blood circulation in the mother-fetus system in order to prevent hypoxia and possible underdevelopment of the child.
Currently, there are well-defined criteria for the normal degree of maturity of the placenta for each stage of pregnancy. If the degree of maturity of the placenta is higher than it should be according to the gestational age, then they say that it is old. So, until the 30th week of pregnancy, the placenta should be at a zero degree of maturity. If before the 27th week 1 or 2 degree of maturity is detected, then the placenta, in relation to this situation, is old. If in the period from the 31st to the 34th week of pregnancy the degree of maturity of the placenta is 2 or 3, then it is also old. From the 36th to the 37th week, the normal degree of maturity should be 2 or 3.
Thus, the concept of "old placenta" is relative, and is used to describe certain changes in the structure of the organ that occur ahead of schedule.
