Thickening of the placenta during pregnancy 20. Thickening of the placenta. Clinical manifestations and diagnosis

The placenta is a temporary organ that develops in a woman's body during pregnancy. The children's place has a complex structure, it connects the mother with the child without mixing their circulatory systems. The placenta is formed from the villi of the chorion from the moment the ovum is attached to the wall of the uterus, it provides the fetus with nutrients, supplies oxygen, removes metabolic products, and protects against infections. One of the key functions is the creation of a fetoplacental barrier.

This kind of filter protects the unborn child from everything bad. Beginning to fully function by 12 weeks, it passes some substances and delays the transportation of others that are dangerous to the fetus and fetus. The child's place produces the hormones necessary during pregnancy and provides immunological protection for the fetus.

Development and maturation

These parameters can be determined by ultrasound. Three dimensions are measured: longitudinal with transverse form two perpendicular segments drawn through the most distant points of the edges from each other, and thickness (depth).

Usually, the placenta completes its formation by the 16th week of pregnancy, with a normal course without pathologies, and grows up to 37 weeks, reaching its maximum size by this time.

The first measurement of the parameters of the child's place is carried out at 20 weeks. Further - according to indications. By the end of the gestation period, the thickness of the child's place decreases. This size also has its indicators within the normal range, in accordance with the gestational age. May vary within certain limits, as long as there is no danger of disruption of basic functions.

In addition to the physiological thickness of the placenta, an important sign of the normal course of pregnancy is the degree of maturity of the child's place. Thickening in combination with premature aging (involution) usually indicates pathology during gestation. A decrease in the functional ability of this organ, which is important for the full-fledged intrauterine period of a child's life, is called fetoplacental insufficiency.

Development periods

As it matures, a child's place goes through a series of stages. They are tied to the time of pregnancy and at a certain period must meet certain parameters. There are 4 degrees of maturity:

• Zero degree - an organ of a homogeneous structure is formed, with a normal course of up to 30 weeks.
• The first is the growth and development of the organ, with the appearance of echogenic inclusions from 27 to 34 weeks.
• The second is a mature placenta, changing its structure, multiple inclusions, a period from 34 to 39 weeks.
• The third - the time of placental aging, occurs after 37 weeks, the structure acquires lobulation, calcifications appear.

The normal thickness, on average, in millimeters, is close in value to the gestational age by weeks; at 20 weeks, the average thickening is 20 mm. Normally, on ultrasound at 20 weeks, thickening of the placenta ranges from 16.7 to 28.6 mm.

If the thickening has large parameters, we can talk about pathology. A thick placenta does not cope with its tasks so well and often leads to violations of the life support and development of the fetus, the hormonal background of a pregnant woman.

Hyperplasia of the placenta

The diagnosis of placental hyperplasia will alarm a woman at 20 weeks at the first measurement of parameters on ultrasound, and at any other time.

Hyperplasia or thickening of the placenta is a serious pathology during pregnancy, it can lead to chronic placental insufficiency.

Excessive growth of tissues, and not necessarily functional ones, disrupts the supply of oxygen and nutrition to the child. The excretory function also suffers. This can lead to a slowdown in fetal development, oxygen starvation, weight loss and complicating childbirth.

What threatens pathology?

Excessive placental hyperplasia indicates rapid growth and premature aging of the organ with the loss of its main functions. The placenta changes its structure to a lobular one, calcifications appear, which disrupts the normal supply of oxygen and essential nutrients from the mother to the fetus.

The child begins to suffer from oxygen starvation and malnutrition, lag behind in development. In severe pathologies, there may be intrauterine fetal death and premature detachment of the placenta.

The endocrine function of the organ is disrupted, which can provoke a fading of pregnancy or premature birth.

Reasons for the appearance

Any deviations from the norm in the body of a pregnant woman do not occur without a good reason and require study. This thesis also applies to placental hyperplasia. Most often, this condition is provoked by the following factors:

• Anemia during gestation, especially severe forms. Here we are talking about a compensatory mechanism.
• SARS diseases. Viruses easily enter the placenta, destroy cells and disrupt their function.
• Diabetes. Glycosylated hemoglobin and other proteins are not able to adequately perform the tasks assigned to them, the metabolism changes greatly.


• Venereal and TORCH infections in a chronic course.
• Gestosis in the later stages. Exposure to toxins often leads to damage to areas of the placenta and the replacement of normal tissues with scar tissue.
• Multiple pregnancy. Here, more or less, a variant of the norm: in order to provide several children with everything necessary, one has to increase in size.
• Low or overweight mother.
• Rh-conflict between the blood of the mother and the fetus. A very serious reason. Indirectly indicates that the fetoplacental barrier is damaged, there was contact of the mother's blood with the embryonic one and there is a risk of fetal death.

With diabetes in the mother, there is another factor in the thickening of the placenta: for pregnant women with this pathology, the development of a large fetus is characteristic. To provide him with everything necessary, the children's place is also forced to increase.

Gestational trophoblastic disease

One of the variants of the flow is sometimes called an incomplete hydatidiform mole. Occurs when one egg is fertilized by two sperm at the same time, which leads to a genetic abnormality of the embryo. It occurs infrequently, but requires special attention, as it can cause oncological pathology.

Chromosomal abnormalities in 90% of cases lead to early termination of pregnancy, but in 10% of cases, gestation does not stop. The placenta thickens in places, the size of the uterus corresponds to the gestational age. Even the fetal heartbeat is heard.

The diagnosis is made only with ultrasound examination and the sooner the better. The only option for help is scraping.

Clinical manifestations and diagnosis

External symptoms of placental hyperplasia of any origin, as a rule, are absent. Symptoms do not appear in the early stages, the diagnosis is established at the next ultrasound examination, starting from the 20th week of pregnancy. The thickness of the placenta is measured at the widest points.

There are no symptomatic manifestations of abnormal thickening of the placenta in the early stages up to 20 weeks.

This organ does not have painful nerve endings, therefore, hyperplasia can be suspected on its own only by indirect signs:

1. At later dates, when movement is already heard, at 18–20 weeks, there is a change in fetal movements from activation to slowdown.
2. The appearance or increase in the intensity of preeclampsia, especially in the early stages.
3. Almost always there is a violation of the heartbeat when listening to cardiotocography.

Based on survey results. the doctor finds out the reasons, prescribes an additional examination to the pregnant woman (if necessary) and conducts symptomatic treatment based on the reasons that caused the thickening.

ultrasound diagnostics

To determine the thickness of the child's place, ultrasound is performed starting from 18–20 weeks. It is not worth delaying this study, since placental anomalies detected in the early stages are easier to compensate. The most important indicators:

1. Correspondence of the degree of maturity of the placenta to the gestational age.
2. Structure homogeneity.
3. Physiological tissue density.
4. The presence or absence of additional lobules.

With the preservation of the structure and a slight thickening of the placenta, no measures are required, monitoring is carried out in dynamics.

The most important indicator is the condition of the fetus and what effect thickening of the placenta has on its growth and development, whether it affects the normal course of pregnancy.

There is no more informative method for detecting placental pathology than ultrasound. Therefore, it is impossible to neglect the terms of research.

Prevention of complications

If a thickening of the placenta was found on ultrasound in a period of up to 20 weeks, there is no need to panic: the doctor will find out the reasons and give recommendations on the prevention of placental insufficiency. If necessary, treatment will be carried out.

The woman herself can contribute well to the prevention of complications:

• Need to be outside more often.
• To refuse from bad habits.
• Good quality and good food.
• Avoid contact with viral infections.
• Treat chronic infections at the planning stage of pregnancy.
• Control your weight, vitamin intake.
• Prevent anemia by taking tests on time.
• Regularly visit a antenatal clinic for early identification of causes that can be eliminated.

If the placenta is too thick and the reasons are clarified, the specialist prescribes therapy in accordance with the term in order to improve metabolism and support the fetus in the prevailing conditions. Timely measures taken significantly increase the chances of having a normal baby, even with a significant thickening of the placenta.

Ideally, during pregnancy, the placenta has a certain thickness, regulated by weeks. So at the 22nd week of the term, the thickness of the child's place should be 3.3 centimeters. At week 25, it increases to 3.9 centimeters, and already at 33 weeks of gestation, the thickness of the placenta is 4.6 centimeters.

When a thicker placenta is observed during pregnancy, this may indicate an intrauterine infection of the fetus. In this case, it is necessary to take a blood test for toxoplasmosis or cytomegalovirus.

If a placenta is found in a pregnant woman, which is thicker than normal, then a specialist observes the woman and directs her to ultrasound and CTG. Only thanks to such examinations can one accurately determine the presence or absence of pathologies in a baby.

Causes of a thick placenta

The reasons that affect the thickening of the placenta may be the following:

• viral diseases;
• infectious diseases;
• maternal diabetes;
• severe anemia;
• risk of miscarriage;
• multiple pregnancy;
• preeclampsia;
• excess or shortage in the weight of the pregnant woman.

Consequences of a thick placenta

When the place for the baby becomes thicker, calcifications appear in it, affecting the functioning of the placenta. As a result of such processes, the fetus does not receive enough oxygen, and this affects its intrauterine development. In addition, due to swelling of the placenta, its hormonal function decreases, which threatens to terminate the pregnancy or give birth prematurely.

In severe cases of thickening of the placenta, premature detachment of the placenta is also possible. In order to avoid terrible consequences, the doctor prescribes an additional examination as soon as he suspects a thickened placenta. If his fears are confirmed, then the disease is treated immediately.

Thickening of the placental tissue can lead to a change in the course of pregnancy. Placental hyperplasia has a number of features that can affect the intrauterine development of the fetus.

What it is?

Normally, the placenta has a certain size. With each day of pregnancy, the thickness of the placental tissue increases. The normal thickness of the placenta depends on the duration of pregnancy. If its thickening occurs, then doctors call this condition hyperplasia.

By childbirth, the thickness of the placenta is approximately 2-4 cm. If the placenta becomes very thick before the due date, then the course of pregnancy may change.

Causes

A variety of reasons can lead to the development of thickening of the placental tissue. As a rule, if a too thick placenta is diagnosed during pregnancy, then this is evidence that there are some pathologies in the body of the expectant mother.

Various viral and bacterial infections can lead to the development of placental hyperplasia. Pathogenic microbes cause an inflammatory process that leads to disruption of the formation of the placenta. Ultimately, this contributes to the fact that the placental tissue thickens excessively, which leads to the development of its hyperplasia.

Also, a change in the thickness of the placental tissue can develop in anemic conditions, which are accompanied by a strong decrease in hemoglobin in the blood. Diabetes mellitus can also lead to the development of placental hyperplasia. A persistent increase in blood glucose leads to the development of damage to the placental tissue.

Vascular pathologies can also lead to the development of hyperplasia - it can develop with arterial hypertension. In this case, the development of damage contributes to a persistent increase in blood pressure. The higher these numbers in the expectant mother, the higher the risk of developing placental pathology.

Hyperplasia can also develop after suffering infectious pathologies. So, ureaplasmosis, toxoplasmosis, as well as a number of diseases that are sexually transmitted can lead to thickening of the placenta.

The Rhesus conflict that occurs between mother and baby can also contribute to the development of characteristic changes in the placenta. In this case, intrauterine development of the fetus may be disturbed due to the development of complications.

Late toxicosis of pregnancy can also affect the development of placental disorders. This pathology is dangerous because the prognosis for the development of pregnancy, as a rule, worsens. The expectant mother develops severe edema, the general condition is disturbed, and a violation of the uteroplacental blood flow may also develop.

How can it manifest?

In most cases, placental hyperplasia is asymptomatic. It is simply impossible to suspect the presence of this pathology in this case for some clinical signs. That is why, most often, placental hyperplasia becomes a real “find”, which is detected during planned ultrasound scans during pregnancy.

Thickening of the placenta in some cases can lead to the development of dangerous complications. In this case, the expectant mother begins to worry about adverse symptoms that affect her well-being. So, a woman may have discharge from the genital tract or experience a slight soreness in the lower abdomen.

Sometimes it happens that the only symptom that worries a future mother who has placental hyperplasia during pregnancy is poor health and general weakness. Such a non-specific manifestation, as a rule, is not a reason to consult a doctor, which leads to untimely diagnosis of the pathology.

Diagnostics

The main diagnostic method that allows you to identify this pathology is an ultrasound examination. During the ultrasound, the doctor can determine the thickness of the placenta, as well as identify various anatomical defects. Quite often, thickening of the placenta is first diagnosed at 18-20 weeks of gestation, but this pathology can be detected much later.

During the determination of the thickness of the placenta, the ultrasound specialist also evaluates its density. The structure of placental tissue largely depends on the duration of pregnancy. So, in the second trimester, it is quite smooth and uniform.

As labor approaches, the placenta changes its density. Diffuse changes appear in it, as well as areas of compaction. For example, the structure of placental tissue at 32 weeks of gestation is significantly different from that at 20-22 weeks. Such changes are absolutely normal and indicate a healthy course of pregnancy.

If, for some reason, the placenta changes its thickness earlier than it should be for this period, then the ultrasound doctor diagnoses the presence of its hyperplasia. At the same time, he necessarily conducts accurate measurements of the thickness of the placental tissue and indicates the results in his medical report, which is issued after the examination to the expectant mother. This conclusion must be included in the medical card in the future. Evaluation of the thickness of the placenta in dynamics allows doctors to track how this pathology develops.

If the expectant mother has been diagnosed with placental hyperplasia, then she is also assigned a number of additional examinations. A pregnant woman will need:

• take a biochemical blood test, as well as general blood and urine tests;
• undergo cardiotocography;
• be examined for the presence of sexually transmitted infections;
• determine the presence of antibodies (according to indications);
• visit the dopplerography room to identify various disorders of the uteroplacental blood flow;
• visit an obstetrician-gynecologist for a clinical examination and sampling of swabs from the genital tract for analysis.

Possible consequences

A strong thickening of the placenta most often threatens the development of an extremely dangerous condition - fetoplacental insufficiency. This pathology is accompanied by a strong violation of the uteroplacental blood flow, as a result of which the fetus does not receive oxygen, which means that the process of oxygenation of the child's body is disturbed. Persistent oxygen deficiency can even lead to the development of fetal growth retardation syndrome. In this case, the normal course of intrauterine development of the fetus is disturbed.

A slower growth rate in a baby in this situation can also cause him to grow and gain weight much more slowly. Ultimately, severe placental hyperplasia can contribute to the fact that the baby will be born small and much earlier than the due date.

If placental tissue hyperplasia is also accompanied by oligohydramnios, then in such a situation the fetus has a rather high risk of developing disorders in the structure of its musculoskeletal system. The child may develop curvature of the limbs, as well as various pathologies of the skeleton.

Treatment

The choice of therapy tactics depends on many factors. The doctor necessarily assesses the general condition of the expectant mother and her baby, the degree of violations, the risk of complications, gestational age, and much more. Only such a comprehensive assessment allows specialists to choose the right tactics for further pregnancy management.

Placental hyperplasia can be treated in different ways. Basically, basic therapy involves the appointment of drugs. They are selected individually, taking into account the features of the expectant mother. Also, when prescribing drugs, their effect on the fetus is also necessarily evaluated.

The expectant mother is waiting for the procedure of a planned ultrasound with bated breath - what will the doctor say to her? Unfortunately, some women receive disturbing news. These include the diagnosis of "thickening of the placenta during pregnancy." The pathological condition threatens the normal development of the fetus and promises serious complications during childbirth. An unfavorable prognosis of the disease can be corrected by timely treatment. We will talk about the signs, treatment and prevention of deviation in the article.

The placenta (children's place) is a specific organ that is formed in the female body during the period of the birth of a new life. It has a complex structure, due to which the circulatory systems of the mother and fetus exist independently of each other. The birth of the placenta begins simultaneously with the implantation of the fetal egg into the wall of the uterus. After a while, the child's place takes over the job of providing the child with substances useful for growth and oxygen. In addition, the placenta protects the future person from all kinds of infectious diseases.

The placenta becomes a full-fledged organ when the pregnancy reaches 16 weeks, and continues to increase in size up to 37 weeks (if there are no pathologies). The first ultrasound to study the parameters and assess the condition of the placenta is prescribed at the 20th week of pregnancy. As the birth approaches, the baby's place becomes thinner. This process also proceeds in accordance with established norms, which depend on the gestational age.

Thickening of the placenta during pregnancy: what happens in a woman's body

Thickening or hyperplasia of the placenta is said to occur when an excessive thickening of the organ occurs. This is undoubtedly a deviation from the norm and it requires surgical treatment in a hospital setting. Due to the too thick walls of the child's place, the nutrition of the fetus is difficult and the portions of oxygen that the baby should receive regularly are significantly reduced. The excretory function is also impaired. Pathology is diagnosed at 20 weeks or later.

Consequences of thickening of the placenta in a pregnant woman

Too late diagnosed hyperplasia and, accordingly, its untimely treatment threatens with serious complications. Since the placenta is a common organ for mother and baby, both will inevitably suffer.

Complications of thickening of the placenta in the fetus

The consequences of hyperplasia for a child are very severe:

• lack of oxygen and nutrients;
• a moderate form of deviation allows the natural birth of a child, while pronounced hyperplasia forces doctors to give birth through a caesarean section, since the baby is very weakened and will not be able to be born on its own;
• intrauterine growth and development delay;
• underweight and hypoxia at birth;
• organ hypertrophy at birth;
• if hyperplasia was accompanied by oligohydramnios, there is a great threat of curvature of the bones of the skeleton and fusion of body parts;
• the likelihood of developing complications after thickening of the placenta remains for the child during the first year of life;
• if timely treatment of hyperplasia does not follow, the child dies in the womb.

Complications of thickening of the placenta for the mother

The abnormal state of the placenta will also affect the course of pregnancy, which will cause severe inconvenience to the woman:

• development due to thickening of the placenta of fetoplacental insufficiency, which is a serious obstacle to normal delivery;
• hyperplasia in combination with polyhydramnios causes leakage of amniotic fluid or premature birth;
• more likely to have a caesarean section.

Fortunately, thickening of the placenta during pregnancy is not considered a critical condition, although doctors do not deny its danger. The possibilities of modern medicine allow in 90% of cases to prevent the development of complications either during childbirth or after them. The earlier treatment is started, the better the prognosis of the disease.

Causes of thickening of the placenta during pregnancy

Doctors explain the fact of the existence of such an anomaly for many reasons. They can be divided into external and internal factors. Let's list the most common:

• anemia in advanced stage;
• diabetes mellitus (in this case, a diffuse thickening of the placenta develops when it grows so much that it covers almost the entire inner surface of the uterus);
• the presence of a Rh conflict between a woman and a fetus;
• dropsy of the fetus;
• diseases of the genital organs of an infectious nature (chlamydia, syphilis, mycoplasmosis);
• preeclampsia in late pregnancy;
• genetic mutations.

Every expectant mother should be aware of the reasons for the development of hyperplasia, since all of them underlie its prevention. However, if the thickening is nevertheless formed, its timely diagnosis is of great importance.

Signs of thickening of the placenta during pregnancy

The main danger of hyperplasia is the absence of visible signs of pathology. This means that the expectant mother in the presence of such a disease will feel good and will not suspect anything.

The disease becomes known during a planned ultrasound procedure. We single out such characteristic signs of pathology that the diagnostician sees on the monitor of the ultrasound machine:

• excessively expanded space between the villi of the placenta for a period of 18 - 30 weeks;
• a sharp change in the activity of the child's movements: intense movements in a few moments become smooth, slowed down;
• muffled heartbeat of the child and a change in the activity of heart contractions (tachycardia is replaced by bradycardia);
• too much amniotic fluid;
• high blood sugar in a mother with gestational diabetes.

Thickening of the placenta during pregnancy: norm and pathology

For each period of pregnancy, there are certain norms for the size of the placenta, which the doctor always focuses on when managing the pregnancy of each of his patients. Once established, normal values ​​help specialists confirm or refute the diagnosis of hyperplasia. It will not hurt to familiarize yourself with this information for expectant mothers, so as not to worry in vain:

• 20 weeks of pregnancy - the normal thickness of the child's place ranges from 20 mm;
• 25 weeks - 25 mm;
• 33 weeks - 33 mm;
• 37 weeks - the normal thickening of the placenta reaches its limit and is 37 mm.

If the personal indicators of a pregnant woman are the same, there is nothing to worry about. If there are deviations, you should not panic, but go to the hospital. By trusting doctors, a woman increases her chances of successfully giving birth to a healthy child.

Treatment of thickening of the placenta in pregnant women

Medical intervention in the pathological process of the growth of a child's place has two goals - to achieve normalization of blood circulation in the placenta and eliminate the root cause of the disease. The expectant mother is prescribed a course of treatment with drugs, and is also recommended to do everything to ensure the most comfortable intrauterine development of the baby. An approximate course of complex therapy for hyperplasia looks like this:

1. A variety of healthy food.
2. Permanent rest.
3. Measures to eliminate the factor that served as an impetus for the thickening of the placenta.
4. Embryonic blood transfusion if there is an Rh conflict.
5. Taking iron-containing drugs in combination with ascorbic acid (Hemoferon, Aktifferin, Ferrocomplex)
6. Taking medications that help restore normal blood circulation in a child's place (Actovegin, Trental, Dipyridamole).
7. Taking multivitamin complexes, anticoagulants and essential phospholipids.

Often, the treatment is successful and the most terrible fears of an excited expectant mother are not confirmed. However, if the pathology was detected too late and there was little time left before the birth, even the most prompt treatment will not be able to prevent the development of complications when the baby is born.

Thickening of the placenta during pregnancy: how to prevent a complication of pathology

If an ultrasound scan at the 20th week of pregnancy prompted the doctor to think about the hyperplasia of the child's place, the panic of the expectant mother should be set aside. The specialist will certainly prescribe appropriate treatment for her, as well as instruct her on preventive measures in order to prevent the development of complications of the disease.

To contribute to her speedy recovery, nothing supernatural is required from a pregnant woman. Enough:

• regularly walk away from places of heavy traffic. Ideally, you need to get out into the forest more often;
• do not drink alcoholic beverages and forget about smoking forever, if such a habit exists;
• eat high-quality healthy food;
• avoid crowded places so as not to get ARVI;
• monitor body weight;
• take vitamins regularly
• take scheduled tests in a timely manner so as not to “oversee” anemia;
• do not miss scheduled visits to the antenatal clinic.

If the child's place develops incorrectly and the reason for this has already been found, the matter remains small - the doctor draws up a treatment program taking into account the gestational age in order to improve metabolism and help the fetus grow in the prevailing conditions. The main thing is not to miss valuable time, then the baby will have every chance to be born healthy even with such an unfavorable diagnosis. Be healthy!

Bearing a child is a process thought out to the smallest detail, but sometimes the program laid down by nature falters. In order to know that everything is going well, the fetus is developing at a normal pace, doctors, through long-term observations, have deduced norms that make it possible to monitor the course of pregnancy and detect pathologies in time. The placenta is a very important organ, so doctors monitor its functioning and condition, thickness and degree of maturity. And when deviations appear, treatment is prescribed.

The role of the placenta in fetal development

The placenta (or child's place) is a special organ, the formation and existence of which is possible only during pregnancy. It performs a number of important functions:

• provides oxygen respiration of the fetus and the supply of all necessary substances to it;
• removes carbon dioxide and metabolic products formed during the life and development of the baby;
• protects the child from the penetration of dangerous substances from the mother's bloodstream;
• produces hormones necessary for the normal course of pregnancy and the successful development of breastfeeding after childbirth.

In some countries, the placenta has not only physiological, but also mystical significance. So, in Indonesia, she is considered the guardian angel of the child, after childbirth she is buried in front of the house and revered throughout a person’s life.

Since the importance of the state of the placenta for the course of pregnancy and fetal development plays a paramount role, doctors monitor the development of this organ, without fail determine the place of its attachment, thickness and.

When do you start monitoring placenta thickness?

The formation of a child's place begins from the very beginning of pregnancy, when a fertilized egg is attached to the wall of the uterus. In this case, the so-called chorion is first formed, which develops and subsequently becomes the placenta. It can be determined on ultrasound as early as 11–13 weeks, that is, at the first scheduled ultrasound examination, but it begins to perform its functions by the middle of the second trimester.

The thickness of the placenta is measured by ultrasound

Measure the thickness of the placenta begin from the 20th week of pregnancy. It does not make sense to do this earlier, because the obtained indicators do not carry a semantic load. During the ultrasound, the specialist determines and fixes the width of the largest value of the child's place, and then this indicator is compared with the norms developed and adopted earlier.

Table: normal placental thickness by week

Deviations of the thickness of the placenta from the norm: causes, consequences and treatment tactics

Pregnancy does not always proceed smoothly; in some cases, the development of the placenta does not correspond to normal indicators. If the thickness of the child's place is less than normal, but they talk about hypoplasia, otherwise hyperplasia occurs.

Thickening of the placenta or hyperplasia

The diagnosis of hyperplasia is made when the width of the placenta in its thickest place exceeds the upper limit of the norm, and the greater the deviation, the more dangerous the situation. Such a pathology develops for various reasons:

• sexually transmitted infections (chlamydia, syphilis, gonorrhea and others);
• diabetes;
• viral infections, including SARS;
• Rhesus conflict;
• fetal malformations;
• anemia;
• preeclampsia;
• twin pregnancy.

Pregnancy with twins is the situation when hyperplasia is a variant of the norm. In order to provide two fetuses with oxygen and all the substances necessary for them at once, the child's place becomes larger, the volume of placental tissue increases.

During pregnancy, identical twins form only one placenta, which provides them with all the necessary substances and oxygen, so an increase in its size is considered a variant of the norm.

Hyperplasia is the body's response to the influence of external factors, an attempt to protect pregnancy. With an insufficient supply of oxygen to the child, the death of capillaries, an increased growth of the network of blood vessels occurs in order to prevent oxygen starvation of the fetus. Therefore, in modern medicine, a thick placenta is not an independent diagnosis, but a consequence of some other pathology.

Hyperplasia is detected during ultrasound. In most cases, no accompanying symptoms are observed. Doctors consider the pathology dangerous for the fetus when, in addition to thickening the child's place, there is reason to talk about a violation of its functions. If the placenta does not fully fulfill its role, there is a high probability of consequences for both the baby and his mother:

• the child does not receive the amount of oxygen he needs, which affects all his organs and systems, in severe cases, the death of the fetus is not excluded;
• the onset of preterm labor or the need for a caesarean section may occur;
• weakness of labor activity due to a violation of the hormonal function of the child's place can lead to complicated childbirth, birth injuries;
• in the postpartum period, the risk of bleeding in the mother increases, there is a possibility of problems with breastfeeding.

The expectant mother needs to pay attention to the movements of the fetus: with a lack of oxygen, the baby's motor activity increases. A dangerous signal is a decrease in the number of movements. When warning signs appear, you should consult a doctor as soon as possible.

The detection of hyperplasia requires mandatory medical supervision of a woman. First of all, it is necessary to establish the cause of the pathology and the treatment tactics will depend on this. A comprehensive examination of the mother's health is carried out, cardiotocography and doplerometry are prescribed to determine the child's heart rate and establish deviations in the placental circulation. Even if the functioning of the child's place is not impaired, doctors often prescribe drugs that improve blood circulation in the placenta (for example, Actovegin, Curantil). Treatment can be carried out both in the hospital and at home.

Hypoplasia or thin placenta

Hypoplasia occurs when the thickness of the placenta does not correspond to the norm, but is outside its lower border. At the same time, oxygen starvation is observed in the fetus, the heart rate and placental blood flow are slowed down. All this leads to developmental delay, premature birth and even intrauterine death of the baby, so medical intervention is required.

The lag of the thickness of the placenta from normal values ​​can be caused by various reasons:

• fetal malformations;
  

  If the cause of hypoplasia lies in genetic abnormalities, then in this case, doctors talk about the primary form of pathology. She is not amenable to medical treatment. In all other cases, hypoplasia is considered secondary, that is, caused by a concomitant disease, and is corrected with medications.

• high pressure;
• atherosclerosis;
• preeclampsia;
• bacterial and viral infections;
• alcohol, drug use, smoking.

A thin placenta as a variant of the norm can only be in miniature women, in all other cases it is a sign of pathology.

Hypoplasia is found only on ultrasound. Women with this diagnosis are hospitalized, prescribed drugs to improve blood flow in the placenta, prevent blood clots, affecting blood clotting, vitamins and others, depending on the causes of the pathology.

Placental hypoplasia requires constant medical monitoring of the condition of the woman and the child, so the pregnant woman is hospitalized

What is the maturity of the placenta

In addition to thickness, there is such a thing as the maturity of the placenta. The fact is that this body lives only 9 months, during which it goes through all stages of development: from education to aging, and then rejection immediately after childbirth. As it goes through its life cycle, the children's place changes its structure and appearance. So, if at first it is homogeneous, even and smooth, then as it matures (or ages) it becomes wavy, inclusions of calcium salts and seals appear in it, formed as a result of the death of blood vessels. This process is not pathological, it is inevitable for any pregnancy.

Degrees of maturity and their description

There are 4 degrees of maturation of the placenta:

• zero, which is normally observed until the 30th week of gestation - the child's place has a homogeneous structure, its surface is smooth and even, there are no seals and deposits of calcium salts;
• the first, which corresponds to 27-36 weeks of gestation - the structure has ceased to be homogeneous, there are seals and calcium salts, but there are few of them, the surface of the placenta has become wavy;
• the second, which corresponds to 34–39 weeks of gestation - more and more seals and inclusions of calcium salts are found, the surface becomes more wavy;
• the third, which is observed after 36 weeks of gestation - calcium salts and seals in the structure of the placenta are found in large quantities, cysts may appear, the child's place acquires a lobed structure.

In addition to the described four degrees of maturity, in some sources one can also find intermediate stages of placental maturation: 0-I, I-II, II-III. The allocation of such transitional periods is associated with the presence of signs characteristic of both one and the other degree of aging. This is due to the fact that changes in the children's place occur gradually, starting from the edges and moving towards the middle.

There are 4 degrees of placenta maturity: zero, first, second and third

What is the danger of premature and late maturation of a child's place

Although the aging of the placenta is a natural process, it must take place in due time. In case of non-compliance with the norms, they speak of premature / late maturation of the child's place. Deviation both in one direction and in the other direction is a sign of pathology, but it is necessary to judge whether the situation is dangerous not only by the degree of aging, but also by functioning, therefore, doplerometry of the vessels of the fetoplacental complex is mandatory, which allows you to assess whether there is enough oxygen goes to the fetus. If the research indicator is normal, there is no point in sounding the alarm, the gynecologist can only recommend a second ultrasound after a while.

When the placenta does not perform its functions properly, the child does not receive enough oxygen, waste products are not fully excreted, therefore, both the fetus and the chorion itself are intoxicated, which only aggravates the situation. In this case, treatment is required, and in case of a threat to the life and health of the fetus, premature delivery is resorted to.

Video: specialist on premature aging of the placenta

The experience of mothers who have encountered problems with the development of the placenta

In the last pregnancy was (premature aging). But also some calcifications. Went 2 weeks. in a day hospital, where they put Actovegin, Cocarboxylase, and she herself drank Vilprafen. Then everything became normal. What exactly helped and whether there was a need - I do not know.

I don't want to scare you, but I had a similar diagnosis (premature aging) that led to an emergency caesarean at 36 weeks. They said that they got it in time, that the child suffered in utero, there was not enough food for him ...

https://www.u-mama.ru/forum/waiting-baby/pregnancy-and-childbirth/365947/

At 34 weeks, she was diagnosed with grade 3, premature aging, panicked and sent to hospital. In the maternity hospital they did a CTG, doppler - everything is perfect. The doctors shrugged their shoulders and discharged her home. No treatment was given. She gave birth exactly at 41 weeks, and there were no complaints about Doppler and CTG until the very birth. The child is healthy.

https://deti.mail.ru/forum/v_ozhidanii_chuda/beremennost/prezhdevremennoe_starenie_placenty_1494744767/

I had hypoplasia, the diagnosis was made at the 7th month, Curantyl was prescribed. They put me in the hospital 2 weeks earlier before the scheduled date, stimulated several times, but I still gave birth right on time, even 2 days later. My daughter is now 11 years old.

http://www.woman.ru/health/Pregnancy/thread/3918784/

I had intrauterine fetal death at 32 weeks, the cause is placental hypoplasia. My friend's baby died at 40 weeks for the same reason. During pregnancy, the ultrasound did not notice anything :(

https://eva.ru/static/forums/53/2008_1/1210371.html

Deviations from the normal values ​​​​of the thickness of the placenta, its premature or delayed maturation - this is not a reason to panic. If an ultrasound scan has revealed hyper- or hypoplasia, a discrepancy between the degree of maturation of the child's place and the gestational age, you should consult with the gynecologist who is in charge of the pregnancy and follow his advice. It is impossible to neglect common sense in such a situation, because serious consequences are possible for both the child and the expectant mother. But in most cases, women with similar problems become happy mothers.