Causes and consequences of premature aging of the placenta

Premature aging of the placenta is a threatening condition. Any pregnant woman can face him. Why the "child's place" begins to lose its functions ahead of time and what to do with these, we will tell in this article.

How does a "child's place" mature?

"Baby's place", or placenta, is a temporary organ that is necessary for a woman and a child only during pregnancy. It has a spongy structure, with one side tightly attached to the wall of the uterus, from where it draws reserves of maternal blood, and the other through the umbilical cord is connected to the fetus. The placenta performs protective functions, preventing the mixing of the mother's and baby's blood. It also acts as an intermediary in gas exchange and nutrition: through the placenta through a vein in the structure of the umbilical cord, the baby receives fresh blood with oxygen and vitamins, and through two arteries inside the umbilical cord, the child's waste products are returned to the placenta: urea, carbon dioxide, creatinine. The placenta produces hormones that are important for pregnancy and subsequent breastfeeding.

A week after ovulation, the fertilized egg enters the uterine cavity and its main task is to implant. This helps the chorionic membrane, which "grows" into the maternal endometrium. At the site of attachment, a chorion is formed, which is gradually transformed into the placenta. The formation of a "child's place" is completed by 14-16 weeks of pregnancy. The young placenta takes its final shape by 20 weeks. Until the middle of pregnancy, the "child's place" grows and expands. After that, it only slightly increases in thickness.

The closer to childbirth, the less functional the placenta: it develops its resources, begins to age. First, its membranes become wavy, then disseminations of calcium salts appear in the placenta, then these inclusions become more extensive - the placenta becomes denser from spongy, begins to become thinner. All these processes fit into four degrees of maturity.

If the degrees replace each other on time, this does not pose any danger. If the placenta "fades away" too quickly, they speak of its premature aging.

Norms and deviations

A young and full of strength, the placenta is at zero maturity. This means that the resources of the "child's place" are not exhausted - the baby receives everything necessary for his development. Normally, zero maturity is recorded before 30 weeks of gestation.

The first degree of maturity of the placenta speaks of the changes that have begun: the proliferation of the network of vessels and tissues has stopped, the membrane becomes wavy. But the "child's place" performs its functions regularly - the baby is comfortable, and everything is enough. The first degree normally corresponds to a period of 30-34 weeks of pregnancy.

The second degree of maturity describes active regressive processes in the "child's place": fragmentary thinning of the placenta may appear, its structure becomes denser, and calcium salt deposits appear. If the 2nd degree is set in the appropriate time frame, you do not have to worry - the placenta copes with its tasks without harming the baby. The second degree will not be considered pathological if the gestational age is already 35–38 weeks.

The third degree is a mature or old placenta. The structure, which previously resembled a rather flat cake, becomes lobular: lobes are determined, the membrane is uneven, salt deposits are clearly distinguishable. Usually grade 3 is recorded immediately before childbirth: in the last couple of weeks, and sometimes just a few days before giving birth.

If the doctor establishes an intermediate degree, for example, 0-1 or 1-2, it means that the ultrasound showed signs of a transition from one stage of development of the "child's place" to another, but the transition itself is not yet complete. With transitional degrees, the most incomprehensible moments and misunderstandings usually arise. To make it easier to understand what is normal and what is not, you should know that 0-1 degree at 27-28 weeks of pregnancy is not a pathology, but a variant of the norm.

After 30 weeks, the doctor can diagnose both the first and the transitional (0-1) degree. But 1-2 degrees at 32 weeks is an obvious pathology, since it is still about a month before the transition to the second degree. The onset of 3 degrees of maturity before 38 weeks is also an alarming and dangerous situation in which, most likely, a decision will be made on early delivery.

The greater the time gap between the norm and the real state of the placenta, the more dangerous the consequences can be.

Why is it dangerous?

Since the placenta is naturally entrusted with important functions of protection, nutrition, oxygen supply, as well as hormonal support for the pregnant woman's body, any changes in the structure of the placenta ahead of time can lead to serious complications. When aging is on time, it is physiological: the loss of some functions of the placenta, their decrease is compensated by the organisms of the mother and fetus. This does not harm the child, since normally the extinction of the function proceeds rather smoothly.

If early maturation is observed, then the baby does not receive enough oxygen, the placenta copes worse with the removal of its waste products, and it lacks nutrients. In addition, the placenta does not perform well with protective functions. The most common consequence of premature maturation for a child is hypoxia.

Against the background of oxygen deficiency, the baby's brain and nervous system suffer. Prolonged hypoxia can lead to the death of a child in utero. Often, it is intrauterine hypoxia that causes fetal developmental delays, gross violations of the central nervous system.

Children who suffered from hypoxia in the mother's womb are more painful, they may have various neurological abnormalities, as well as dysfunctions of the musculoskeletal system. In addition, such children study worse, disability is not excluded.

Lack of nutrients leads to a delay in the intrauterine development of the baby. She is diagnosed during pregnancy. The height, weight, length of the fetal limbs lag behind the normal values typical for a particular gestational age. Often, the delay in physical development is accompanied by cerebral and metabolic disorders, which after birth is determined in the form of delays in mental and mental development. Against the background of starvation, various defects of the internal organs and the skeletal system of the baby can develop.

The delayed withdrawal of the waste products of the fetus by the early matured placenta creates a threat of intoxication, death of the child. A decrease in the barrier functions of the "child's place" can lead to infection of the crumbs with dangerous viruses that can easily penetrate through the bloodstream to the baby. Intrauterine infection is a condition that is regarded as a threat to a child's life.

What is the reason?

The placenta ripens ahead of time for a variety of reasons. Most often, doctors are faced with such a phenomenon as premature aging of the placenta in women who, while carrying a baby, continue to smoke or cannot deny themselves the pleasure of taking alcoholic beverages. Women who amuse themselves with the hope that "light" cigarettes are not dangerous, and red wine is useful, such a pathology after 30 weeks of pregnancy occurs quite often.

However, the absence of bad habits during and before pregnancy does not guarantee that problems with the placenta will not arise. The maturation of the "child's place" ahead of time may be a consequence of a viral infectious disease, for example, SARS or influenza in the early stages, as well as sexually transmitted infections.

Pregnant women with Rh negative blood, provided that they are carrying a baby with a positive Rh factor, may develop an Rh conflict, in which the placenta begins to suffer almost at the stage of formation. Its early maturation is often a consequence of those immune processes that take place during a conflict in the body of a future mother.

If a woman had diabetes before pregnancy or acquired gestational diabetes while carrying a baby, the likelihood that the placenta will age quickly is much higher.

With such ailments, placental hyperplasia (an increase in its thickness) is usually observed, which almost always leads to an early loss of its functions. Early aging of the "child's place" also occurs in women who have had several abortions: the thinned endometrium in this case cannot ensure the normal development of the placenta. In this case, it is initially thinner and ages much faster.

Chronic diseases of the expectant mother, especially if they concern the kidneys, liver, thyroid gland, heart and blood vessels, as well as blood clotting disorders, increase the likelihood of premature maturation of the "child's place".

The rate of maturation of the placenta can be negatively affected by many medications, which is why expectant mothers are strongly advised not to take any medication unless approved by her attending physician. The contact of the expectant mother with toxic substances, varnishes and paints, solvents, bleaches and other chemicals also affects the placental tissues and blood vessels. Working in hazardous and hazardous industries increases the likelihood of negative changes in the rate of maturation of the placenta.

Premature aging of the placenta is more often observed in women who live in large cities with unfavorable environmental conditions than in women who live in a village or small town where there are no large city-forming industrial enterprises. And also pathology, according to the observations of doctors, is inherited - from mother to daughter.

Gestosis (late toxicosis) quite often leads to the aging of the "child's place" before the established time. Dangerous from the point of view of the likelihood of developing a pathological condition and changes in blood pressure in the expectant mother, hypertension. If a pregnant woman at any stage of pregnancy has had even minor placental abruptions or has a “child's seat” presentation, the risk of early maturation is several times higher than in women who do not have such problems during pregnancy.

When carrying twins or triplets, the risk of early maturation is higher than with a singleton pregnancy. And in women with hormonal problems, placental abnormalities are almost always found to one degree or another, including an old placenta at an inappropriate gestational age.

Symptoms and signs, diagnosis

There is no way to feel the degree of maturity of the placenta, as well as to determine its thickness and other parameters. The accelerated maturation of the "child's place" proceeds completely without symptoms. That is why it is important to regularly visit a doctor, undergo all the examinations due to the date, take tests and do an ultrasound scan. The sooner the anomaly is detected, the more favorable the doctors' predictions for the forthcoming treatment will be.

Signs of premature aging of the placenta at a later date, when the consequences of placental insufficiency are already manifested, are mainly felt as a change in the baby's motor activity. An increase in activity speaks of the initial stage of hypoxia: the baby's movements become sharp, can cause severe pain to the pregnant woman. So the baby is trying to massage the placenta with the arms and legs, trying to get more oxygen.

Prolonged hypoxia is manifested by the opposite signs - the baby almost stops moving. It enters a mode of saving oxygen and nutrients, trying to use as little energy as possible. The complete cessation of movements may be a sign of the death of the baby.

Only a doctor can establish the fact of hypoxia, delayed intrauterine development of the fetus, its intoxication and other unsuccessful conditions. That is why it is so important not to miss visits to the antenatal clinic.

When the baby's behavior changes, the woman is prescribed a study of the placenta and the characteristics of the uteroplacental blood flow for ultrasound, ultrasound, and CTG. Cardiotocography, which can be performed from 28-29 weeks of pregnancy, can give a fairly accurate answer to the question of whether the baby has changes in condition.

The degree of maturity of the placenta is established by ultrasound, starting from the 20th week of pregnancy. At earlier stages, neither the thickness of the "child's place", nor its characteristics of maturity have diagnostic value.

Treatment

Despite the fact that the consequences can be quite serious, a woman should not panic: premature aging of the placenta is always more favorable than her pathological immaturity. With early detection of pathology, doctors can help the baby and his mother. Treatment is usually carried out in a hospital setting.

The choice of tactics depends on the time frame. If the premature maturation of the placenta is detected at 31-35 weeks of pregnancy, then the doctors are trying to do everything possible to preserve it and prolong it, because the baby at this time is not yet ready to be born. The woman in the hospital is monitored, they provide the necessary therapy, they do CTG every day to find out if the condition and well-being of the baby has changed. An ultrasound is done every few days to monitor the processes taking place in the placental structures.

If the gestation period is more than 36 weeks, then, with a high degree of probability, doctors will decide on an early delivery: stimulation of labor or a cesarean section. Although, if the degree of deviation from the norm is small, they can put on preservation and try for at least two more weeks to support the baby inside the mother's womb with medication so that he has time to gain weight.

The standard treatment regimen contains antispasmodic drugs (Papavern, No-shpa) to reduce the contractile ability of the smooth muscles of the uterus. To improve blood flow in the "mother-placenta-fetus" system, "Curantil", "Actovegin" are used both in tablets and in the form of intravenous drip. To fill the nutritional deficit of the baby, vitamin preparations are used. If you suspect fetal hypoxia, a woman is recommended oxygen cocktails.

If infectious diseases become the reason for the premature maturation of the "child's place", in parallel with the standard scheme, the woman is prescribed appropriate treatment with antiviral or antibacterial drugs. With late toxicosis, diuretics are prescribed to reduce swelling, and drugs to lower blood pressure, if the expectant mother has hypertension.

If systematic observations of the baby indicate the slightest negative changes in his condition, preserving therapy is canceled and an emergency delivery is performed. This is necessary in order to save the child's life.

Tips for expectant mothers

Prevention of problems with the placenta during pregnancy does not exist, since there is no way to influence the processes of maturation and aging of the "child's place", and even expensive advertised medicines are powerless in this matter. The fact that problems may arise with the placenta, a woman should remember at the stage of planning the replenishment of the family.

It is necessary to give up smoking, alcohol, uncontrolled intake of medicines in advance - antibiotics, anticonvulsants, hormonal agents, including contraceptives, are especially dangerous.

If a woman is being treated with such means or is protected with oral hormonal contraceptives, before conceiving a baby, you should consult a doctor and pass the necessary tests to avoid problems in the future.

From the first weeks of pregnancy, it is important to monitor your diet, to avoid contact with toxic substances, radioactive radiation, and not to work the night shift, since lack of sleep leads to hormonal disturbances. If bloody discharge occurs at any time, you need to consult a doctor to exclude placental abruption, and get the necessary treatment if it occurs.

A woman should breathe fresh air, walk, if the weather permits, sleep with an open window. The more oxygen she receives herself, the more she can give it to her baby through the placental blood flow. You should also avoid viral infections, carrying out correct and timely prevention of influenza and SARS, especially during periods of mass morbidity.