During pregnancy, special attention is paid to the condition of the placenta. Much depends on her health: the well-being and development of the baby, his life. When assessing the placenta, a parameter such as the thickness of the "child's place" is used. You will learn about what it should be at different periods of gestation, what may be the reasons, consequences of deviations from the norms, having read this article.
Structure and function
The placenta is a temporary organ that is needed only in the process of carrying a child. It provides a close connection between the mother and the fetus, acting as an intermediary in the most important processes for the development of the baby: gas exchange, nutrition, excretion of waste products. Through the uteroplacental blood flow, the baby receives blood enriched with oxygen, vitamins, minerals and water from the mother. Urea, creatinine, carbon dioxide are excreted back through the placenta.
The placenta is a "factory" of hormones needed to safely carry and give birth to a child. It produces hCG, progesterone, estrogens, placental lactogen. Without a sufficient level of these hormones, it will not work to endure a baby, and breastfeeding will be a big question.
The placenta begins to form after implantation of the ovum into the uterine cavity. This usually happens 8-9 days after ovulation if the egg is fertilized. First, the appearance of the placenta is preceded by the chorion, thanks to which the blastocyst attaches to the functional layer of the endometrium of the uterus. Gradually the chorion grows, new layers appear, and by 14-16 weeks of pregnancy, the young placenta begins to perform its functions.
The "baby's place" grows and thickens until the middle of the second trimester, then the growth of the placenta stops, and its maturation or aging begins. Until 30 weeks, the placenta normally has a zero degree of maturity, then it becomes denser: deposits of calcium salts appear in it. Until the 34th week of pregnancy, the first degree, and after it (almost before childbirth) - the second. The third degree, indicating that the placenta has almost completely exhausted its resources and capabilities, is fixed shortly before childbirth (with the normal course of pregnancy).
Standards
Before 20 weeks of pregnancy, the thickness of the placenta has no diagnostic value. The "child's place" is determined by ultrasound, the place of its attachment is fixed, but the thickness will be measured only after 20 weeks. An ultrasound sensor will determine the thickest part of the placenta, take a measurement - this indicator is considered decisive. It is important whether the thickness corresponds to the standard values for the current gestational age. The rates are shown in the table below.
Here is a table of the thickness of the placenta by week.
Values shown are average. In practice, there may be minor deviations from these norms, and in each specific case the doctor makes an informed decision based on the individual circumstances and characteristics of pregnancy. However, obvious deviations, which are not limited to tenths of a millimeter, require additional examination. A thin placenta that is no more than 20 mm thick or a thick placenta that is no more than 5 cm is abnormal.
If, in addition to the thickness of the placenta, which does not correspond to the timing, there are no other pathologies and complications of pregnancy, the decision is usually made to wait and observe. It is possible that the placenta has its own structural features, and they should not inspire concern if this thickness does not affect the functionality of the "child's place".
Causes and consequences of deviations
Deviations from the norms are of two types: a thick placenta or a very thin placenta. Both are risk factors, because anomalies in the structure of the "child's place" disrupt its functions, on which the well-being and development of the baby directly depends. It is worth considering both situations in detail.
Fat
Placental hyperplasia is spoken of when the thickness of the "child's seat" is above the upper limit of the permissible range of standard values. The greater the difference, the more serious the situation. A thick placenta alarms doctors much more than a thinned one, because with hyperplasia, the temporary organ ages faster, matures, and this is fraught with premature birth, fetal hypoxia, fetoplacental insufficiency and delayed development of crumbs.
If the placenta ages prematurely, the baby in any case does not receive enough oxygen, vitamins and nutrients. He may show symptoms of intoxication of the body, because the placenta is worse and slower to cope with the excretion of waste products.
There are many reasons that can cause hyperplasia of the "child's place". This, for example, is diabetes in the expectant mother. With it, not only the thickness is disturbed, but also the structure of the placenta - an additional lobule may be present.
Thickness can be increased due to chronic anemia, which some pregnant women begin to experience early in their pregnancy.
If a woman has a viral illness (for example, influenza or ARVI) at an early stage, the likelihood of placental hyperplasia is very high. By thickening the "child's seat" can respond to infections of the genital tract, sexually transmitted diseases, as well as "winged" infections (chlamydia, ureaplasmosis, and others).
At any stage of pregnancy, the thickness of the placenta may begin to increase due to the Rh-conflict, if the Rh-negative mother carries an Rh-positive baby, as a result of which sensitization has occurred. In the later stages, hyperplasia of the "child's place" threatens pregnant women with gestosis, edema, high blood pressure and overweight.
The functions of the placenta with thickening significantly deteriorate, especially the protective function. If the hyperplasia is due to an infection, such a placenta will not be able to protect the baby, he is more likely to become infected and may die in utero. The early stages of thickening do not make themselves felt in any way. Only with the passage of ultrasound diagnostics is it possible to determine such a violation.
But at a later date, the woman will be informed about the development of the pathology by the baby's movements: he will begin to show pronounced anxiety, and then episodes of motor activity will become more rare. On CTG, abnormalities in the condition of the fetus can be detected, uteroplacental blood flow on USDG will also be impaired.
Treatment is prescribed only after determining the exact cause of the anomaly. If this is an infection, the woman is prescribed a course of antimicrobial or antiviral therapy, with diabetes mellitus, a standard course of treatment by an endocrinologist is prescribed, with gestosis, hospitalization may be required, as well as a diet, and normalization of blood pressure. Unfortunately, there are no medications that can lower the thickness of the placenta.
A woman is recommended drugs to improve blood flow in the uteroplacental vessels. Most often used "Actovegin" and "Curantil". In addition, vitamins and mineral supplements, iron supplements are prescribed.
In case of Rh-conflict, intrauterine blood transfusion can be performed.
Thin
If the thickness of the placenta for a given period does not exceed the values of the lower limit of the permissible range, they speak of underdevelopment or hypoplasia of the "child's place". The functionality of such a placenta is significantly limited, and only in one case it can be a variant of the norm: the woman herself has a fragile, slender physique and bears a small baby. In this case, the development of the crumbs will not suffer.
In all other cases, an underdeveloped "child's place" can lead to negative consequences: hypoxia, developmental delay, the threat of death of the baby. A thin placenta is sometimes an indicator of genetic abnormalities in the fetus. The risk of thinning the placenta is increased after early viral infections, as well as due to sexually transmitted diseases.
Gestosis in the second half of pregnancy is one of the most common causes of hypoplasia, as is the presence of chronic diseases of the kidneys, heart, thyroid gland in a woman. Smoking during pregnancy, as well as the intake of alcohol and drugs, often leads to thinning.
Usually, with hypoplasia, there is a delay in the intrauterine development of the baby. You can cope with the problem by using drugs that improve uteroplacental blood flow, taking vitamins, and correcting the mother's nutrition. If the reasons are malformations or chromosomal abnormalities of the fetus, it is not possible to eliminate IUGR.
Useful Tips
Since there is no way to independently feel the thinning or thickening of the "child's place", a woman should regularly and on time visit her doctor during pregnancy, undergo all the required examinations, take tests and do an ultrasound scan. Refusing to be examined can cost a mother and her baby a lot.
When detecting deviations in the thickness of the placenta, you do not need to fall into experiences - medicine has a sufficient arsenal of tools, techniques and medications to support the baby, to prolong gestation until the due date.
Avoid viral and infectious diseases during pregnancy, do not take medications without a doctor's prescription, stop smoking and alcohol, eat right, and be sure to monitor your blood pressure and weight.
The absence of risk factors reduces the likelihood of placental abnormalities.
About what the placenta is, what it is intended for, how it is located in the uterus, see the next video.
