The placenta is an embryonic organ, unique in its properties, which is the most important component in the process of intrauterine development and the life of the fetus. The placenta is a temporary organ, it appears at the beginning of pregnancy, and during childbirth it is rejected. The functions of the child's place are diverse and include protecting the fetus from infections, saturating it with nutrients, delivering oxygen and removing toxins. All these functions are vital for the fetus.
Like any other organ of the human body, the placenta is subject to physical development. Most of the pregnancy proceeds in its continuous growth: the number of vessels increases, the child's place becomes thicker. The development of this process can be traced only with the help of ultrasound. At a certain point, the embryonic organ stops growing and the aging process begins for it. It is worth noting that the greater the degree of maturity of a child's place, the fewer functions it is able to perform.
Degrees of maturity of the placenta
There are four degrees of placental maturity. For normal course pregnancy, it is necessary that each stage of development of the child's place corresponds to its term.
- 0 degree - the duration of this phase is up to 27-30 weeks. During this period of pregnancy, the development of the placenta can reach the first stage. This can be caused by smoking, drinking alcohol during pregnancy, or a viral illness.
- I degree - in medical circles, this stage is called "active growth" and it begins at week 27 and lasts up to 34. At this time, any deviations can be dangerous for the intrauterine development of the fetus, so vitamin therapy can be prescribed to normalize the development of the embryonic organ, taking medicines that stimulate blood circulation, nutrition correction.
- II degree - this period is called "mature" and its duration is from 34 to 39 weeks of pregnancy. It is the most stable period and minor deviations from the norm should not be cause for concern;
- III degree - this phase is already characterized by natural aging. Its beginning occurs at 37 weeks and it lasts until the birth itself. In most cases, the results of an ultrasound examination will show the third degree of development of the placenta, which in turn is the norm for this period of pregnancy. The slightest deviation at this time can cause. To avoid the most severe consequences the expectant mother will have to undergo complex treatment in a hospital. Additionally, cardiotocography is prescribed, and childbirth in case of complications can be carried out using caesarean section to protect the life of the child.
It is diagnosed if some deviations occur in the process of its growth, for example, the second degree occurs earlier than 32 weeks. However, this does not mean at all that deviations from the norm will cause. Timely diagnosis of the growth of the embryonic organ, as well as various methods treatments minimize the risk of other unpleasant complications.
The placenta is called a temporary embryonic organ, thanks to which the unborn child is connected with the mother's body. The maternal side of the placenta faces the wall of the uterus, and the umbilical cord departs from the fruit, with the help of which future child receives all the necessary substances from the mother's body through the umbilical cord. Throughout pregnancy, the placenta protects the fetus from infections, delivers the necessary substances, oxygen and removes decay products.
The child's place begins its formation after the implantation of the embryo, and by the 12-16th week the placenta is already fully coping with its functions, and after childbirth the body rejects it along with the fetal membranes. The course of pregnancy depends on the state of this organ, therefore, to assess the effectiveness of the placental complex, the degree of placental maturity is taken into account.
Degrees of maturity of the placenta by week
Like any organ of the human body, it develops, most of the time it grows continuously, becomes thicker, the number of its vessels increases systematically to ensure the vital activity of the growing fetus. At a certain stage, the growth process of the placenta stops, and it begins to age. Calcium is deposited in the structures of the organ, the placenta itself becomes denser, which prevents it from fully performing its functions. This is a normal process, but earlier placental aging is a pathology that can be detected by ultrasound.
In the conditions of a normal, uncomplicated course of pregnancy, 4 stages of placental maturity are distinguished, they look like this:
- 0 stage of placental maturity . At this stage, the placenta is even and homogeneous in structure, and is still able to develop. Normally, the child's place remains so until the 30th week of pregnancy;
- stage 1 placenta . In healthy women, the transition from stage zero to stage one is possible from 27 to 34 weeks, but more often occurs from 30 to 34 weeks of pregnancy. The structure of the placenta at this stage has a certain amount of seals (echogenic inclusions), there are practically no calcium deposits.
- stage 2 placental maturity . On the chorionic part of the placenta adjacent to the fetus, depressions are found, its structure has many small echo-positive inclusions and visible calcium deposits. If, according to the results of an ultrasound scan of a pregnant woman at a period of 34-39 weeks, the 2nd degree of placental maturity was set, then this is considered a variant of the norm.
- Stage 3 placental maturity . At this stage, the functioning of the body is reduced. By 37 weeks, or between 35 and 39 weeks, the third stage indicates full-term pregnancy and readiness for childbirth. Begins natural aging placenta, the characteristic features of which is the depth of the waves reaching the basal layer. Accumulations of calcium salts merge and form spots of irregular shape.
The third degree of maturity of the child's place may develop ahead of schedule, in which case there is a high probability premature birth and fetal oxygen deficiency. These conditions are not treatable, but are solved only with the help of childbirth. Sometimes therapy, which is aimed at increasing blood flow in the vessels, helps to prolong the intrauterine development of the fetus for several weeks.
What is the normal maturity of the placenta?
The degree of maturation of the placenta is determined by its aging. This process can proceed normally, but under the influence of certain factors, accelerated maturation, or aging, of the placenta is possible, which has an extremely negative effect on the course of pregnancy.
With the normal development of pregnancy in a healthy woman, the normal maturity of the placenta corresponds to the gestational age. Zero degree can be observed up to 30 weeks, the first - from 28 to 34, the second - from 34 to 38, and the third from 37 weeks until delivery. If the placenta of the 0 degree of maturity is able to provide the fetus with everything necessary for a long time, then the placenta that has reached the 3rd degree has limited work resources.
The maturity of the placenta is determined using an ultrasound examination at different stages of pregnancy. At normal pregnancy, proceeding without complications, 2-3 such examinations are enough. The doctor observes how the boundaries between the placenta and the uterus change, its echographic density, thickness and calcium deposits. If at the beginning of pregnancy the placenta grows and thickens, then by its completion there is a slight decrease in its parameters.
Is deviation from the norm dangerous and what should be done in such cases?
The aging of the placenta is a natural and irreversible process, but in some cases it develops prematurely, which indicates a serious pathology and requires careful monitoring. Doctors consider the maturation of the placenta to be accelerated if the degree of its maturity at 32 weeks of gestation exceeds the second, or third, before 36 weeks.
The reasons for deviations from the norm are the following factors:
- difficult childbirth and a history of abortion, which led to a violation of the structure of the walls of the uterus;
- chronic diseases of the internal organs of a woman;
- infectious diseases of the reproductive system;
- severe, or preeclampsia;
- and her;
As a rule, premature maturation of the placenta develops asymptomatically and in no way affects the woman's well-being. On the early dates it leads to miscarriage or fetal malformations; in the middle of pregnancy, hypoxia, or oxygen starvation, is possible in the unborn child, which leads to damage to the central nervous system.
To establish the diagnosis, in addition to ultrasound examination, doplerometry and fetal cardiotocography are performed. Therapeutic measures are prescribed only when the fact of fetal suffering is established. If the lag in the development of the child exceeds 2 weeks, then the woman is recommended to be treated in a hospital, in severe cases a caesarean section is performed.
When establishing the fact of premature maturation of the placenta, the expectant mother is sent to a hospital to maintain pregnancy and carry out therapeutic measures. First of all, the appointment of treatment will depend on the causes that caused the development of the pathology:
- in infectious diseases, antibiotic therapy is carried out;
- treatment is adjusted chronic diseases;
- vitamins and drugs are prescribed that enhance uteroplacental blood flow;
- a complete rejection of bad habits is recommended.
Therapy is aimed at maintaining pregnancy until the minimum allowable term of delivery. Unfortunately, there are no methods for rejuvenating the placenta, and drugs such as chimes, actovegin and pentoxifylline do not have a proven therapeutic effect on this organ.
In the issue of safe pregnancy and solving health problems, future mothers should rely only on the experience of a doctor and follow all his instructions, this will help them bear and give birth to a healthy child.
Probably, everyone in their life at least once had to hear the phrase "children's place." So in the common people they call the placenta - an absolutely unique and important organ that exists only among the representatives of the beautiful half of humanity, and then only during pregnancy. What is this organ? Why is he unique? Why do obstetrician-gynecologists monitor her condition and, in particular, the degree of maturity?
What is a placenta?
The placenta is an organ in the body of a woman, which is formed as a result of a pregnancy and for nine months connects the organisms of the mother and fetus. The baby, located in the mother's tummy, serves as the lungs, and the kidneys, and the stomach, and intestines. Moreover, the placenta provides the baby with essential nutrients and oxygen. This organ is located in the uterus. Fastened, as a rule, on its back wall. But there are cases of attachment to the anterior wall of the uterus. By the end of the 15th week of pregnancy, the placenta is already fully formed. Visually, it looks like a flat disk of a round shape.
The main functions of the placenta:
- the implementation of gas exchange, during which oxygen from the mother's blood penetrates to the fetus, while carbon dioxide from the baby flows in the opposite direction;
- the fetus receiving the nutrients that it needs for timely growth and proper development;
- providing immune protection for the unborn child;
- the production of hormones that are simply necessary for the pregnancy to continue, and the fetus to grow and develop.
By the way, it is important to remember (and who does not know - to find out) that nicotine, drugs, drugs and viruses quite easily penetrate the placenta and can have a negative effect on the fetus.
What are the stages of placental maturity?
The maturity of the placenta is one of the main indicators of its condition. During the nine months of pregnancy, when a woman is carrying a child, the placenta undergoes a variety of changes. In particular, its thickness and structure change. This happens due to the maturation and "wear" of the placenta.
The nature of the changes that occur with the placenta at a certain gestational age, their correspondence this deadline, pathological changes - all this is established using ultrasound. They are determined by the method of studying the echogenic structure and density of the placenta. That is why doctors call this parameter “ultrasound”.
The degree of maturity of the placenta is the structure of this organ at a certain stage in the development of pregnancy.
In this regard, there are four main degrees of placental maturity:
- Zero. If there are no health problems for the woman and the pregnancy is proceeding normally, the placenta will be at zero maturity until the 30th week. At this time, the placental membrane is straight and smooth, and its structure is homogeneous.
- the first. At this time, the chorionic membrane of the placenta is slightly wavy, and separate echogenic inclusions appear in its structure. Normally, the first degree lasts until the 34th week.
- Second. Valid up to 37 weeks of pregnancy. At this time, the placenta is already thinning in some places, begins to become covered with lime (salt) deposits. However, this does not interfere with the performance of its functions. Especially if everything goes on time. At this degree of maturity of the placenta, the depressions in the membrane have already increased. But they have not yet reached the basal layer. In addition, multiple linear echogenic zones are visible.
- third. In this degree of maturity, the placenta should normally remain from the 37th week of pregnancy until the moment of delivery. At this time, the structure of the placenta becomes lobulated, and the depressions reach the basal layer. Echogenic zones in the structure are large and partly merged.
What is premature aging of the placenta?
Immediately before childbirth, the physiological aging of the placenta occurs, which is accompanied by a decrease in the area of the exchange surface of the placenta, as well as the deposition of salts. But if signs of one degree of maturity appear in those time frames in which they should not appear, they speak of premature aging of the placenta. For example, if at a period of 32-33 weeks of pregnancy, a verdict “second degree” is issued by an uzist specialist, then the situation needs to be taken under control. As a rule, in such situations, a woman is sent for dopplerography and begins to observe the uteroplacental blood flow.
With premature aging of the placenta, doctors, in most cases, recommend going to the hospital, where to undergo appropriate treatment. There, measures will be taken to reduce uterine hypertonicity, which will allow the child to more easily extract nutrients, as well as to improve blood circulation. To avoid intrauterine ( oxygen starvation) expectant mothers are advised to breathe fresh air as much as possible. If premature aging of the placenta is observed, but the blood flow is not disturbed, the woman will be prescribed prophylactic treatment to improve the functions of the placenta.
The rapid aging of the placenta, among other things, indicates that during the period of pregnancy a woman has repeatedly suffered various infectious diseases or has bad habits(smoking, drinking alcohol). You also need to know that if a woman is diagnosed with diseases such as diabetes, intrauterine infection, and also if the pregnancy is complicated between maternal organism and the fetus, then the indicators of the degree of maturity of the placenta may exceed the allowable.
There is also a late maturation of the placenta, although such cases are much less common than premature. Sometimes this indicates congenital malformations of the fetus.
Based on the above, we can conclude that the degree of maturity of the placenta is a very important indicator. Therefore, it is very important to visit a doctor and conduct an ultrasound examination on time in order to avoid problems with the health of the baby. May he develop safely and be born healthy!
Specially for Olga Rizak
- this is a unique organ, the life expectancy of which is only 40 weeks - the gestational age. We can say that the placenta is a temporary organ, which is absolutely necessary exclusively for growth and development in the womb. After childbirth, the placenta becomes unnecessary, so it is also removed from the uterus. However, like any other organ, the placenta goes through all stages - from birth to death. The death of the placenta is the moment of separation from the walls of the uterus after the birth of the child. But the life stages of the placenta - birth, growth, maturity, aging and death - occur within 40 weeks.
The term "degree of maturity" of the placenta reflects a certain stage of development and physiological changes in this organ. In fact, the degree of maturity is the stage of aging of the placenta. Each degree of maturity corresponds to certain structural features of the placenta and thickness. There are currently four grades placental maturity, denoted by Arabic numerals 0, 1, 2 and 3. In this case, the youngest placenta corresponds to the degree of maturity 0, and the oldest - 3.
The aging of the placenta occurs gradually, with each of the four degrees of maturity corresponding to a certain gestational age. This can be compared with the fact that signs of aging of organs and systems are recorded in the body at a certain age. If such signs appear before the age for which they are characteristic, then they speak of premature aging. The same is true for the placenta, it's just that its age is calculated by weeks of pregnancy.
Thus, at each gestational age, the placenta must be a certain degree of maturity. Today, clear standards for the correspondence of the degrees of maturity of the placenta and the duration of pregnancy have been defined:
- Up to 30 weeks of pregnancy, the degree of maturity of the placenta should be 0;
- From the 27th to the 36th week of pregnancy, the degree of maturity of the placenta 1;
- From the 34th to the 39th week of pregnancy, the degree of maturity of the placenta is 2;
- From the 37th to the 40th week of pregnancy, the degree of maturity of the placenta is 3.
If the degree of maturity of the placenta at any gestational age is greater than it should be (for example, at the 26th week of pregnancy 1 or 2 degree of maturity), then doctors talk about premature aging (maturation) of the organ. Such premature aging of the placenta is a sign of fetoplacental insufficiency, which leads to a deficiency of nutrients and oxygen delivered to the fetus and, accordingly, to a delay in its development. In addition, fetoplacental insufficiency can cause the threat of premature birth, intrauterine death of the fetus and other terrible complications of pregnancy. Therefore, premature aging of the placenta requires treatment in the conditions of the pregnancy pathology department.
As the fetus develops in the mother's womb, the structure of the placental tissue also changes. One of the important indicators of the placenta evaluated by doctors is its maturity. This article will tell you more about what the second degree of placental maturity means and what week of pregnancy it normally corresponds to.
What does it mean?
Doctors distinguish several degrees of placental maturity, which correspond to certain stages of pregnancy. Determination of the degree of maturity of the placental tissue is necessarily carried out during a comprehensive examination of the expectant mother during different terms pregnancy.
The general classification of the degrees of maturity of the placenta provides for 4 gradations - from zero to third. It is believed that the older the placenta, the less functions it is able to perform. This is understandable, since the female body, by the end of pregnancy, gradually begins to prepare for childbirth, after which the placenta is not needed.
Placenta needed children's body only during his intrauterine life. After birth, the baby can already exist independently. By the time of birth, he had already formed internal organs and systems, which means that the child can breathe and process independently all the nutrients he needs for nutrition and growth. During pregnancy, placental tissue took an active part in providing these functions.
Each period of pregnancy should correspond to a certain maturity of the placenta. If this does not happen, then, as a rule, the course of physiological pregnancy is disturbed. A variety of causes and pathologies observed in the body of a future mother can lead to early "aging" of the placental tissue. In such a situation, doctors carefully monitor the condition of the pregnant woman and her baby, and also plan further pregnancy management.
If the second degree of placental maturity in a woman was detected much earlier than the due date, then in the future expectant mother a number of recommendations are given. So, she should carefully monitor her general condition and the well-being of the child.
If the placental tissue ceases to fully perform its functions due to excessively early "aging", then in such a situation the child in the mother's womb will begin to experience some discomfort. This can cause the baby's heart rate to change or physical activity. In such a situation, a mandatory consultation with an obstetrician-gynecologist and a possible change in the tactics of further pregnancy management are required.
In some cases, with excessively early maturation of the placenta to 2-3 degrees of maturity, the expectant mother must be hospitalized in a hospital. There, a woman can stay until the very birth. This usually happens if the course of pregnancy is greatly complicated and there is a threat of premature birth.
Norm
Placental tissue that has reached stage 2 of maturity is also called mature. The characteristic changes that have occurred in the placenta are considered normal for a period of 34-39 weeks of pregnancy.
It is important to note that these data are averages. So, if a future mother who is already carrying a baby for 32-33 weeks of pregnancy has a 2nd degree of placental maturity, then she should not panic. In this situation, doctors also necessarily evaluate how a particular pregnancy proceeds in general. If the fetus develops well, and his mother does not have any adverse symptoms, then such a somewhat early maturation of the placenta does not threaten anything dangerous.
How to determine?
Determination of the degree of maturity of the placenta is carried out by performing an ultrasound examination. Modern ultrasound machines make it possible to study placental tissue in pregnant women quite accurately. The indicators obtained as a result of the study are quite informative.
In order for the doctor to be able to determine the 2-3 degree of placental maturity, he must note several clinical signs. So, an ultrasound specialist necessarily evaluates the structure of the placental tissue. In earlier pregnancy, the placenta has a smooth and even surface. None external signs there are no changes to it. As the pregnancy progresses, the structure of the placental tissue also changes - it becomes more uneven and even rough.
The placenta, which has a 2 degree of maturity, has depressions and grooves on the outer surface. Its thickness gradually begins to decrease. The recesses that appear in the placental tissue are quite deep and extend inside the placenta almost to the basement membrane. During the ultrasound examination of the placental tissue, the specialist also determines the presence of multiple linear bands of echogenic zones.
As the placenta matures, special compacted areas begin to appear in it - calcifications. The placenta of the 2nd degree of maturity with calcifications is considered quite normal. The appearance of dense areas in the placental tissue is associated with ongoing changes in the placenta in the final trimester of pregnancy.
The appearance of calcifications in the placental tissue at 34-39 weeks of gestation is quite normal. Many expectant mothers begin to worry about this when they find out about such an ultrasonic “find”. They worry that the child's blood flow may be disturbed, however, even if there are calcifications at this time, the placental tissue is able to perform its functions provided by nature.
During a routine ultrasound examination, during which the doctor determines the main clinical parameters of the placenta, dopplerography is also performed. It is usually performed during an ultrasound examination by the same specialist. The purpose of the Doppler study is to determine the blood flow in the main blood vessels that provide blood supply to the fetus in the uterus.
With Doppler ultrasound, the doctor can assess how well the uteroplacental blood flow is functioning. With premature aging of the placenta, it can worsen, which can also negatively affect the well-being of the fetus. Also, with the help of a Doppler study, doctors can determine the development of fetoplacental insufficiency - a dangerous condition that can lead to a violation of the course of intrauterine development in the fetus. This pathology can also develop with too early maturation of the placenta to 2-3 degrees in early pregnancy.
Determining the degree of maturity of the placenta is a very important clinical sign.
In order to timely identify various disorders and pathologically early maturation of the placenta to the 2nd degree of maturity, the expectant mother must definitely undergo ultrasound examinations. This must be done within the stipulated time frame.
To assess the state of placental tissue, it is very important to conduct dynamic monitoring. This means that during the final period of pregnancy, women who have been found to have an excessively early maturation of the placenta may be prescribed several repeated ultrasound research. This is necessary so that doctors can timely identify dangerous complications that can occur with this condition. This will allow doctors to intervene in a timely manner and choose the optimal tactics for further pregnancy management, as well as determine the correct method of obstetric care in a particular case.
In order for the placenta to reach stage 2 of maturity only by due date pregnancy, the expectant mother should follow a number of recommendations and conduct healthy lifestyle life. Scientists have found that active smoking can lead to excessively early maturation of the placenta. All bad habits for expectant mothers during the bearing of their babies should be excluded.
The normal functioning of the placental tissue will be facilitated by a balanced diet, good sleep, the elimination of stress, as well as regular walks in the fresh air.
What is the placenta and what functions does it perform, see below.
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