What does attaching to the front wall mean? Is placenta previa along the anterior wall a pathology or a slight deviation from the norm? Features of the anterior location of the placenta

Without the normal functioning of the placenta, it is impossible to imagine the full growth and development of the baby. This article will help you understand what placenta previa on the anterior wall of the uterus means and what it affects.

What it is?

To ensure the vital activity of the chorion, and subsequently the fetus, adequate blood flow is required. The baby can get all the nutrients and oxygen through the uteroplacental artery system. They pass through the placenta in large quantities, ensuring the growth and development of the fetus.

The main function, which is inherent in placental tissue by nature, is to provide the fetus with nutritional components, as well as its protection from external influences. The intrauterine development of the fetus largely depends on how the placenta is located. At a certain stage of pregnancy, fetal movements help determine the intensity of fetal growth.

The intensity of the baby’s intrauterine development also depends on how the placenta is attached. The attachment of placental tissue is determined, in fact, from the first weeks of pregnancy. The location of implantation of the fertilized egg influences where the placental tissue will be located.

The placenta is most often located along the posterior wall of the uterus in the area of its fundus. In some cases, it can be located in the area of the side walls - either right or left. If there is a lot of placental tissue, then it can attach to several uterine walls at once.

This physiological location of the placenta is explained quite simply. The blood supply in the area of the fundus of the uterus and its posterior wall is quite well expressed. This helps the fetus to grow quickly and intensively.

Obstetricians and gynecologists note that the placenta in some cases can also attach to the anterior wall of the uterus. It should be noted that this is much less common.

The normal attachment of the placenta along the posterior wall is not randomly determined by nature. This arrangement is more beneficial for the intrauterine development of the fetus.

Placental tissue can be attached in different parts of the uterus. So, most often it is attached to the bottom. However, under certain conditions, the laying of placental tissue occurs lower - in the area of the lower segment of the uterus. Too low a location of the placental tissue is fraught with the development of its presentation.

Doctors consider placenta previa to be a pathology when the placental tissue is in close proximity to the internal os of the uterus. Normally, there is a certain distance between them. So, in the 2nd trimester, the placental tissue is normally 5 cm higher than the internal os. If this distance is significantly reduced, then this pathological condition is called presentation.

Doctors distinguish several clinical variants of placental tissue previa. Thus, placenta previa can be central, marginal or lateral. The different clinical variants of this pathology are determined by the wall to which the placental tissue is attached.

Why is this happening?

The placenta is attached to the anterior wall of the uterus from the very early stages of pregnancy. This happens quite simply. For certain reasons, a fertilized egg cannot attach to the fundus of the uterus and begins to sink lower. So it descends almost to the internal pharynx, where its implantation occurs.

The development of anterior placenta previa can contribute to various gynecological diseases. Chronic inflammation that occurs in the reproductive organs of a woman leads to their damage. In this case, the mucous membrane lining the inner surface of the uterus changes. Such changes contribute to the fact that a fertilized egg can attach in the lower sections.

The placenta can be attached to the anterior wall of the uterus even if the woman has undergone a number of gynecological operations. So, curettage or the consequences of surgical abortions can contribute to the development of this type of presentation.

Doctors note that the risk of developing placenta previa is slightly higher in multiparous women. If at the same time a woman has a burdened obstetric and gynecological history, then the likelihood of anterior presentation of placental tissue increases several times.

Various congenital pathologies of the reproductive organs can also contribute to the development of this pathology. Placenta previa can occur in women suffering from uterine hypoplasia. Anatomical defects in the structure of the uterus can also contribute to the development of this pathology.

Features of this location

Attachment of placental tissue along the anterior wall is less physiological. This arrangement of placental tissue has both disadvantages and advantages. There are far fewer pros than cons.

It should also be noted that such a clinical situation requires a certain medical approach. A pregnant woman who has such a location of the placenta requires quite close monitoring by doctors.

pros

The advantages of anterior placenta previa include the possibility of migration. During the several months of waiting for the baby to be born, the placental tissue may change its position. Doctors note that the placental tissue with anterior placenta previa moves much more easily than with a posterior one.

Minuses

It is noted that the placenta is extremely rarely attached to the anterior wall of the uterus. This feature has important biological significance. This is explained quite simply. Placental tissue is very delicate. It can be easily damaged due to various external traumatic influences.

The location of the placenta on the anterior wall of the uterus can be dangerous due to the development of its detachment. In this case, abdominal injuries can contribute to the development of dangerous uterine bleeding. If it is too intense, then in such a situation acute oxygen starvation of the fetus may develop, which means there will be a severe threat to the baby’s life.

Is placenta migration possible?

Migration is a change in the original location of the placenta. Experts believe that a change in the localization of placental tissue during presentation along the anterior wall is possible. Pregnant women and doctors are usually warned about this when consulting them.

If placenta previa is detected to the anterior wall in the early stages of pregnancy, the expectant mother should not panic first of all. There is still quite a long way to go before birth occurs. During this time, the placental tissue can shift and even significantly change its position.

Such changes are assessed through ultrasound. As a rule, to track dynamics, doctors prescribe several sequential ultrasound examinations. When placental tissue previa is present, vaginal examinations should often not be performed. The lower the placenta is, the higher the likelihood of damage. Tracking the dynamics of the location of placental tissue during presentation is very important. It helps doctors timely identify developing complications and take the necessary measures to improve the situation.

It should be noted that in most cases the placental tissue changes its position rather slowly. It is optimal if this process occurs in the female body within 6-10 weeks. In this case, the likelihood that the expectant mother will experience any significant discomfort symptoms is quite low. Typically, migration of placental tissue is completely completed by the middle of the 3rd trimester of pregnancy.

If the placental tissue shifts too quickly for some reason, adverse symptoms may occur. The most dangerous of them are the development of bleeding and detachment of placental tissue from the uterine wall. As a rule, adverse symptoms develop if the placenta migrates within 1-2 weeks. The speed of placental migration depends on many factors and reasons, including how high the placental tissue was originally located.

Consequences

During a pregnancy that occurs with the development of anterior placenta previa, you can expect various surprises. Typically, adverse symptoms begin to develop from the 2nd trimester of pregnancy. The course of the 3rd trimester can also be complicated by the development of a number of pathologies.

Expectant mothers should remember that The presence of placenta previa is not a death sentence for the birth of a healthy child. Quite a few women have already encountered this pathology and given birth to their healthy, long-awaited babies.

It is important to remember that such a “special” pregnancy requires only a more attentive attitude of the expectant mother to her health, as well as careful monitoring of the course of intrauterine development of the fetus by specialists.

With a low location of the placenta and its presentation, the most dangerous complication is, perhaps, the development of bleeding. If it's strong enough, it won't go unnoticed. In this situation, a woman notices the appearance of blood from the genital tract. The severity of bleeding can vary, the color of the blood ranges from bright red to dark brown. In this situation, the main thing is to remember that when such bleeding appears, women with placenta previa should immediately seek advice from an obstetrician-gynecologist.

Placental abruption is another complication that can develop during such a pregnancy. The severity of the resulting disorders in this case largely depends on how much the placenta has separated from the uterine wall.

If this area is small, then the detachment can only be detected through ultrasound. In this case, the woman may not even experience bleeding from the genital tract, or it will be so insignificant that it will go unnoticed.

If the placental tissue exfoliates quite strongly, then in such a situation it is already possible to suspect this condition based on clinical symptoms. So, the expectant mother begins to feel pretty bad. She experiences severe weakness, pain in the abdomen may develop, and bloody discharge from the genital tract may also appear.

Severe placental abruption is also dangerous and a violation of the general condition of the fetus. Disruption of oxygen supply leads to the fact that the fetus begins to experience hypoxia - oxygen starvation. This situation, as a rule, contributes to the fact that the clinical parameters of the fetus change. Thus, his heart rate and motor activity change significantly.

If severe placental abruption develops, a pregnant woman must be urgently hospitalized in a hospital. The further algorithm of medical actions will largely depend on the length of pregnancy.

If the threat to the life of the mother or fetus is too high, doctors will be forced to resort to emergency obstetric care. This is carried out according to vital indications.

How is childbirth?

The choice of obstetric care tactics for placenta previa is, as a rule, quite responsible. The life and health of the expectant mother and her baby depend on this.

It should be noted that nowadays, more and more often, obstetricians-gynecologists give their preference to the surgical method of childbirth, choosing a caesarean section. In this situation, the risk of developing birth injuries and damage is much lower. Of course, a caesarean section has certain disadvantages, since it is essentially a surgical operation.

However, with placenta previa, preserving the baby’s life is important.

The placenta is an important organ that forms and develops only during pregnancy. The placenta is a kind of connecting element between mother and baby. Through this important organ, the child receives oxygen and nutrients. The baby receives antibodies, as well as hormones that are responsible for the preservation of pregnancy and the normal development of the unborn child.

The formation of the placenta begins a week after fertilization, and after birth, within half an hour it leaves the uterus, having completed all its functions.

Many pregnant women are interested in the question of the correct location of this organ. Usually located or back, closer to the bottom of the uterus. This arrangement ensures the safety of this organ and the performance of its necessary function.

The location of the placenta depends on where the fertilized egg is implanted after conception. You can find out placentation through ultrasound.

The position of the placenta in the uterus can be as follows:

Placenta on the anterior wall;

Placenta on the posterior wall;

Placenta in the fundus of the uterus;

Placenta in the lateral wall.

All of the above points are normal and do not pose any threat to both the mother and the fetus.

The placenta along the anterior wall can pose a threat only in case of surgical delivery (cesarean section). This is associated with an increased risk of possible bleeding. The placenta on the front wall of the uterus may be located exactly in the place where the doctor needs to make an incision to remove the baby.

If you are having a caesarean section and have anterior placentation, there is no need to worry in advance. Surgeons will definitely take all necessary measures to reduce the risk, and in case of bleeding they will be able to quickly stop it.

In some cases, abnormal (incorrect) attachment of the placenta is possible.

A low position of the placenta is a pathology in which the connecting organ between the mother and the fetus is located at a level of six centimeters or less from the internal cervical os. It does not matter where the placenta is located: on the front wall, on the side or on the back. The distance to the cervix plays a role. In most cases, it does not pose a threat, since with the growth of the abdomen it moves higher, to the bottom of the uterus.

Placenta previa is an arrangement in which the internal os is blocked (partially or completely). There are three types of presentation: marginal, lateral and complete.

In case of complete presentation, the mother undergoes a planned cesarean section at 38 weeks of pregnancy. If a marginal or lateral presentation is observed, the pregnant woman can give birth on her own if the doctor makes such a decision after examination. In this case, during spontaneous childbirth, opening of the amniotic sac at an early stage is indicated, as well as full readiness of the operating room in case of unforeseen circumstances.

If the placenta is located on the anterior wall of the uterus, lateral or posterior, closer to the fundus of the uterus, then this is normal. Such a pregnant woman can carry and give birth to a child on her own. If you have a low position of the placenta or its presentation, you need constant monitoring and observation by your attending physician, who will be able to make an adequate decision on the issue of delivery.

The placenta is a “bridge” from the mother’s body to the child, which supplies oxygen and all the necessary substances for its development. This mediator also removes toxins, waste products from the embryo, thus protecting it. Due to the importance of the placenta, doctors closely monitor its condition and location. Let's figure out what the placenta on the anterior wall should be like normally and what it is.

How should it be positioned?

For the proper growth and development of the baby, it is important that the placenta is formed properly. Its location is an important factor in the proper course of pregnancy.

Ideally, the placenta should be attached to the back wall of the uterus, in its upper part and closer to the bottom. After all, as the fetus grows, the walls of the uterus stretch very much. But not evenly, but more along the front wall. It thins out significantly. The back wall remains dense and less susceptible to stretching.

Therefore, the attachment of the embryo to the back wall is considered natural and normal, because the placenta does not have the properties of stretching. That is, the placenta along the back wall is less subject to loads that burden it. This means that the attachment of the fetus along the back wall and the development of the placenta is ideal.

Options for placing the placenta can be different: lateral attachment (to the right or left of the back wall), on the anterior wall of the uterus. The last option is the most dangerous. After all, the placenta on the anterior wall is subject to heavy loads due to uterine distension, the activity of the fetus and mother. This is a risk of damage to the placenta or its premature detachment. Also, the placenta can descend close to the pharynx of the uterus, and can block the exit to the birth canal.

Causes of anterior presentation

Why does placenta previa occur along the anterior wall? The reasons for this are not entirely understood. One of the main ones is damage (to the inner layer of the uterus). That is, the consequences of inflammation, curettage, scars from operations. The cause of placenta previa along the anterior wall may be other pathologies. By the way, in primiparous women this pathology is detected much less frequently than in second and third births. Gynecologists explain this by the condition of the inner lining of the uterus.

But the cause of this pathology may not only be the mother. Sometimes the problem lies in the development of the fertilized egg. Developmental lag contributes to the fact that it does not have time to penetrate the endometrium. Implantation then occurs in the lower part of the uterus.

Often the fertilized egg is attached to the anterior wall of the uterus, but in its upper part. Then the placenta migrates down.

Diagnostics

Anterior placenta previa is diagnosed in several ways. Palpation gives different sensations with complete and partial presentation. In the first case, the gynecologist feels to the touch that the os of the uterus is completely blocked by the placenta. If the presentation is partial, then the doctor feels the placental tissue and membranes. But the lateral and marginal presentation are equally perceived during examination. That is, the doctor, without additional research, will not be able to determine what type of partial presentation we are talking about. This study is an ultrasound. Therefore, expectant mothers are strongly recommended to attend all scheduled examinations and ultrasound examinations.

Treatment of pregnant women with anterior presentation

The treatment process means constant monitoring and observation by a gynecologist, timely and sometimes additional studies. At the same time, not only the state of the placenta, but also the pregnant woman is monitored. In anterior presentation, blood tests check for hemoglobin and blood clotting. After all, anemia or blood incoagulability can be fatal for a woman in the event of bleeding.

If this happens for more than 24 weeks, the woman is admitted to the hospital. At the same time, the hospital must have an intensive care unit in case of large blood loss. The main purpose of such women is absolute peace. After the bleeding stops, as a rule, the woman is left in the hospital until delivery, because she needs to be monitored regularly and often. Usually doctors successfully prolong pregnancy at least until the period when the life of the fetus can be saved.

So, if you have anterior placenta previa, then you should take care of yourself as much as possible. You must protect your stomach, move carefully and avoid any impact on it. Let it even be the desire of one of your relatives to stroke your belly with the best intentions. This is especially dangerous in the later stages, because it can cause false,.

Be healthy and calm!

Especially for Elena TOLOCHIK

The placenta is a unique organ that appears in a woman’s body only during pregnancy. Its main purpose is to ensure the connection of the fetus with the maternal body and supply it with all the substances necessary for development. The placenta begins to develop from the first week of pregnancy, and its complete formation ends at 15-16 weeks. Where the egg is located during fertilization will determine where the “baby spot” will attach. As a rule, this is the posterior or anterior wall of the uterus. It is generally believed that the first option is optimal for the development of the baby. If a diagnosis of “placenta along the anterior wall” is made, then some difficulties may arise during pregnancy. Although in most cases this does not in any way affect the process of bearing a child or natural childbirth.

Risks of this pathology

If the placenta is located on the anterior wall of the uterus, then it can cause the following complications:

Who is susceptible to this pathology?

As a rule, the placenta is attached to the anterior wall in multiparous women. After all, with each subsequent pregnancy, the muscle fibers of the uterus stretch more and more. This especially applies to the anterior section of the uterus, which explains the possible risks of this pathology.

Placenta along the anterior wall: diagnosis

The location of the baby's place can only be determined as a result of a modern ultrasound examination, which expectant mothers must undergo at least 3 times during the entire pregnancy. The placenta is clearly visualized from the 14th week.

The placenta is an important organ whose main purpose is to connect the blood circulation of mother and child during pregnancy. The first signs of the placenta appear at the very beginning of the period, but this organ acquires its final appearance only by the 16th week. From the placenta to the baby, 2 arteries and 1 vein are sent along the umbilical cord (sometimes it happens). Thanks to these vessels, the child is fed, waste products are removed from his body, there is a constant supply of oxygen to the fetal cells and protection from major infections.

Where should the placenta be located?

The placenta is located where the fertilized egg is attached to the wall of the uterus after the end of the movement through the fallopian tube.

Positive aspects of the location of the organ along the posterior wall of the uterus

This does not mean that women who have been diagnosed with a placenta along the anterior wall of the uterus during pregnancy need urgent treatment! Just such a pregnant woman should know what possible complications can be in this case.

There are a lot of options for attaching the placenta and they depend only on the individual characteristics of the organism of the expectant mother. This may be the bottom of the uterus, completely left or right side of the uterus, the back wall. You can find out how the baby's place is located in your case with the help of the second planned ultrasound at 19-24 weeks of pregnancy.

If the placenta is located on the anterior wall of the uterus

In such cases, there are some inconveniences:

it is difficult for the obstetrician to listen to the fetal heartbeat,
it is more difficult to palpate the position of the baby in the uterus,
the expectant mother will feel the baby's movements less clearly and the first tremors may begin later than usual (18-22 weeks), because the placenta in this location acts as a "pillow", which reduces sensitivity.

But, despite these inconveniences, in itself, such an arrangement is not dangerous for the health of the pregnant woman and the fetus.

In very rare cases, complications occur:

The likelihood of placenta previa increases. Here you need to use your imagination. Imagine (for greater clarity, use the pictures above) that the placenta is attached to the posterior wall of the uterus very low to the internal os (read). As the abdomen grows, it will rise and by the time of birth, in most cases, it will already be at a safe distance from the pharynx. But if the baby’s place is located low and on the front wall, then over time the uterus will grow and the placenta will shift, increasing the likelihood that it will completely or partially block the internal os. In this situation, the obstetrician-gynecologist will decide in favor of a cesarean section in order to protect the woman in labor from possible bleeding. Therefore, with this location of the placenta, special attention should be paid to the distance to the internal os of the uterus.
If a woman has had a cesarean section or other uterine surgery in the past, the likelihood of placenta accreta increases.
The risk increases. The child in the womb leads an active life: he moves, pushes, squeezes the umbilical cord. This is not dangerous, but if the child seat is secured to the front wall, the risk of detachment increases. When the due date approaches, training contractions may occur and excessive contractions in the unusual location of this organ also increase the likelihood of abruption.

Don’t be scared and try on all possible complications for yourself. They are very rare, in 1-3% of pregnancies; in other cases, childbirth occurs safely naturally.