What does front wall attachment mean? Placenta previa on 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 in the future, the fetus, a full blood flow is required. The baby can receive all the nutrients and oxygen through the system of uteroplacental arteries. They pass through the placenta in large numbers, ensuring the growth and development of the fetus.

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

Enter the first day of your last menstrual period

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 30

The rate of intrauterine development of the baby also depends on how the placenta is attached. Attachment of placental tissue is determined, in fact, from the first weeks of pregnancy. The location of implantation of a fertilized egg affects where the placental tissue will be located.

The placenta is most often located on the back wall of the uterus in the region of its bottom. In some cases, it can also be located in the region of the side walls - either right or left. If there is a lot of placental tissue, then it can be attached 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 in some cases the placenta 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 back wall is due to nature not by chance. 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 below - in the region of the lower segment of the uterus. Too low 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 presentation. So, placenta previa can be central, marginal or lateral. Different clinical variants of this pathology are due to which wall the placental tissue is attached to.

Why is this happening?

Attachment of the placenta to the anterior wall of the uterus is due already from the earliest stages of pregnancy. It happens quite simply. A fertilized egg, for some reason, cannot attach to the bottom of the uterus and begins to sink lower. So she descends almost to the internal pharynx, where her implantation takes place.

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. The pros are much less than the cons.

It should also be noted that such a clinical situation requires a specific medical approach. For a pregnant woman who has such an arrangement of the placenta, quite careful monitoring by doctors is required.

pros

The advantages of anterior placenta previa include the possibility of migration. During several months of waiting for the baby to be born, the placental tissue can change its position. Doctors note that the placental tissue with anterior placenta previa is much easier to move than with the posterior one.

Minuses

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

The location of the placenta along the anterior wall of the uterus can be dangerous for the development of its detachment. In this case, abdominal trauma 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 that there will be a strong threat to the life of the baby.

Is it possible for the placenta to migrate?

Migration is considered to be 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. This is usually warned by pregnant women and doctors when contacting them for advice.

When a placenta previa to the anterior wall is detected in the early stages of pregnancy, the expectant mother should not panic first of all. Before the onset of childbirth is still quite far away. During this time, the placental tissue can shift and even significantly change its position.

Such changes are assessed through ultrasound. As a rule, doctors prescribe several consecutive ultrasound examinations to track the dynamics. With placental tissue previa, vaginal examinations often should not be performed. The lower the placenta is, the more likely it is to be damaged. Tracking the dynamics of the location of the placental tissue during presentation is very important. It helps doctors detect developing complications in a timely manner 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 pronounced uncomfortable symptoms is quite low. Usually, the migration of placental tissue is completely completed by the middle of the 3rd trimester of pregnancy.

If for some reason the placental tissue moves too quickly, adverse symptoms may also 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 migration of the placenta occurs in 1-2 weeks. The rate of placental migration depends on many factors and reasons, including how high the placental tissue was initially located.

Effects

During a pregnancy that occurs with the development of anterior placenta previa, various surprises can be expected. Usually 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 sentence for the birth of a healthy child. Quite a few women have already encountered such a pathology, who gave birth to their healthy, long-awaited babies.

It is important to remember that such a “special” pregnancy only requires a more careful 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 be different, the color of the blood - from bright red to dark brown. In this situation, the main thing is to remember that when such bleeding occurs, 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 exfoliated from the uterine wall.

If this area is small, then detachment can only be detected through ultrasound. In this case, a woman may not even have spotting from the genital tract, or they will be so insignificant that they will be ignored.

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

Severe placental abruption is also dangerous and a violation of the general condition of the fetus. Violation 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. So, his heart rate and motor activity significantly change.

With the development of severe placental abruption, a pregnant woman needs to be urgently hospitalized in a hospital. The further algorithm of medical actions will largely depend on what the gestational age is.

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

How is childbirth going?

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

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

However, with placenta previa, saving the life of the baby 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 safety of the pregnancy and the normal development of the unborn child.

The formation of the placenta begins a week after fertilization, and after childbirth, 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 body and the performance of its necessary function.

The location of the placenta depends on where the fertilized egg will attach 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 back wall;

Placenta in the fundus of the uterus;

Placenta in the lateral wall.

All of the above items 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 the case of operative delivery (caesarean section). This is associated with an increased risk of possible bleeding. The placenta on the front wall of the uterus can be located exactly in the place where the doctor needs to make an incision to remove the baby.

If you are going to have a caesarean section and you have an anterior placentation, there is no need to worry in advance. Surgeons will necessarily take all necessary measures in order 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.

The 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 a location in which the internal os is blocked (partially or completely). There are three types of presentation: marginal, lateral and complete.

With full presentation, the woman in labor is scheduled for a caesarean section at 38 weeks of gestation. If there is a marginal or lateral presentation, the pregnant woman can give birth on her own, if such a decision is made by the doctor after the examination. In this case, with independent childbirth, the opening of the fetal bladder at an early stage is shown, as well as the 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 bottom of the uterus, then this is the norm. Such a pregnant woman can bear and give birth to a child on her own. If you have a low position of the placenta or placenta previa, you need constant monitoring and supervision by your doctor, who can 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 intermediary also removes toxins, the waste products of 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 norm should be and what the placenta is along the anterior wall.

How should it be located?

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. Indeed, as the fetus grows, the walls of the uterus are very stretched. But not evenly, but more along the front wall. She thins out considerably. The back wall remains dense and less prone 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 the 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 is placenta previa along the anterior wall? The reasons for this are not well understood. One of the main ones is damage (of 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 its other pathologies. By the way, in primiparous women, this pathology is found much less frequently than in the second, third births. Gynecologists explain this by the state of the inner lining of the uterus.

But the cause of this pathology can be not only mother. Sometimes the problem lies in the development of the fetal egg. The developmental delay contributes to the fact that it does not have time to infiltrate the endometrium on time. Then implantation takes place in the lower part of the uterus.

Often the fetal 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 full and partial presentation. In the first case, the gynecologist feels to the touch that the cervix of the uterus is completely blocked by the placenta. If the presentation is partial, then the doctor feels the placental tissue and fetal membranes. But the lateral and marginal presentations are equally perceived during examination. That is, a doctor without additional research will not be able to determine what kind of partial presentation in question. 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 an anterior presentation, blood tests are checked for hemoglobin and blood clotting. After all, anemia or blood incoagulability can be fatal for a woman in case of bleeding.

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

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

Be healthy and calm!

Specially 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 mother's body and supply it with all the substances necessary for development. The placenta begins to develop from the first week of pregnancy, and its full formation ends at a period of 15-16 weeks. Where the egg is located during fertilization will determine where the “baby place” 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 the diagnosis "placenta on the anterior wall" is made, then some difficulties may arise during pregnancy. Although in most cases this does not affect either the process of bearing a child or natural childbirth.

The 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 affected by this pathology?

As a rule, the placenta is attached to the anterior wall in multiparous women. Indeed, with each subsequent pregnancy, the muscle fibers of the uterus are stretched more and more. This is especially true for the anterior part of the uterus, which explains the possible risks of this pathology.

Placenta along the anterior wall: diagnosis

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

The placenta is an important organ, the main purpose of which is to connect the blood circulation of the mother and child during pregnancy. The first signs of the placenta are laid at the very beginning of the term, but this organ acquires its final form 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 cells of the fetus 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 body on the back 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:

1. it is difficult for the obstetrician to listen to the fetal heartbeat,
2. it is more difficult to palpate the position of the child in the uterus,
3. 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:

1. Increased chance of placenta previa. Here you need to connect your imagination. Imagine (for greater clarity, use the drawings above) that the placenta is attached to the back wall of the uterus very low to the internal pharynx (read). As the belly grows, it will rise and by childbirth, in most cases, it will already be at a safe distance from the pharynx. But if the child's place is located low and on the front wall, then over time the uterus will grow and the placenta will move, it increases the likelihood that it will completely or partially block the internal pharynx. In this situation, the obstetrician-gynecologist will decide in favor of a caesarean 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.
2. If a woman has had a caesarean section or other operation "on the uterus" in the past, then the likelihood of placenta accreta increases.
3. The risk rises. A child in the womb leads an active life: he moves, pushes, squeezes the umbilical cord. This is not dangerous, but if the child's place is fixed along the front wall, the risk of detachment increases. When the time of delivery approaches, training contractions can occur and excessive contractions with an unusual location of this organ also increase the likelihood of detachment.

Do not be afraid and try on all possible complications for yourself. They are very rare, in 1-3% of pregnancies, in other cases, childbirth takes place safely in a natural way.