Attachment of the embryo to the anterior wall of the uterus. Is placenta previa along the anterior wall a pathology or a slight deviation from the norm? Correct placement of the placenta
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 forms 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 posterior wall is considered natural and normal, because the placenta does not have stretching properties. That is, the placenta along the posterior wall is less subject to loads that burden it. This means that the ideal is for the fetus to attach along the posterior wall and develop the placenta.
Options for placing the placenta can be different: lateral attachment (to the right or left of the back wall), on the front 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 stretching of the uterus, activity of the fetus and mother. This is a risk of damage to the placenta or its premature detachment. Also, the placenta may descend close to the os of the uterus, or may 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 lateral and marginal presentation are perceived equally upon examination. That is, the doctor, without additional research, will not be able to determine what type of partial presentation we are talking about. This test 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 condition of the placenta is monitored, but also the condition of the pregnant woman. 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 beyond 24 weeks, the woman is admitted to hospital. At the same time, the hospital must have an intensive care unit in case of large blood loss. The main purpose for 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 formed in the first weeks of pregnancy and acts as a conductor of nutrients and oxygen to the fetus and removal of waste products, and also serves as a barrier to infections.
There are several options for its attachment in the uterus. One of them is the location on the front wall. Having heard such a verdict from a doctor, it is important for a woman to know how this threatens the normal course of pregnancy and the development of the child.
From a physiological point of view, the most optimal is the attachment of the placenta along the posterior wall. The fact is that during pregnancy the walls of the uterus stretch unevenly. As the child grows, the front wall increases in size and stretches, while the back wall retains its density and stretches much less.
The front wall becomes thinner as it stretches. From here it becomes clear that for the normal functioning of the placenta, a location along the rear wall is more advantageous, since this way it is exposed to a minimum of stress.
Advantages of location on the rear wall
- The placenta is ensured immobility - placenta previa on the posterior wall is extremely rare, the placenta does not descend down and there is no threat to pregnancy.
- Uterine contractions and increased tone will not increase.
- The placenta is less exposed to blows and jolts from the baby when it moves.
- Lower risk of increment.
- There is a lower risk of injury to the placenta due to an accidental blow to the abdomen.
- There is a lower risk of bleeding with a caesarean section.
Causes of anterior placenta previa
However, not everything during pregnancy always goes according to the ideal scenario. Often the placenta is attached in a different place - on the side or in front. At the moment, many doctors consider the attachment of the placenta along the anterior wall as a normal option that requires special monitoring.
There can be many reasons why the placenta is attached to the anterior wall of the uterus. The mechanism of such attachment has not been fully studied, but it has been revealed that it can be provoked by:
- changes in the endometrium of the uterus;
- Features of the development and implantation of the fertilized egg;
- scars and adhesions on the walls of the uterus.
Various inflammatory diseases of the genital area, endometriosis, can lead to changes in the endometrium.
Scar changes on the walls of the uterus appear as a result of operations on the uterus, abortion, and inflammatory diseases. Hence the conclusion is that multiple abortions and cesarean sections increase the risk of anterior placenta attachment.
According to statistics, such attachment rarely occurs during the first pregnancy. But in multiparous and multiparous women, this is a much more common occurrence, which may be explained by changes in the uterus and especially the inner lining.
If for some reason the fertilized egg does not have time to penetrate the endometrium within a certain time, then it is attached to the anterior wall.
Possible complications of the anterior attachment of the placenta to the uterus
Is there any danger in this position of the placenta? It is impossible to answer this question unequivocally.
The fact is that if the placenta is located high on the anterior wall, pregnancy can proceed completely normally and end in a natural birth without pathologies.
At the same time, there are some risks. This is due to the fact that the placenta is an organ that is not capable of stretching. And when the wall on which it is attached begins to stretch too actively, complications are possible.
First of all, this is insufficient functioning of the placenta and impaired delivery of nutrients and oxygen to the fetus. And this in turn can lead to or.
If the distance to the uterine pharynx is reduced to 4 cm, we will talk about such a complication of the anterior location as. Anterior placenta previa can cause dysfunction of the placenta.
In extremely rare cases (if the position is too low), the placenta can completely block the cervix of the uterus, which will exclude the possibility of natural childbirth. More often, this complication develops during repeated pregnancy.
Anterior placenta previa in combination with placental insufficiency can provoke such a serious complication of pregnancy as partial or complete abruption.
In some cases, indirect symptoms are:
- weakly felt fetal movements;
- difficulties with - sometimes the heart sound is completely inaudible in the absence of pathology of the fetal cardiovascular system;
- Large belly size.
Unpleasant symptoms may appear if the placenta begins to descend and becomes previa. In this case, a woman needs to pay attention to:
- heaviness and;
Diagnostic methods
Diagnosis is quite simple and is based on a gynecological examination and ultrasound examination.
Only ultrasound gives a complete picture of how the placenta is located and whether there is a risk of its presentation.
Therefore, you should not refuse to undergo an ultrasound scan on time. The sooner this feature of pregnancy is identified, the easier it will be to prevent possible complications.
Features of pregnancy
The anterior position itself does not cause any trouble to the woman and does not worsen her well-being. Being simply a feature of pregnancy, it does not require treatment. In addition, there is no treatment for it, since it is impossible to influence the location of the placenta, as well as change its position and move it to the back wall.
However, this feature of pregnancy requires constant and close monitoring so as not to miss the possible onset of complications, which are still more likely with an anterior location than with a normal one.
To reduce the risk, pregnant women with this placement are advised to rest more, completely avoid lifting weights (even if it seems that the objects are not heavy at all), and avoid worries, stress, and physical exertion.
If, then you should try to touch the stomach as little as possible so as not to provoke increased tone and placental abruption.
This is especially important in the later stages.
It is important to visit the doctor on time so as not to miss changes in the placenta and its location. This approach will allow you to notice in time that the child’s seat tends to move downwards.
Childbirth with placenta on the anterior wall
In the absence of complications, this placement of the baby's place does not have any effect on the course of labor. Moreover, some women note that childbirth is easier and faster. But this is true when it comes to natural childbirth.
If a woman is indicated for a cesarean section, an anterior position may complicate the operation, increasing the risk of large blood loss. This is due to the fact that the incision is made in the place where the placenta is located.
Therefore, when indicating a cesarean section, doctors must take into account the location of the placenta and adjust the surgical intervention in such a way as to minimize the risk of large blood loss. Naturally, for this, a woman must be regularly monitored and have all the necessary studies.
The anterior position does not have any effect on the health of the born child.
Anterior location is not a pathology, but an individual feature of pregnancy.
Therefore, you should not worry and expect complications - in the vast majority of cases, everything ends in a successful birth without complications. The only peculiarity here is the need for closer monitoring of the course of pregnancy.
In contact with
The medical features of pregnancy are not known to everyone. Most expectant mothers carry a child without thinking about the physiological processes in the body. The main thing for her is to bear a strong, healthy baby, to give birth naturally, on her own.
And yet you need to know the basic principles of the physiology of pregnancy. For example, about the location of the placenta. This organ plays a decisive role in the successful development of the fetus: the health of the mother during gestation directly depends on its position and functionality.
Correct placement of the placenta
Placenta (also called children's place)- a vital organ that ensures normal blood circulation between mother and baby. Its formation begins in the first weeks of pregnancy, and the organ takes on its final form by the 16th week. The fetus is connected to the placenta by two arteries and a vein located in the umbilical cord. Through these vessels, the child receives nutrients and oxygen, and the release of waste products is ensured. Also, the protective surface of the amnion (water membrane) protects the body from possible Rh conflict.
From a physiological point of view, the correct placental location during pregnancy is when the organ is attached to the fundus of the uterus or along the posterior wall in the upper part. As the fetus develops, the uterus stretches, but the back remains tight, so the placenta position on the back side is the safest.
Cases of placenta attachment not on the bottom or back wall, but on the sides, right or left, are common. This arrangement is not pathological. Under conditions of careful monitoring of the pregnant woman, resolution occurs naturally.
In rare cases, the organ is attached to the anterior wall of the uterus, which means increased stress due to uterine distension due to the movement of the growing fetus. If the child's seat is located high in the front, this feature is safe for the female body.
Should I panic with this diagnosis?
The anterior placental location increases the risk of possible complications during pregnancy and childbirth. It is worth understanding what causes this risk.
Due to excessive stress, sometimes the placenta descends to the os of the uterus and blocks the birth canal. If the placental attachment is fixed at a distance of 6 cm above the internal os, this position is called low placentation. The pathology is called placenta previa along the anterior wall. With this diagnosis, the expectant mother will not be able to give birth to a child on her own; childbirth occurs surgically.
Reasons for this condition
Anterior placentation is often caused by the following factors:
- repeated births;
- a scar on the uterus left after a previous cesarean section or other operations;
- pathologies of the cervix (erosion, fibroids, endometriosis, endocervicitis, underdevelopment);
- abortions;
- inflammatory diseases;
- bad habits;
- late maternal age.
Possible complications
The danger of the diagnosis lies in the fact that along with it the risk of associated complications increases:
- Increased uterine tone and bleeding lead to threats of miscarriage in the early and late stages.
- Oxygen starvation of a child affects his development.
- Poor circulation causes anemia or hypotension.
- Early abruption of the placenta at an extended period of time, caused by the pressure of the weight of the fetus. This in some cases leads to his death.
- Incorrect fetal position causes complications during childbirth.
- Premature birth. Self-resolution is not possible. Internal os, covered by the placenta with a distance of 4 cm or 3 cm - indicators of cesarean section.
Diagnostic methods
Statistics show: 75% of women diagnosed with anterior presentation have repeat births. With treatment and the right lifestyle, the placenta migrates and the organ rises to its original place. According to reviews of women who had lower placentation along the anterior wall, by the time of delivery the baby's place migrates.
The main symptom by which one can understand that the placental location is incorrect is sudden painless bleeding. Blood discharge can be triggered by sexual intercourse, physical activity, defecation, or a vaginal examination by a gynecologist. There is a version about the psychological cause of the condition. In a woman who fears for the loss of her unborn baby, the instinct of self-preservation is triggered, and the body blocks the exit from the baby's place. Various stresses affect the mother's well-being.
Indirect signs indicate pathology:
- rare weak movements of the baby;
- faint hearing of the baby's heartbeat;
- large belly - the fetus presses its weight on the baby's place, the walls are stretched, the fundus of the uterus is stretched.
Pathology is diagnosed by vaginal examination by a gynecologist to identify the following signs:
- Standing of the fundus of the uterus.
- Violation of fetal position.
- Formations of soft consistency, partially or completely covering the internal pharynx.
- Listening to the blood flow through the vessels of the reproductive organ.
Later, an ultrasound examination is prescribed to reveal the peculiarities of the position of the child's place. The mother is prescribed complete bed rest with medication: hemostatic and reducing contractions of the reproductive organ. If the predominant location of the placenta does not change by the time of delivery, a caesarean section is prescribed as planned.
How does pregnancy go with this diagnosis?
Despite possible complications, the chances of a favorable pregnancy are high. The main condition is compliance with the regimen prescribed by the gynecologist. There is no 100% guaranteed treatment for previa, since it is impossible to change the position of the baby's place and fix it closer to the uterine fundus.
But the risks of complications can be reduced if the following conditions are met:
- Bed rest depending on the state of health of the pregnant woman.
- Taking medications prescribed by a doctor.
- Bleeding causes anemia, so a diet is prescribed to normalize hemoglobin levels.
- Thermal procedures are completely prohibited: baths, saunas, hot baths.
- Elimination of physical activity: lifting weights, having sex, long trips. Anxiety and stress are completely eliminated.
Anemia caused by bleeding is treated by taking iron supplements.
The diet of a pregnant woman includes foods that help increase hemoglobin:
- beef
- liver
- apples
- grenades
- peaches
- walnuts
- dried fruits
- beet
- black chocolate
- citruses.
What to do if the placenta is located on the anterior wall
If the baby's place is located not closer to the bottom of the uterus, but along the front part, the expectant mother should know that this fact means a feature of the body, and not a disease. Pathology is lower placentation. Therefore, there is no need to worry or panic. Medical supervision, careful attention to health and adherence to the regime will make pregnancy a pleasant and exciting period of life. If anterior presentation is not associated with complications, then the mother’s well-being does not suffer.
The task of doctors in this situation is: monitor the condition of the placenta and check the blood for coagulation and hemoglobin levels.
Mother's task: Take care of yourself and your child and notify your doctor at the slightest abnormal signs. If the slightest spotting appears, there is no need to wait for a scheduled appointment.
In cases of increased uterine tone, and the woman will feel this by the fact that the abdomen will be very hard, frequent touching of it is undesirable.
Features of childbirth with anterior presentation
Anterior placentation does not affect the condition and health of the baby. If there are no complications, it is quite possible that childbirth will be easy and quick, naturally.
Cesarean section increases the risk of blood loss. The incision during the operation is made at the level of the placental location of the placenta; there is a risk of damaging it with a scalpel. Therefore, the placental location is taken into account and the features of the operation are adjusted.
The placenta and anomalies of its location are described in detail in this video:
Conclusion
In expectant mothers, the body's sensitivity to various kinds of changes within the body increases. It seems to them that as soon as you feel bad, this already indicates serious pathologies. Such worries are in vain. During pregnancy, a woman’s body experiences additional stress, so minor problems with well-being are natural.
Low placentation occurs in 3% of women. If such a diagnosis is nevertheless made, then remember that taking your own health and the health of the unborn child seriously will help raise the placenta, which will increase the chances of giving birth naturally.
The placenta is an organ that begins to develop after fertilization of the egg has occurred.
The placenta connects mothers and the fetus; it determines how the pregnancy period will proceed. This organ begins to develop from about 10 weeks of pregnancy, but final formation occurs by 16 weeks. Until this moment, the embryo feeds and develops with the help of the fetal membrane. The condition of the child directly depends on the placenta.
For the normal course of pregnancy, it is very important how it will be formed, as well as its functioning and location. As a rule, during the second trimester, the placenta is attached very high, the distance to the pharynx is about 5 centimeters. During the third trimester, the distance is 7 centimeters. The low location of the above organ is diagnosed when the distance to the pharynx is 3 centimeters.
Correct location
A good place in the uterus for the placenta to attach is the back wall. With the constant development of the child, the uterine muscles begin to stretch, but the distribution of this process begins unevenly. The front wall begins to stretch very well, but the back wall remains virtually unchanged. As a result, it turns out that the front wall becomes thin after some time, and the back wall remains the same as it was before the period of conception.
That is why it turns out that it is best when the placenta is attached to the back wall, the stress becomes minimal. Also, do not miss the fact that the fetus can attach to other parts of the uterus. A lateral position may also occur, this is the norm. As a rule, if the placenta is located on the anterior wall, one cannot speak with certainty about the deviation; of course, any other place would be much better. There are a number of positive factors for the placenta being on the posterior wall.
- Lack of mobility. Due to the fact that the back wall of the uterus does not stretch, it is denser and thicker. When the contraction of the above organ occurs, there will be no stress, and accordingly the possibility of placental abruption decreases.
- Minimal injury. When the fetus begins to move and rotate, the process of touching the placenta does not occur.
- Minimum likelihood of occurrence from puff pastry.
More on the topic: Nodular uterine fibroids
If a pregnant woman has been diagnosed with anterior placenta localization, there is no need to immediately panic and stress yourself out, since there is nothing to worry about. As a rule, even with this diagnosis, a woman can give birth to a baby without complications. The only factor in the above diagnosis is constant monitoring by a leading physician.
What danger could there be?
As previously said, the muscles of the anterior wall have the ability to stretch, and this can cause damage to the placenta from stretch marks, and the functioning of this organ will not be the same as before. In certain situations, placental abruption can occur. Due to the constant growth and stretching of the uterine walls, there is a possibility of the anterior wall drooping down.
It is extremely rare, but it can still happen in second-bearing women that the above organ can descend so much that the cervix of the uterus is blocked, and this is dangerous because the baby’s path to the exit is blocked. If this situation occurs, then the pregnant woman must be operated on (cesarean section), since she will not be able to give birth herself. Also, if the placenta is along the anterior wall, the likelihood of labor starting ahead of schedule increases, and in the first two trimesters the possibility of miscarriage increases.
If the above diagnosis is made, then a pregnant woman may be diagnosed with gestosis, and the baby may be diagnosed with oxygen starvation. This occurs due to the fact that the baby begins to put pressure on the placenta and cuts off the oxygen itself.
Factors influencing the location of the placenta
In addition to the main reason - stretching of the uterine muscles, there are also certain factors that can affect the prolapse of the above organ. Experts identify several types of reasons.
- Deformation of the internal walls of the uterus, which can be affected by any inflammatory process.
- and either an infection.
- Previously undergone surgical interventions, after which adhesions or small scars could form on the uterus.
- Bearing multiple children.
More on the topic: Diagnosis and treatment of lactostasis
Also, one of the reasons may be the fact that the fetus attached to the wall at a time when it had already descended to the lower part. According to statistics, women who are giving birth more than once are at risk.
Classifications
According to statistics, placenta of the anterior wall in the third trimester of pregnant women occurs in approximately 3%. During the second trimester, the diagnosis is made after an ultrasound scan, it is discovered that the place where the fetus is located is quite low.
This occurs because the placenta moves as the uterus begins to grow, thereby moving the placenta upward. Two classifications of presentation of the above organ have been recorded, which are determined during the period of bearing a child, as well as in the initial stage of the birth process.
Presentation at the initial stage of labor when the cervix opens.
- Central.
- Regional.
- Lateral.
The result of an ultrasound examination can show the extent to which the placenta is located on the anterior wall.
- First. The organ is localized in the lower part of the uterus at a distance of at least 3 centimeters from the pharynx.
- Second. The above organ is localized near the pharynx, but does not cover it.
- Third. The pharynx is completely covered by the lower part of the placenta, leaving a piece of the baby's place, which is located asymmetrically.
- Fourth. The main part of the placenta completely covers the pharynx, the edges are all symmetrical.
Symptoms of manifestation. Diagnosis.
The expectant mother does not feel the moment when the placenta is attached to the front wall. That is why quite often it is not possible to make a diagnosis on time. In certain cases, a pregnant woman may experience bleeding from the vagina, which may be periodic. This symptom occurs in the first stages of pregnancy.
In cases where a woman is in the last trimester of pregnancy and she has bleeding, this is the main signal that the placenta is premature.
Features of the above diagnosis.
- The baby's heartbeat is remote, it is very difficult to listen to it, sometimes it is not possible at all.
- A pregnant woman's belly can be huge, which can cause stretch marks to appear.
- The baby's movements are felt weaker.
