Placenta at 29 weeks. Low placentation during pregnancy: causes, consequences and recommendations. Formation and hormonal functions

It's no secret that pregnancy is a wonderful time in the lives of many women, but it is also the most responsible. Expectant mothers should pay special attention to their health.

However, not everything will depend on a woman in an interesting position.

– this is one of such cases. But, having heard such a diagnosis from a doctor, you should not panic, because This is not a pathology, but a borderline state.

Often, by the end of pregnancy there is no longer any threat. As medical statistics show, in 99% of cases, childbirth with this condition goes well.

Placenta and its role during pregnancy

What is placenta? This is a baby's place, the weight of which reaches 1.5 kg, and the diameter is 15 cm. The connection between mother and baby is ensured by an extensive network of numerous blood vessels that are located in the placenta.

The role of the placenta during pregnancy is simply enormous, because it performs very important functions. It is she who secretes a number of hormones, including those responsible for maintaining pregnancy.

Through it, the fetus receives minerals, nutrients, vitamins, as well as oxygen - everything that is so necessary for the normal development of the baby. In addition, the placenta will also remove carbon dioxide.

The condition and full development of the child directly depends on the functioning of the fetoplacental–phytoplacental system.

Low placentation during pregnancy: what is it?

After successful conception, the fertilized egg-embryo looks for a favorable and suitable place to attach itself to the body of the uterus. Often this place becomes the bottom of the uterus or the back wall.

However, for a number of reasons, the embryo may seek “another shelter” in order to establish itself normally. This is exactly how low formation of a place for the fetus - the placenta - happens.

Reason for diagnosis low placentation during pregnancy the location of the placenta becomes below 5.5 cm internal pharynx. However, this is not such a rare condition.

So, in 15% of cases the placenta is attached to the underside of the uterus. Increasing in size, it can block the birth canal. But the situation during pregnancy can change for the better.

When the fetus grows and the uterus increases in size, the attachment site also rises higher, which means there is no longer such a threat to the fetus.

It is worth noting that such a diagnosis is a serious situation when a woman is forced to be under the close supervision of her doctor, since there is a risk of placental abruption.

Most often, such a diagnosis can be heard from a doctor by patients for whom this is not the first pregnancy. This condition can be detected during examination - ultrasound examination. Do Ultrasound on - , - , - pregnancy.

What is the reason?

Even doctors cannot name the exact reasons for the low location of the placenta. However, low placentation is not uncommon for women who have already given birth.

Often this condition is facilitated by inflammatory processes that provoke changes in the internal walls of the uterus.

There are a number predisposing factors that can lead to this condition: complicated first birth, abortion, uterus, chronic endometritis, parity ( a large number of childbirth), as well as the woman’s age (if she is over 35 years old).

Behavior rules

If a woman has received such a diagnosis from a doctor, she should follow a number of simple requirements:

• do not make fast, sudden movements, do not run, do not jump, and also avoid physical activity;
• refuse sexual activity;
• give your legs an elevated position when lying down or sitting;
• minimize travel on public transport;
• if bleeding occurs, immediately consult a doctor, and if the bleeding is severe, call an ambulance;
• You should not refuse inpatient treatment in the pregnancy pathology department if this option is offered by your attending physician.

The mother in labor does not require any special treatment in this condition. However, the expectant mother is obliged to closely monitor her condition.

How does childbirth go with this diagnosis?

If the distance between the cervix and placenta is more than 6 cm, childbirth proceeds normally. If the distance is a little less, then in this case the birth will most likely be normal.

If the doctor decides that a low-lying placenta is undesirable, he will puncture the amniotic sac. After this, the baby's head will fix the placenta. But in this case, the birth process should be under the supervision of experienced specialists.

If the fetus is located in the wrong position (legs forward), then doctors will C-section to avoid complications.

If a woman has low placentation, a situation may arise that the exit from the uterus is completely blocked. In this case it will be done on pregnancy caesarean section.

Dear ladies, it should be taken into account that in most cases, during pregnancy, the placenta shifts - it rises up (behind the growing uterus), which means that any threat to the mother or baby disappears.

During the last trimester of pregnancy, the fetus experiences rapid weight gain, which cannot but affect the weight of the expectant mother. By week 29, a woman’s total weight gain since the beginning of pregnancy can reach 11.5 kg.

Baby at 29 weeks of pregnancy

At the beginning of the third trimester, the baby weighs approximately 1200-1300 g, and his height can be about 36-40 cm. The child’s body is actively preparing for life outside. The fetal thermoregulation system continues to form, as well as the immune and respiratory system. The bone marrow already fully copes with its task of generating red blood cells.

The receptors and nerve endings responsible for the sense of smell are completely ready to function in the external environment, and the baby’s nostrils are no longer blocked by the mucus plug, and amniotic fluid freely enters them.

The child’s kidneys and urinary system are fully functional. The daily volume of his urine entering the amniotic fluid, is about half a liter.

All twelve systems of the baby’s body begin to work interconnectedly, uniting into a holistic mechanism.

The placenta is aging and can no longer filter substances reaching the baby as thoroughly as it used to.

This is useful to know: the degree of maturity of the placenta and fetoplacental insufficiency

Since the main task of the placenta is to provide a connection between the fetus and the mother’s body to receive nutrients and oxygen, during the growth and development of the child it also undergoes changes associated with the changing needs of the baby. If pregnancy proceeds without pathologies, then the placenta goes through four stages of maturation:

• up to 26-30 weeks it has a homogeneous structure (zero degree of maturity);
• from the 26th week of pregnancy, inclusions begin to appear at the edges of the placenta, blood flow through which becomes difficult or stops altogether: fatty structures and calcifications. If there are few such areas, then they do not have a big impact on the overall blood flow in the umbilical cord. This state of the placenta is called stage I of maturity.
• from 34 to 39 weeks of pregnancy, the number of small calcifications and fatty structures in the placenta increases, which corresponds to the II degree of its maturity;
• from 37-39 weeks of pregnancy, the structure of the placenta becomes lobulated, its useful area decreases, and the number of inclusions containing calcium salts increases, which corresponds to the third degree of placental maturity.

When on Ultrasound It turns out that the degree of maturity of the placenta does not correspond to the timing, an additional study of blood flow in the uterine arteries (Doppler) is carried out. If, according to the results of this study, the blood flow is not impaired, then there is no cause for concern, although due to premature aging of the placenta, the risk of fetoplacental insufficiency in the future increases.

Fetoplacental insufficiency (FPI) is a condition in which the placenta cannot fully perform its functions. There are chronic and acute FPN. The chronic form is very common; every third pregnant woman is diagnosed with it. With minor disturbances in blood flow in the placenta, the chronic form of FPN does not have much effect on the development of the fetus, however, in order to prevent more serious disturbances in the functioning of the placenta, expectant mothers can be prescribed preventive drugs that improve blood supply to blood vessels, such as Actovegin, potassium orotate , as well as vitamins E and C.

However, if there are signs of disturbance of placental blood flow, hypoxia and fetal malnutrition, it is necessary to treat FPN, including inpatient treatment.

Acute FPN is a dangerous condition that poses a threat not only to the fetus, but also to the mother. A symptom of acute FPN in the form of placental abruption is bloody vaginal discharge. A mild form of placental abruption can be compensated for in hospital treatment, while in a severe form, immediate surgical delivery is recommended.
Therefore, bloody discharge is grounds for immediate hospitalization of a pregnant woman.

Recommendations for the 29th week of pregnancy remain the same. To ensure that the baby receives a complete supply of oxygen and nutrients through the placenta, to the expectant mother need to spend more time on fresh air, try to avoid staying in stuffy and smoky rooms, minimize the use of products household chemicals, as well as various deodorants and air fresheners. It is not recommended to participate in repair work that involves the use of paints and varnishes. In addition, it is necessary to take medications and vitamin complexes recommended by your doctor, get plenty of rest and eat well.

The placenta is the primary organ that determines the normal course of pregnancy. The thickness of the placenta by week plays a significant role for the life support of the developing fetus.

Placenta Interesting
what to do at the doctor's care
ultrasound pain heaviness
Convenient listening to the doctor

Translated from Greek, this word means “cake”. Despite the frivolity of the name, the organ is of exceptional value.

Its uniqueness is that:

• firstly, it lives only during pregnancy and is rejected within 15 minutes after the birth of the child, it is not without reason that it is otherwise called the “baby place”, like any living organ, it goes through all stages of formation, development and even aging;
• secondly, the placenta is the only organ that simultaneously belongs to the mother and the child, the thickness of the placenta depends on the week of pregnancy, the norms are indicated in a special table.

Formation and hormonal functions

The base of the placenta consists of villi, which begin to form on the seventh day after conception. Inside the villi, the fetal blood circulates, and outside, the villi are washed with maternal blood.

Visual layout

A two-system process of blood circulation and gas exchange occurs: maternal and fetal. Oxygen is supplied to the fetus and returned to the mother's blood as carbon dioxide.

Depending on the week of pregnancy, the thickness of the placenta increases; active growth occurs at 19-35 weeks.

Very important point: mixing of maternal blood flow and baby blood is excluded. Between vascular systems There is a membrane that has the property of blocking the passage of harmful substances, allowing only those necessary and beneficial for the child to pass through. This function is called the “placental barrier.”

The systematic development and formation of a child's place leads to full functioning by approximately the 12th week of pregnancy.

There are several levels of placental maturity, which are determined by thickness standards using ultrasound at 20 weeks of pregnancy. First, the place of attachment is determined, then the area with largest size, from which the thickness is calculated.

In addition to providing respiratory and other functions for the baby, there is an important hormonal function. The placenta contributes to the production of about fifteen hormones that have various properties that are necessary for the normal bearing of a child. They are the ones who preserve and prolong pregnancy.

Until week 27, the placenta is at an early stage of development. Starting from week 32, the normal thickness changes and the second stage of development begins. Closer to childbirth, she begins to age, which indicates the third stage of maturity.

Possible developmental disorders

There are cases of disruptions in the functioning of a child’s place under the influence of external or internal circumstances. If the pregnancy proceeds normally, then the thickness of the placenta constantly increases and, closer to the 36th week of pregnancy, the value ranges from 20 mm to 40 mm. Any deviations from the norm in the weeks of pregnancy and in the thickness of the placenta carry the risk of serious consequences.

No deviations from the norm

Quite often, doctors diagnose hypoplasia - this is a reduced thickness of the placenta. If this is a minor deviation from the norm, then there is no need to panic. Significant thinning of a child's seat is a fairly rare occurrence. Moreover, there are sizes that fit a certain woman. They depend on body type and other special parameters, when the normal thickness of the placenta is determined individually according to the weeks of pregnancy. The diagnosis is made only after genetic testing and consultation.

During pregnancy, the placenta may shrink multiple times. The reasons may be different:

• drinking alcohol or drugs, smoking;
• poor nutrition, diets;
• depressive or stressful conditions;
• hypertensive state of a pregnant woman;
• the presence of infectious and inflammatory processes;
• gestosis, swelling, the presence of protein in the urine.

Sometimes hypoplasia is associated with congenital defects of the child, which threatens serious problems for the baby’s health.

If by the 30th week of pregnancy the placental thickness is significantly underestimated and is less than 28 mm, this can lead to the following consequences:

• there will be a change in the baby’s heartbeat, usually the rhythm becomes weak;
• physical inactivity will develop.

There are opposite cases - this is hyperplasia, when the placenta is greatly enlarged. The reasons for this fact may be different:

• presence of toxoplasmosis, syphilis or diabetes mellitus in a pregnant woman;
• in case of Rh conflict;
• impaired kidney function or dropsy in the baby;
• development of thrombosis in the placental villi;
• transferred virus or latent carriage of a viral disease.

Active thickening of the placenta can cause premature birth. The functions of providing the fetus with oxygen, hormones and nutrition begin to work intermittently. Treatment involves constant medical examination.

Continuation of the family line

If by 31 weeks the normal thickness of the placenta is significantly increased and is an order of magnitude greater than 32 mm, then this can lead to the following consequences.

1. Hypoxia (lack of oxygen) in the fetus may occur. If timely measures are not taken, there is a risk of asphyxia, intrauterine death of the child from suffocation.
2. There have been cases of intrauterine growth retardation, which leads to various diagnoses after childbirth. For example, cerebral palsy in a child.

There is a risk of miscarriage or premature birth.

Compliance table

Mom and dad's baby

What should be the normal thickness of the placenta during pregnancy can be found out by looking at the parameters in the specified table. For example, a size of 31 mm corresponds to 30-31 weeks of pregnancy. This value indicates that you are in the first stage of maturity, which ideally corresponds to the norm.

One of the main parameters of an organ that characterizes its condition is the determination of the degree of maturity. An ultrasound examination makes it possible to identify in advance the physiology and pathology of the child's place.

The specialist deciphers the indicators

Using this table, you can always be aware of the changes occurring inside you, as well as monitoring the norms of placental thickness in relation to the duration of pregnancy.

Ways to enlarge the placenta

There are no specific schemes or recipes for how to increase or decrease the thickness of the placenta. There is no treatment as such, but it is possible to keep the mother and fetus in a stable condition.

Complex therapy consists of:

• constant monitoring and medical consultation;
• eliminating the reasons that caused the deviation of the thickness of the placenta from the norm relative to the gestational age;
• taking vitamins and medications prescribed by your doctor.

The main task is to improve hypodynamics for the formation of the placenta and fetal development. Where you can contact is listed below.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

Another week is over. Your baby has already grown noticeably - up to 36 cm, and weighs more than a kilogram. Now he looks quite like a baby. His face became rounder, the fluff disappeared from his body, and wrinkles appeared on his arms and legs. The lubricant that previously covered his entire body now remains only on his tummy and in the area of ​​the folds. The diameter of its head is already 73 mm, and the volume of the chest and tummy is 74.4 mm and 79.3 mm. You notice that he no longer moves so quickly inside you. He's simply cramped. Soon he will take a position in which he will remain until the birth.

The baby's blood now contains all the necessary components to carry oxygen and protect the body from infections. True, before the baby is born, venous and arterial blood are still mixed. And the final separation of the arterial and venous flows will occur later, when the baby’s lungs are involved in enriching the blood with oxygen.

The baby's kidneys secrete almost half a liter of urine every day. And the digestive system is developed enough to adapt to milk intake.

Although sometimes you feel like you're terribly tired of your pregnancy, there are still at least seven to eight weeks of waiting ahead. But now you can calmly put aside your business and get on with the main thing - preparations for the birth of a child. Let your career wait. It's time to go to maternity leave. And, you must admit, now it couldn’t come at a better time.

Because of your growing belly, any outing “out into the world” - to the store, to the market, to visit your parents - is a real feat for you. You feel that your usual daily activities are already difficult for you, you have to rest more often. Worried about back pain.

The uterus has already risen by 29 cm. From time to time there is a feeling that the skin on the abdomen, due to the rapid increase in its size, does not have time to stretch. Itching appears in areas of stretch marks (striae). Perhaps a daily light massage with a damp, hard washcloth and moisturizing creams will help you. At the very least, they will help relieve the feeling of dryness.

As a rule, on later Many women complain of heaviness in their legs and notice bulging veins. Varicose veins veins can appear not only on the legs; similar signs occur in the area of ​​the external genitalia. Similar reasons lead to hemorrhoids. The reason for this is the increased pressure on blood vessels during pregnancy. As a rule, the manifestations of hemorrhoids are aggravated by frequent constipation, which occurs for a similar reason - due to the pressure of the uterus on the intestines.

How to avoid such problems with blood vessels? For varicose veins of the legs it is recommended to wear compression stockings, try to place your feet on a cushion or elevation to facilitate the outflow of blood. To reduce the tendency to constipation, it is worth adding vegetables, cereals, and plums from fruits to the menu. Vitamin C is responsible for strengthening the walls of blood vessels. The same rosehip will bring double benefits - it contains ascorbic acid and improves kidney function.

29th week of pregnancy: vaginal discharge

29th week of pregnancy: nutrition for a pregnant woman

It must be said that many pregnant women noticed that during this period they often crave salty foods. And in the summer, when more water is removed from the body through sweat, the need for salt increases. It is no coincidence that some women say that they often simply could not drink water if it was not added with salt.

So, the conclusion: the body needs table salt (sodium chlorine). But only in moderation. Salt is part of the blood, helps maintain blood vessels in tone, and is involved in the transmission of nerve impulses.

Excess or deficiency of anything, including salt, is harmful. Therefore, let the salt you eat only complement dishes that are healthy for you. You need no more than a teaspoon per day. Therefore, those who are very fond of all kinds of smoked meats and pickles need to know that this way you will immediately exceed daily norm. And for pregnant women, such overfulfillment of the plan can result in swelling, increased blood pressure and even gestosis.

As an option, you can use salt with a reduced content of sodium chloride, where it is partially, in percentage terms, replaced by potassium and magnesium compounds with chlorine.
It is recommended to use iodized salt. But the fact is that as soon as you open the pack, the iodine immediately evaporates from there. Although, of course, iodine is also very useful.

Ultrasound:
Now your baby’s weight is more than a kilogram - on average 150-160 g. And the body length is up to 37 cm. Therefore, you notice that when the child moves on the surface of the abdomen, you can feel parts of his body - the heel, the elbow. His bone marrow, responsible for the production of red blood cells, is already quite developed. As well as ribs, intercostal spaces and other organs and systems. Even individual facial features are already quite recognizable. Even teeth and enamel on them have formed, but for the time being they will be hidden under the gums. The baby responds sensitively to voices, music, and light.

The placenta (“baby place”) is a temporary organ through which the organisms of mother and child are connected.

The full development of the fetus depends on the correct location and functioning of the placenta, so its condition is assessed by doctors throughout pregnancy.

Changes detected in a timely manner can be corrected with medication, so that the pregnancy will develop successfully.

The formation of the “baby place” begins from the first days of pregnancy, when the fertilized egg attaches to the uterine wall. This process is completed by 12-16 weeks of pregnancy, and from this moment the placenta begins to fully function. It performs the following functions:

• respiratory – supplying the fetus with oxygen and removing carbon dioxide;
• trophic – providing the child with the nutrients he needs;
• endocrine – hormonal support pregnancy. The placenta itself produces a number of vital hormones, and also transfers maternal hormones to the fetus;
• barrier – protecting the child from exposure harmful substances, but not from everyone. Medicines, alcohol, and nicotine can penetrate through it;
• immune protection – prevention of immune conflict between the organisms of mother and child.

The placenta can function correctly only if there are no abnormalities in its condition. The location, structure and thickness are monitored periodically during pregnancy.

How long are the indicators monitored?

The placenta is visualized during ultrasound examination already at 11-13 weeks of gestation, but monitoring its thickness begins at 20 weeks.

During an ultrasound, the thickest part of the organ is measured, after which the resulting indicator is compared with the accepted norm for each week of pregnancy.

Table. Norms for placental thickness at different weeks of pregnancy

Normally, the thickness increases until the 36th week of pregnancy. Then its growth stops and by the date of birth the thickness of the organ decreases slightly.

If the thickness at a certain stage of pregnancy goes beyond the established norms, this is a sign of its improper functioning. This condition of the placenta is also fraught with intrauterine growth retardation, so the woman needs drug therapy.

Sometimes the thickness of the placenta slightly exceeds the acceptable limits, but this does not affect the development of the fetus. In this case, doctors take a wait-and-see approach, monitoring the condition of the placenta and fetus over time.

Thick placenta

Hyperplasia (thickening) of the placenta is diagnosed when its thickness exceeds the upper limit of the permissible norm.

The following factors can provoke thickening of the placenta:

• acute viral infections;
• sexually transmitted diseases (gonorrhea, syphilis);

Thickening of the placenta is a much more serious pathology than thinning it. A thick placenta ages faster, which can lead to.

In this case, the “children’s place” ceases to fully fulfill its functions.

This condition is dangerous for the child: he may develop hypoxia ( oxygen starvation), intrauterine growth retardation. If placental hyperplasia is caused by a sexually transmitted disease, then the infection can be transmitted to the fetus in utero. In especially severe cases, antenatal fetal death is likely.

The initial stage of thickening of the placenta, which does not yet affect the well-being of the child, can only be determined using ultrasound.

A later stage of hyperplasia, when the fetus is already beginning to suffer, can be suspected by the changed nature of the child’s movements or on the CTG machine.

The effectiveness of treatment for hyperplasia depends on the correct diagnosis of the cause of the disease. To determine the factor that provoked the thickening of the “baby spot”, a woman needs to undergo a set of diagnostic procedures:

• examination for TORCH infections;
• general urine and blood tests;
• gynecological smear for flora;
• blood test for antibodies;

It is impossible to influence the thickness of the placenta with medications, but uteroplacental blood flow can be improved. For this, the expectant mother is prescribed a course of treatment with the drugs "" or "Actovegin".

At the same time, the underlying disease that caused the hyperplasia is treated. Depending on the diagnosis, the woman is prescribed a course of antibiotics, antivirals, drugs to lower blood sugar levels, or.

In case of Rh conflict, only intrauterine blood transfusion is effective; in severe cases, pregnancy must be terminated.

If the thickness of the “baby place” is less than it should be according to the norm, hypoplasia of the placenta is assumed, that is, its underdevelopment and limited functionality.

Thin placenta may be physiological feature women of small stature and fragile build. In this case, the discrepancy in the size of the placenta does not in any way affect the development of the child.

But there are other reasons why the thickness does not fit into the lower limits of the norm:

• genetic abnormalities in the fetus;
• infectious diseases suffered by the mother during pregnancy;
• late toxicosis;
• concomitant diseases (atherosclerosis, and some others);
• maternal use of alcohol, tobacco or drugs during pregnancy.

A thin placenta is not able to provide the child with the necessary amount of nutrients and oxygen. This leads to developmental delays in the fetus.

If, in the presence of a thin placenta, ultrasound determines low weight and height of the fetus, doctors prescribe additional examinations - CTG and Doppler.

They will allow you to assess the severity of intrauterine development disorders.

Placental hypoplasia can only be corrected if it is caused by a maternal disease. The woman is placed in a hospital, where the underlying disease is treated and corrected intrauterine development child.

The patient is prescribed medications that stabilize blood flow in the placenta. The child’s heartbeat and activity are monitored throughout the treatment period.

In some cases, when placental hypoplasia provokes a serious deterioration in the child’s condition, emergency delivery is performed. But at the current level of development of medicine, such a result is rather an exception. With timely identification of the problem, competent drug support and monitoring of the condition of the fetus, treatment of hypoplasia is successful.

The discrepancy between the thickness of the placenta and the gestational age cannot be determined and leveled independently. Therefore, a pregnant woman should not avoid visiting doctors and undergoing necessary examinations.

If the diagnosis reveals thickening or thinning of the placenta, there is no need to get upset prematurely. Treatment of this pathology is carried out only when there is a threat to the full development of the fetus.

In this case, the woman will be asked to undergo treatment in a hospital. Timely therapy will support the functioning of the placenta and the negative impact on the child will be minimized.