What does attaching to the front wall mean? Who is susceptible to this pathology? Risks of this pathology

The placenta is formed in the first weeks of pregnancy and acts as a conductor of nutrients and oxygen to the fetus and the 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.

WITH physiological point In terms of vision, the most optimal is the attachment of the placenta according to back 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 this it becomes clear that for normal functioning It is more advantageous to place the placenta on the posterior wall, because 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, abortions, inflammatory diseases. Hence the conclusion is clear that numerous abortions and C-section increase the risk of placenta attaching anteriorly.

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 os is reduced to 4 cm, we'll talk already about such a complication of the anterior location as. Anterior presentation placenta may cause dysfunction of the placenta.

In extremely rare cases (if positioned too low), the placenta can completely block the os of the uterus, which eliminates the possibility natural birth. 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 cardio-vascular system fetus;
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 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 due dates. 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 possible start 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 get more rest, completely avoid lifting weights (even if it seems that the objects are not heavy at all), avoid worries, stress, physical activity.

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 on later.

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.

– a complication of pregnancy, which is characterized by the localization of the baby’s place in the lower segment of the uterus, closer than 6 cm from its internal os. The danger is that the anomaly does not manifest itself in any way. It is possible to determine the low location of the placenta only during ultrasound scanning or with the development of complications - damage, organ detachment, accompanied by pathological signs. Treatment is carried out on an outpatient basis, a therapeutic and protective regime is indicated and drug therapy. In most cases, with a low-lying placenta, delivery is carried out by cesarean section.

As a rule, a low location of the placenta is detected during ultrasound screening of the first trimester, but closer to the 20th week, in approximately 70% of cases, migration of the child's place occurs, and the diagnosis is removed. By the end of pregnancy, this pathology persists in only 5% of patients. If a low location of the placenta is detected in the third trimester, the likelihood of it moving is extremely low.

Causes

Scientists have still not been able to definitively establish the reasons for the low location of the placenta. However, based on numerous studies, it has been suggested that abnormal attachment of the child’s place occurs against the background of diffuse hyperplasia of the chorionic villi and marginal death of individual elements of the decidua. Thinning of the myometrium, which has developed as a result of numerous abortions, curettage and other gynecological manipulations, can cause such changes and lead to a low location of the placenta. The risk of obstetric anomalies increases against the background of previous miscarriages, inflammatory and infectious diseases reproductive organs.

A low-lying placenta is often diagnosed after a cesarean section as a result of scar formation on the uterus. WITH more likely pathology develops during multiple pregnancy, if the woman has a history of 3 and more births, on the background benign diseases, for example, fibroids. Congenital anomalies of the uterus, in particular, a bicornuate or saddle-shaped uterus, the presence of septa in the organ cavity, also increase the possibility of a low-lying placenta. The high-risk group includes patients prone to bad habits, exposed to stress, and performing heavy physical work.

Classification

In obstetrics, two types of low placenta are diagnosed depending on the location of the embryonic organ in relation to the uterus itself. Based on this criterion, the pregnancy prognosis can also be different. The following forms of anomaly are distinguished:

Low location of the placenta on the posterior wall of the uterus. This is a more favorable option for the development of pathology. As the uterus increases in size, migration of the baby's place often occurs. Accordingly, space is freed up for the child, and childbirth is highly likely to occur through natural means.
Low location of the placenta on the anterior wall of the uterus. It is diagnosed quite rarely, but has an unfavorable prognosis. If, when the baby's place is localized on the back wall, it tends to move upward, then in this case, as the uterus enlarges, the placenta will “move” downward. In this case, there is a threat of partial or complete blocking of the uterine os. The anterior low location of the placenta often causes umbilical cord entanglement, fetal hypoxia, and premature placental abruption.

Symptoms of low placenta

Clinically, a low location of the placenta in most cases does not manifest itself. Women usually feel well, and abnormal attachment of the baby’s place can be detected during a routine obstetric ultrasound. A low location of the placenta may be accompanied by pathological symptoms if complications begin to develop against its background. With premature detachment, possible nagging pain in the abdomen, sacrum, bleeding. It is extremely rare that this diagnosis contributes to the development of late toxicosis. In addition, a low location of the placenta in late gestation can lead to fetal hypoxia. Oxygen deficiency is manifested by a decrease motor activity baby, fast or slow heartbeat.

Diagnosis and treatment

It is possible to identify a low location of the placenta during ultrasound screening I, II or III trimester pregnancy, which are prescribed routinely by an obstetrician-gynecologist to all patients at 12, 20 and 30 weeks, respectively. Determination of abnormal attachment of a child's seat on early stages is not critical, since closer to the middle of gestation it migrates and takes the correct position without risk to the health of the woman or the fetus. Ultrasound at a low location shows not only its exact location, but also its thickness, the level of blood flow in the vessels, and the condition of the fetus. Evaluation of these parameters allows us to suspect more serious complications, in particular, hypoxia, entanglement, and incipient detachment.

Treatment for low-lying placenta depends on gestational age, as well as general condition woman and fetus. Detection of an anomaly in the first trimester does not require additional therapy; it is enough to limit physical activity. WITH high probability The baby's place migrates as the uterus increases in volume. Hospitalization for low placenta is indicated if there is a threat premature detachment, severe fetal hypoxia or closer to childbirth in the period of 35-36 weeks to examine the patient and determine the delivery plan.

The low location of the placenta requires correction of the daily routine. The patient should rest as much as possible. It is important to completely exclude psycho-emotional and physical stress, sexual contact, as all this can provoke complications in the form of detachment. If the placenta is low, you should walk less and avoid traveling to public transport. It is recommended to rest in a lying position, while raising the leg end to increase blood flow to the pelvic organs, in particular to the uterus and placenta.

Drug treatment for low-lying placenta is not prescribed. Management of pregnancy in this case requires more careful monitoring; most likely, consultation with an obstetrician-gynecologist will be prescribed more often than usual. Correction of the condition of the patient or fetus is carried out only if there is a threat or development of complications against the background of abnormal attachment. When placental abruption begins, the use of drugs that improve blood flow in the vessels of the umbilical cord is indicated, vitamin complexes. If uterine hypertonicity is present against the background of a low placenta, tocolytics are used.

With a low location of the placenta, delivery is possible both through the vaginal genital tract and by cesarean section. The first option is possible if the baby seat is placed no lower than 5-6 cm from the internal os of the uterus, as well as good condition of the mother and fetus, sufficient maturity of the cervix and active labor activity. A planned cesarean section is performed when a low location of the placenta is accompanied by the threat of premature detachment, with severe fetal hypoxia.

Prognosis and prevention

The vast majority of pregnancies occurring with a low-lying placenta have a favorable outcome. In 70% of patients with this diagnosis, closer to childbirth, the baby's place is occupied. correct position along the anterior or posterior wall of the uterus. In other cases timely diagnosis and the appointment of a protective regime make it possible to avoid complications, carry the pregnancy to 38 weeks and give birth absolutely healthy child. In 40% of women with a low-lying placenta, birth is carried out by caesarean section. In other cases, children are born through the natural birth canal. Sometimes the fetus shows signs of intrauterine hypoxia.

Prevention of low placenta consists of early diagnosis and treatment of gynecological abnormalities that contribute to the thinning of the uterine mucosa. Women should also avoid abortions and register their pregnancy with an obstetrician-gynecologist in a timely manner. Avoiding stress and physical activity after conception will help reduce the likelihood of developing a low-lying placenta. You should also avoid working in hazardous enterprises, refuse bad habits, get plenty of rest and ensure a sufficient supply of nutrients to the expectant mother’s body. Walking outside has a positive effect on the health of the woman and the fetus. fresh air. Each patient must follow all recommendations of the obstetrician-gynecologist, take necessary tests and conduct screening studies to detect a low-lying placenta as early as possible and begin therapy.

Placenta - important organ, the main purpose of which 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 attaches to the wall of the uterus after the end of its 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 were diagnosed with a placenta along the anterior wall of the uterus during pregnancy need to urgent treatment! It’s just that such a pregnant woman should know what possible complications may arise in this case.

There are a lot of options for attaching the placenta and they depend only on individual characteristics the body of the expectant mother. This may be the fundus of the uterus, completely left or Right side uterus, posterior wall. You can find out how the baby's place is located in your case with the help of a second scheduled 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,
baby's movements future mom will feel 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, this arrangement in itself is not dangerous to 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 it is necessary Special attention pay attention 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 baby in the womb leads 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 occur very rarely, in 1-3% of pregnancies; in other cases, childbirth occurs safely naturally.

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 pregnancy and normal development 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 correct location of this organ. Usually located or posterior, closer to the fundus of the uterus. This arrangement ensures the safety of this organ and its performance required function.

The location of the placenta depends on where the fertilized egg is implanted after conception. Placentation can be determined 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 area.

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 if operative delivery(C-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 in mandatory everyone will accept necessary measures in order to reduce the risk, and in case of bleeding they can 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, when independent childbirth autopsy of the amniotic sac is indicated early, 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 formation of the placenta along the anterior wall of the uterus is normal, but in some cases it can increase the risk of developing pregnancy complications.

Possible risks

Increased risk low location and . If the placenta initially forms quite low, then as the uterus enlarges, it will descend closer to the internal os, which can lead to complete or partial presentation;
Increased risk normally located placenta. The anterior wall of the uterus undergoes significant changes during pregnancy: it significantly stretches and thins. As pregnancy progresses, the sensitivity of the uterus increases. Even minor influences (, stroking the stomach) can lead to and. The placenta cannot contract, which may result in abruption;
Increased risk of true placenta accreta. This pathology is quite rare. An increased risk of its occurrence occurs in women with a history of surgical interventions on the uterus or damage due to abortion, diagnostic curettage. In this case, the placenta may form and adhere to the area of scar or internal damage;
Difficulty in auscultation. The location of the placenta on the anterior wall can make it difficult to listen to the fetal heartbeat with a stethoscope: the tones are heard more dull.

Information It should be noted that the location of the placenta along the anterior wall of the uterus is not pathological condition, and the risk of complications is extremely low. In most cases, women quietly carry a child and give birth through natural birth canal without any negative consequences.