The structure is heterogeneous due to the sections of the extended MVP. Causes and treatment of the heterogeneous structure of the placenta. Why is there a heterogeneous placenta

The placenta is one of the most important temporary organs of pregnancy. A few decades ago, the function of the placenta could only be assessed indirectly - by the state of the fetus itself. If the fetus is in order, then the placenta is working well. With the development of medicine and, especially, ultrasound diagnostics, it became possible to examine the placenta in utero.

What is placental hyperplasia?

Hyperplasia is an ancient Greek word meaning "excessive development", "increase". This term is applicable to any organ of the human body. In the case of the placenta, the term hyperplasia usually implies an increase in its thickness, mass and circumference. However, on ultrasound scanning, it is possible to accurately measure only the thickness of the placenta, so they are repelled from this indicator. It should be noted that a single ultrasound examination is not authorized to make a diagnosis of placental hyperplasia. A dynamic observation of a pregnant woman, the opinion of several doctors, and extended studies are necessary. Moreover, self-assessment of the results of ultrasound is unacceptable.

Hyperplasia or diffuse thickening of the placenta implies its edema, as well as a compensatory increase in the number of structural units. There are several reasons for this:

Infections. This is perhaps the most common cause thickening of the placenta. Bacteria, viruses and other foreign agents can enter the uterine cavity, amniotic membranes and water both ascending from the vagina and with blood flow from other foci. The placenta is rarely infected in isolation. Inflammation children's place called placentitis and very often it is combined with inflammation of the membranes and intrauterine infection of the fetus. With the development of the inflammatory process, placental edema occurs and apparent magnification its thickness.
Immunological conflict between mother and fetus, for example, according to the Rh factor. In this case, the picture will be similar to the infectious process, only it is not viruses and bacteria that affect the placental tissue, but the mother's antibodies. In simple terms, in this case, the mother's body tries to kill the fetus and all temporary organs of pregnancy, mistaking them for foreign ones.
Severe or long-term preeclampsia. With preeclampsia, blood pressure rises, protein appears in the urine and edema increases, including hidden ones. Placental edema also belongs to such latent edema. In addition, preeclampsia affects the vasculature of the placenta, also leading to edema.
Severe anemia in the mother. When the hemoglobin level falls below 80 g/l, the fetus begins to experience oxygen starvation. In this case, the placenta begins to grow compensatory in order to increase the area of gas exchange and thus help the fetus.
natural feature. It is not necessary to exclude the possibility of an increase in the placenta simply as a developmental option. Often, large children have massive placentas, or this feature is passed down through generations.

Very often, thickening of the placenta is combined with polyhydramnios or oligohydramnios, as well as the expansion of the intervillous spaces (MVP) of the placenta. In the first two cases, these are additional manifestations of infection or immune conflict. The expansion of the MEP suggests that the placenta is trying to compensate for its function. An isolated expansion of the urinary tract is not a diagnosis, but can only imply an infectious process, anemia, fetoplacental insufficiency, or simply a developmental feature.

Symptoms and diagnosis of placental hyperplasia

The placenta is devoid of pain innervation, therefore, with the initial signs of its defeat, nothing bothers the pregnant woman. Usually the main symptoms appear after weeks and even months.

The main symptoms of dysfunction of the placenta are signs of oxygen starvation of the fetus: growth retardation, impaired fetal-uterine blood flow, acute hypoxia. The woman notes a decrease in fetal movements, a decrease in its activity. On examination, the doctor pays attention to a decrease in the growth rate of the pregnant woman's abdomen, poor heart rate or cardiotocography.
Manifestations of the infectious process can also act as the main complaints. The pregnant woman complains of fever, weakness, headaches and muscle pain, chills, discharge from the genital tract. Often, when asked, a woman recalls a recent exacerbation of a chronic inflammatory process (otitis media, sinusitis, pyelonephritis) or an acute illness (ARVI, influenza, tonsillitis, thrombophlebitis).

If a thickening of the placenta is detected at the next ultrasound, it is necessary to perform the so-called diagnostic search - a series of examinations to identify possible causes:

General analysis of blood, urine and blood biochemistry to look for inflammatory changes, as well as determine the level of hemoglobin and ferritin.
Vaginal culture and swab, testing for sexually transmitted infections and the TORCH group.
Determination of the level of antibodies to the Rh factor and blood groups to exclude Rh sensitization.
Blood for glucose.
Consultations of a therapist and a cardiologist to exclude preeclampsia, an infectious disease specialist in complex cases of intrauterine infection.

Continuous CTG monitoring and fetal Doppler ultrasound are included in the monitoring protocols for such pregnant women.

Placental hyperplasia: consequences for mother and baby

Since the placenta is a temporary organ for the existence of the fetus, the consequences of a violation of its functions mainly affect the child:

chronic;
fetal growth retardation;
acute fetal hypoxia;
intrauterine fetal death;
premature birth.

The danger to the mother is not so much the hyperplasia of the placenta itself, but the reason that caused it. Preeclampsia and eclampsia, an infectious process, severe anemia certainly threaten the health and life of a woman.

Treatment of thickening of the placenta

Therapy for placental hyperplasia consists in treating the immediate cause that caused this complication:

Antibacterial and antiviral therapy in case of infection.
Treatment of preeclampsia, as well as early delivery.
Treatment of Rh-conflict, which consists in periodic intrauterine blood transfusion to the fetus and maternal plasmapheresis. In this case, the fastest possible delivery is also shown with mandatory prevention of the Rh conflict with anti-Rh immunoglobulins in the next pregnancy.
Therapy with iron preparations of anemia in a pregnant woman, as well as the transfusion of red blood cells in case of a decrease in hemoglobin below 75 g / l.

Given the impaired function of the placenta, the use of various drugs that improve placental blood flow is indicated: Curantil, Actovegin, Piracetam, Pentoxifylline.

Alexandra Pechkovskaya, obstetrician-gynecologist, specially for website

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The placenta is the most valuable organ of the female body during pregnancy. Its main functions are to deliver the necessary amount of nutrients to the fetus and provide it with oxygen. The normal course of pregnancy, as well as childbirth, directly depend on the state of development of the child's place. In addition, the embryonic organ performs protective functions, preventing various infections from entering the child, and ensures that it is supplied with a sufficient amount of hormones that allow the fetus to grow and develop.

Diagnosis of the condition of the placenta is extremely important and should be carried out throughout pregnancy using ultrasound (ultrasound).

This method allows you to timely detect any deviations in the development of the embryonic organ. And the sooner pathologies are detected, the greater the chances for successful treatment. With the help of ultrasound, doctors determine its structure, location,. In the course of such a study, the expectant mother can be diagnosed with a heterogeneous structure of the placenta.

Reasons for heterogeneity

In most cases, the heterogeneous structure of the embryonic organ should not be a cause for concern, because. is the norm. The final formation of the placenta falls on, after which, up to the thirtieth week, its structure should remain unchanged. And if at this time any changes occur in the structure of the child's place (the doctor can detect echo-negative areas, or other inclusions), then these changes can cause serious violations of the functioning of the placenta.

The main causes of such violations may be the presence in the body of a woman in labor of any infection or the consequences of drinking alcohol, anemia, smoking, etc. The heterogeneous structure of the placenta can provoke a violation of the blood flow between the pregnant woman and the fetus, resulting in a slowdown in the intrauterine development of the child, difficult childbirth. If during the ultrasound after changes in the structure of the child's place are found, then there is nothing to worry about, and the pregnancy proceeds normally. Sometimes changes in the placenta that are detected on are considered the norm, provided that the child continues to develop fully and according to its term. When examining ultrasound, the following phenomena associated with a violation of the structure of the child's place can be detected:

The structure of the placenta with the expansion of the IEP (intervillous spaces). The MVP is the place in the embryonic organ where metabolism takes place between the mother and the fetus. As pregnancy progresses, the baby requires more and more nutrients to grow and support vital functions. To meet his needs, the profit margin is increased. The expansion of this space does not lead to , but does not exclude it either. Additional studies are not carried out when expanding the MVP.
Heterogeneous structure of the child's place with calcifications. These accumulations of calcium salts prevent the embryonic organ from performing its functions effectively enough. As a rule, calcifications are detected in the placenta after (in 50% of cases). For more later dates(after 37 weeks) the presence of calcifications does not pose any threat to pregnancy, because. this is due to the natural aging of the placenta.

Treatment

The heterogeneous structure of the child's place can be associated with or, as well as her. In this case, additional studies may be prescribed, such as doppler, cardiotocography.

Complete restoration of the heterogeneous structure of the placenta is impossible. However, there are medications, which normalize the tone of the uterus, oxygen delivery, improve blood circulation. Also, the absence of stressful situations, all kinds of worries, has a positive effect. And the key to the normal course of pregnancy is the timely conduct of the necessary diagnostics, proper nutrition and healthy lifestyle life.

The placenta is an important organ of the female body, which facilitates the transport of nutrients to the fetus and provides sufficient oxygen. The final formation of the organ occurs at the 6th week of pregnancy, so the heterogeneous structure of the placenta should not bother the mother.

Norms and deviations

What does the heterogeneous structure of the placenta mean? In the process of bearing a child, the placenta changes its structure and is characterized by the degree of maturity at a certain period. It also happens that the second stage of maturity occurs before 34 weeks. This does not indicate an uneasy development of pregnancy.

Structure. The state of the organ can be clearly seen at 12 weeks. The homogeneous structure of the placenta is characterized by a smooth choral covering. The indicator refers to the zero degree and indicates homogeneity.

Thickness. With the help of ultrasound examination, the thickness of the organ is determined. Up to 32 weeks, it increases and normally is no more than 30 mm. A rapid thickening or, on the contrary, a decrease indicates the process of premature aging of the organ. The reasons are: mismatch of the Rh factor, the development of an infectious disease, diabetes women.

Heterogeneity indicators there may be inclusions of a different nature, areas of an echo-negative state. They indicate a violation in the functioning of the placental organ. A heterogeneous placenta with hyperechoic inclusions indicates serious disorders that affect the development of the child.

On examination, much attention is paid to the thickness of the placenta at the 20th week of pregnancy. The normal figure is from 1.5 cm to 5 cm. If the placental organ is thin and less than 1.5 cm, then there is a risk of fetal underdevelopment. But this phenomenon is quite rare.

Diagnostics

Ultrasound procedure - milestone control of the state of the body during pregnancy. Diagnostics allows you to detect the formation and accumulation of calcifications, tumors and the threat of exfoliation.

Degrees of heterogeneity:

1 degree. Uniformity is noticeably lost. There are characteristic changes in the structure;
2 degree. Formation of sections similar to a comma;
3 degree. The process of salt deposition on the dead parts of tissues is greatly enhanced. Calcification occurs.

In the process of passing an ultrasound, with an accuracy of up to a millimeter, the place of attachment of the placenta in the uterus is determined. Starting from the 10th week, the doctor fixes the fact of the location of the fetus. The third examination procedure shows the stage of development of the child and reveals the initial pathologies.

The method of ultrasound examination allows you to identify not only changes in the embryonic organ, but also determine the thickness, exact location, stage of maturity. Since the final development is formed at 16 weeks of gestation, then up to 8 months the structure should not change.

The practice of conducting an ultrasound examination includes cases of expansion of the intervillous space. The MEP is the space in the embryonic organ where metabolism takes place between mother and fetus. As the child grows, the amount of nutrients consumed increases.

Timely diagnosis allows you to detect calcifications on dead tissues. This is a common phenomenon associated with the natural aging of the embryonic organ. The doctor keeps under control the volume of formation of salts. After 33 weeks of gestation, the amount of calcifications can increase dramatically. The rate of growth and development of the child should correspond to the degree of deterioration of the placenta. Only in this case you should not worry.

Causes and symptoms

The main causes of placental heterogeneity can be infectious diseases, even those that were previously, or Negative consequences heavy drinking and smoking. This leads to disruption of blood flow from mother to child. Oxygen starvation of the fetus or fading of the pregnancy process occurs. A striking symptom is a change in the movement of the child inside. Quitting smoking and drinking reduces the risk of placental defects

If the changes occurring in the structure are detected by the doctor at week 30, this fact is the norm in development. The main condition is the absence of serious abnormalities in the fetus. Causes of heterogeneity, it is most often a combination wrong actions mother, including nervous experiences. The more comfortable, calmer the mother will be, the better the well-being of the unborn baby. Psycho-emotional state determines the state of the female body.

You should refrain from contact with sick people, as you can become infected with an infectious disease. And this is another negative factor leading to improper development of the structure.

20 - 27 weeks. The heterogeneous structure of the placenta at 20 weeks is a common occurrence among mothers. In the event of a negative change in the state of the organ, the ultrasound procedure will immediately report the initial stage of the pathology. The placenta can remain heterogeneous up to 27 weeks, after which it returns to normal. Do not panic, each individual organism with its own developmental characteristics.

30-32 weeks. Upon reaching a period of 30 weeks, the structure of the organ should become homogeneous. If for a period of 30-32 weeks the structure remains heterogeneous, then this indicates the presence of pathology in the female body. A heterogeneous placenta at week 32 indicates a serious pathology that occurs in the body.

Treatment and childbirth

Complete restoration of homogeneity with the help of drugs is impossible. The absence of stress and anxiety has a beneficial effect on the entire period of pregnancy.

A heterogeneous placenta during pregnancy is directly related to hypoplasia and hyperplasia. The doctor makes an appointment medicines to improve uterine tone, blood circulation and proper oxygen delivery to the fetus. As an additional method - a healthy lifestyle and the rejection of bad habits. The passage of ultrasound before the onset of childbirth is also a necessary aspect of health monitoring.

Treatment of heterogeneity of the placenta:

exclusion of stress and depression;
decreased tone, hypoxia;
therapy of diseases: hypoplasia and hyperplasia;
delivery.

A woman should strictly follow the doctor's recommendations and take medications if they have been prescribed. Monitoring the development of the fetus should take place at all stages of gestation. If you follow the rules and lead a healthy lifestyle, then you should not be afraid for the unborn child and childbirth.

The tactics of conducting childbirth with placental insufficiency is prescribed by the attending physician based on the state of the woman's body. Premature aging placental organ - an abnormal indicator that inspires fear even for a doctor. At proper treatment the problem is fixable.

Calcifications

Calcifications are salt formations that are deposited in areas of dead tissues of the organ. The placental organ contains multiple blood vessels. They transport vital substances to the unborn child. In the event of a spasm of the vessel or failure, it leads to the death of the site. Calcium salt deposits form on dead tissue areas.

The deposition of calcifications in the placenta can lead to:

pathological process of the uterus;
anemia in a severe stage;
preeclampsia and its manifestations;
infection and chronic diseases;
sexually transmitted diseases;
bad habits.

In order for the pregnancy to proceed positively, periodic examination by a doctor is required. The modern method of monitoring the process is the ultrasonic method, that is, ultrasound. It is used to detect pathology early dates and detection of calcifications in areas.

Symptoms. In the case of a single deposition of calcifications, the woman will not feel discomfort. It will not harm the unborn child. If multiple foci of salt deposits form on dead tissues, this seriously harms the fetus. With a strong phenomenon, a woman notices a change in the nature of the behavior of the child inside. He becomes too active or vice versa subsides. Disrupted operation results in failure to perform proper life support functions. The child is not getting enough oxygen. In severe cases, fetal death occurs inside the female body.

Treatment. It is impossible to completely remove salt deposits inside the body. To begin with, the doctor establishes the specific cause of the appearance of salts and tries to eliminate the possibility of relapse. If salts were noticed in the late period of pregnancy, and their number is small, then periodic examinations of the woman in labor are prescribed. The doctor controls the situation with the help of ultrasound, observes the heterogeneous placenta with calcifications. Examination reveals a large number of foci of salts, but at the same time, the functioning of the placental organ can take place without disturbance. If the fetus continues to receive the necessary vital substances, then taking therapeutic drugs is not required.

Complications. If a dysfunction is detected, if the fetus suffers from the lack of oxygen and nutrition, the doctor prescribes appropriate treatment. It includes taking medications that normalize blood circulation, as well as vitamins. Additional drugs in the treatment are stimulants of the metabolic process.

Close monitoring of the structure of the placenta during pregnancy is required. Also, do not forget about the normal, comfortable development of the fetus inside the mother's body. According to his behavior, well-being, conclusions are drawn about the normal process of gestation.

The normal development of pregnancy and the course of the birth itself largely depends on the state of the placenta. It is she who is responsible for feeding the baby and supplying him with oxygen. Therefore, doctors monitor this organ throughout pregnancy.

Regular ultrasound will allow you to identify certain deviations in time and take appropriate measures. In the course of the study, the location of the child's place, the degree of its maturity, and its structure are determined.

And if a woman is told that there is a heterogeneous structure of the placenta, this naturally causes anxiety and concern. And this is not surprising, because the placenta, in addition to nutrition and respiration, plays the role of a protector from infections, a supplier of necessary hormones and a transporter of waste products of the child in the womb.

Why is there a heterogeneous placenta?

Placenta heterogeneity is not always a cause for concern. In some cases, this condition is considered the norm. The placenta is finally formed by 16 weeks. And after that, until the 30th week, the structure of the placenta should not change. And you need to worry if it is during this period that the doctor detects changes in its structure.

The reason for concern is the structure of the placenta of increased echogenicity and the detection of various inclusions in it. In this case, the heterogeneous structure of the organ indicates a violation of its normal functioning.

The cause of these disorders may be infections present in the body of a woman. Smoking, alcohol, anemia and some other factors negatively affect the development of the placenta. As a result of the heterogeneity of the placenta, the blood flow between the mother and the child may be disturbed, from which the latter will suffer. As a result, the development of the fetus can slow down and even completely stop.

If changes in the structure of the placenta are found after 30 weeks, this means that everything is normal and is going as expected. Sometimes, even at week 27, changes are considered normal, if there are no deviations in the development of the fetus.

It is found in the conclusions of the ultrasound recording "the structure of the placenta with the expansion of the MVP." MEPs are intervillous spaces, a place in the placenta where the exchange of substances between the blood of the mother and the child takes place. The expansion of these spaces is associated with the need to increase the exchange area. There are several options for expanding the MVP, but all of them are not associated with the development of placental insufficiency. With this diagnosis, there is no need for additional studies.

The heterogeneous structure of the placenta with calcifications is another variant of the violation of the structure of the placenta. In this case, the danger is not calcifications as such, but their presence. They prevent the placenta from performing its functions to the fullest.

The structure of the placenta with small calcifications in late pregnancy is not a cause for concern. This rather speaks of the aging of the placenta, which after 37 weeks is quite normal. In 50% of cases after 33 weeks, calcifications are found in the placenta.

The degree of maturity of the placenta and its structure

The placenta is clearly visible on ultrasound, starting at 12 weeks. During this period, its echogenicity is similar to that of the myometrium. At maturity 0, a homogeneous structure of the placenta is noted, that is, homogeneous, limited by a smooth chorionic plate.

Already at degree 1, the structure of the placenta loses its homogeneity, echogenic inclusions appear in it. The structure of the placenta of the 2nd degree is marked by the appearance of echo-positive areas in the form of commas. And grade 3 is characterized by increased calcification of the placenta.