The placenta is a very important, albeit temporary organ that exists while the fetus develops and grows. After the baby is born, it dies and is rejected.
Moreover, like any human body, the placenta goes through all stages: birth, maturation and aging.
This process is completely natural, but it is necessary that everything happens in its own time, because otherwise there is a risk of various pathologies or threats to pregnancy.
Its main function is to fully ensure the baby’s vital functions while he is in his mother’s belly. The properties of this embryonic organ are difficult to overestimate, since the placenta is considered the most important component for the process of intrauterine development.
The most important tasks of the placenta are:
- protection of the fetus from the negative effects of the environment, penetration of bacteria, viruses, etc.;
- release of hormones necessary to maintain pregnancy;
- removal of harmful substances;
- providing the child with the necessary nutrients and nutrients, oxygen;
- performing the functions of many of the baby’s organs until they are fully developed and independent (such as excretory, endocrine and other systems).
The placenta does not appear immediately after conception. First (approximately on the tenth day), the cells that are responsible for the future connection between mother and fetus are actively dividing. As a result of this process, the production of special enzymes begins, which slowly line the uterine cavity, creating conditions for the baby to have access to the nutrients of the mother’s body. Next comes the formation of a stable blood exchange between the woman and the child.
Placental development: what is maturity?
The early placenta will form only by 9-10 weeks. As the pregnancy develops, the placenta also develops: it increases in thickness, its vessels grow, etc.
There is the concept of placental maturity, which is practically the main indicator for assessing structural, physiological changes, determining the presence of pathologies, anomalies or disorders.
The placenta develops so that the baby's needs, which are constantly changing, can be met on time and completely.
In this regard, functionality is lost, that is, the child may be more susceptible to viruses, begins to receive less oxygen, etc.
The numbers in the study: what do they mean?
There are four degrees of placenta maturity, each of which reflects a certain stage of development of this organ and the physiological changes that occur in it.
It is necessary that the degree of maturity of the placenta clearly corresponds to the duration of your pregnancy, because this indicator indirectly indicates the state of health and well-being of your child.
Table. Degree of placenta maturity by week of pregnancy
| Degree of maturity of the placenta | The nature of the structure of the placenta | Type and characteristics of the tissue of the chorionic part, which is adjacent to the fetus | Areas of calcium deposits (salts) |
| Up to 27-30 weeks – 0 (zero) | Homogeneous | The fabric is even and smooth | Almost not |
| From 27 to 36 weeks - 1 (first) | With few seals | Individual echogenic inclusions appear, the chorionic plate becomes slightly undulating | Microscopic presence |
| From 34 to 39 weeks – 2 (second) | There are pronounced seals | The waviness increases, many small depressions can be distinguished | Clearly visible |
| After 36 weeks - 3 (third) | Possible placental cysts | The chorionic membrane acquires pronounced tortuosity, and the placenta itself acquires a lobular structure | A lot |
How to diagnose the problem?
Each stage of pregnancy must correspond to a certain degree of maturity of the placenta.
If these indicators are in order, then the doctor will be able to conclude that the organ is functioning normally and is able to fully satisfy the demands of the developing and growing baby for oxygen and nutrients.
If the indicators do not correspond to the norm, then this will become a diagnosis of organ pathology. Next, the doctor will decide on corrective treatment or preventive measures to prevent harm to the child and pregnancy.
To determine the degree of maturity of the placenta and the nature of its changes, various diagnostic methods are used:
- (CTG);
- hormonal studies.
The difficulty is that every ultrasound diagnostician can rather subjectively assess the degree of maturity of the placenta, because the indicators are determined almost “by eye”.
That is why, at the slightest doubt, it is necessary to confirm the diagnosis with other diagnostic methods and studies.
For example, the same Doppler ultrasound can give completely normal readings, relieving you of unnecessary fears. This method is based on assessing blood flow through the placenta, and this can be done by reflecting ultrasonic waves.
If pregnancy proceeds normally, then after twenty weeks the blood resistance in the vessels that connect the woman’s uterus, placenta and baby will begin to decrease. Only Doppler sonography will be able to assess the baby’s condition: whether he is receiving enough nutrients, oxygen, etc.
Ultrasound indicators regarding the degree of placental maturity may not correspond to Doppler measurements.
CTG is another additional diagnostic method. Thanks to it, you can find out how your child is feeling right at the moment. Such a cardiac monitoring study, using special attached sensors, helps the doctor count how often the baby moves, catch and listen to his heartbeat, and record contractions of the woman’s uterus.
All these indicators will indicate either the normal functioning and functionality of the placenta, or its malfunctions and disturbances.
Possible deviations and their reasons
If the results of your research differ slightly from the ideal book norms, do not worry too much. It is important not just to find out the “dry numbers” that reflect the degree of maturity. Much more important is assessing the condition and well-being of the baby.
This is precisely why Doppler testing and CTG are performed: to check how the baby is feeling, whether everything is okay with him, whether his size and development correspond to the duration of your pregnancy, etc. The doctor will definitely tell you how the pregnancy is progressing, and whether there are a real cause for concern.
Dangers of premature aging of the placenta
If the second degree of placenta maturity was detected before the 32nd week, or the third degree before the 36th week, doctors talk about its premature or early aging.
There are many reasons for this pathology:
- hormonal imbalances;
- chronic diseases of women (problems with the cardiovascular system);
- infectious diseases leading to intrauterine infections of the child;
- (hypertension);
- improper or uncontrolled use of vitamins (especially calcium);
- or ;
One of the most common reasons is simply an unhealthy lifestyle: bad habits, drinking alcohol, drugs, smoking.
Premature aging in itself is not a direct threat to the life or health of the baby. However, in combination with other deviations from the norm or violations, this can lead to negative consequences:
Occurs due to lack of oxygen. The child will suffer and this will affect his health. In some cases, even fetal death was recorded.
- Intrauterine developmental delay.
It occurs due to insufficient intake of nutrients and vital substances into the baby’s body. This can result in malnutrition, growth retardation, etc.
- (if there is a very large discrepancy between indicators and standards).
Doctors will try to verify the diagnosis using other diagnostic methods. If it is confirmed again, then the woman will be prescribed comprehensive treatment and prevention measures. You may need to go to hospital under medical supervision. Sometimes emergency delivery is recommended.
Why might there be late maturation?
This pathology is much less common than the previous one. The placenta is considered immature if it has not reached the second or third stages before the end of pregnancy.
Sometimes the reason for such a diagnosis can be a simple technical error: if the mother and child are present, then the placenta will have swelling, which on ultrasound will appear to be of zero degree of maturity.
However, due to such a sign, a serious complication may be missed.
Prolonged immaturity of the placenta sometimes leads to the fact that it does not perform its necessary functions at all, or performs them incorrectly. This threatens to result in the child’s mental retardation, other developmental anomalies, and even lead to his death and stillbirth.
Doctors note that pathology is possible if the baby has congenital defects. Sometimes it can be observed in pregnant women and diabetes mellitus.
Instead of a conclusion
Do not panic or self-medicate under any circumstances. The degree of maturity of the placenta is not yet a clinical diagnosis, but only an important diagnostic sign.
Doctors will carefully monitor the well-being and condition of the child in order to detect in time whether there are serious reasons for concern and take appropriate measures. You need to take care of your health and also follow all the doctor’s recommendations and instructions.
The degree of maturity of the placenta is an indicator that is determined during an ultrasound examination of a pregnant woman. It refers to those changes visible on ultrasound that occur in the placenta during pregnancy.
The placenta is a temporary organ that is only needed for 9 months while the fetus develops, and then it is rejected after the baby is born. The importance of the placenta for a baby cannot be underestimated; it replaces his lungs, kidneys, and gastrointestinal tract, providing oxygen, nutrients, and removing harmful substances. In addition, the placenta secretes hormones that maintain pregnancy.
What does the degree of maturity of the placenta mean?
During pregnancy, the placenta gradually thickens, its vessels grow, and at a certain stage it stops growing and begins to age. Calcium begins to be deposited in it, its structure itself becomes denser, and this can be seen during ultrasound examination.
What does placental maturation mean for pregnancy progression? The higher the indicator, the less functionality a woman’s embryonic organ has. That is, if this indicator is at 0, this means that it is still capable of growing and, in principle, can meet the needs of a growing child for a very long time. And if the placenta is stage 3, then it has limited reserves, since the pregnancy should soon end. However, if such an aged condition is detected at fairly early stages of pregnancy, the baby may not have enough nutrients and oxygen for full development, and there is a risk of intrauterine hypoxia.
What is dangerous about premature ripening of the placenta?
An aged placenta may not be able to deliver enough oxygen and nutrients to the child, which may result in intrauterine growth retardation, malnutrition, the birth of a low-weight baby, and, of course, the most dangerous thing - intrauterine hypoxia (the child suffocates in the tummy, this can lead to him to death).
How is the degree of maturity of the placenta determined?
It can be determined by ultrasound examination, and after the birth of the child by the result of histological examination. As the placenta matures, structural changes occur, which the doctor sees using ultrasound. The appearance of the border between the placenta and the uterus changes, its thickness and echographic density, the ability to reflect ultrasound change, calcium deposits appear, visible on ultrasound in the form of small white inclusions. The thickness of the placenta correlates; at first it grows and thickens, and at the end of pregnancy there is a slight decrease in thickness.
How many degrees of placenta maturity do doctors distinguish?
There are four positions in total, they are normally distributed by week as follows:
Zero degree
A zero indicator is observed up to 30 weeks of pregnancy, however, quite often at an earlier stage, doctors write in the conclusion “the degree of maturity of the placenta is 0-1.” Changes that start early occur under the influence of external factors, for example, if the expectant mother gets sick with ARVI or smokes.
Why is this happening? In such conditions, the placenta is forced to work very actively, protecting the baby, and of course, because of this, it is forced to develop faster.
What is needed to slow down this process so that the placenta is “enough to last”? That's right, it is necessary that good conditions are created for the baby, and there is enough of everything, the mother should not get sick, should not come into contact with harmful substances and should eat properly.
First degree
By 30 weeks of pregnancy, the placenta stops growing and its tissues begin to thicken, this will continue until the 34th week. If already at 32 - 33 weeks, at the second screening ultrasound, you are found to have an increased indicator: 1-2 or 2, then, most likely, you will be offered treatment. Drugs are prescribed that improve blood circulation in the placenta, vitamins, rest and proper nutrition are prescribed.
Second degree
This indicator normally ranges from 35 to 39 weeks. It copes with its functions quite well and provides the child with everything necessary. At this stage, such a placenta is completely normal and treatment is not necessary. As pregnancy progresses, the indicator should increase, the most important thing is that this does not happen ahead of time. But even if at 37-38 weeks the data has already reached grade 2-3, there is no need to worry, this is a full-term pregnancy and there is nothing terrible about it, this is the norm.
Third degree
Before childbirth, as a rule, the uterus reaches the second or even third level. If the placenta is functionally stable, the child does not experience hypoxia, the third degree should not scare you, this is normal. However, if there is hypoxia, they may decide to perform the birth surgically.
Remember, ultrasound results during pregnancy may indicate premature maturation of the placenta, but it is not a fact that there is necessarily placental insufficiency. Clarifies the functionality of the placenta and the condition of the child by fetal CTG. The doctor prescribes it in cases where there is any doubt.
During the second and third trimester, doctors use ultrasound diagnostics to determine the degree of maturity of the placenta. Not every expectant mother understands what we are talking about, and this is a very important indicator when carrying a baby. In this article we will tell you what the degree of maturity of the “children’s place” is and what it should be normally at different stages.
What it is?
The placenta is a temporary organ, its tasks and functions are limited by the duration of pregnancy, and after the birth of the baby there is no need for a “baby place”. But during the period of carrying a baby, you can’t do without a placenta - it protects the baby, provides him with access to oxygen, vitamins, water, minerals, removes the baby’s waste products, carbon dioxide, into the mother’s body, produces many hormones that are necessary for carrying a baby and preparing milk glands of a woman to breastfeeding. Even the slightest disturbance in the placenta can lead to very serious consequences for the health or life of the child and his mother.
The placenta does not appear immediately after conception; it forms gradually. Approximately 8 days after fertilization, the egg, which has become a blastocyst, descends into the uterus, where it will attach to one of the walls, tightly growing into the endometrium with chorionic villi. The chorion at the site of ingrowth is the precursor of the future placenta. From this moment the formation of a “children’s place” begins.
By 12-14 weeks of pregnancy, the young placenta begins to function, but does not yet have certain defined forms. The placenta takes on its final shape by 18-20 weeks of pregnancy. The growth of the “baby place” continues until the middle of the second trimester, after which the placenta no longer grows.
By childbirth, the temporary life support organ of a child growing in the womb gradually loses its functions, “aging”, developing a resource. The aging process is monitored by doctors using ultrasound and assessed in degrees of maturity. If for some reason the placenta begins to age prematurely, the baby will not receive enough oxygen and nutrition, his development may slow down, and hypoxia associated with a lack of oxygen can cause irreversible processes in his nervous system, brain, musculoskeletal system, and also cause intrauterine death of the baby.
The young placenta constantly increases in thickness and grows with new blood vessels. In the second half of pregnancy, growth stops, the placenta retains its thickness for some time, and then becomes not spongy, as in the beginning, but more dense due to calcium deposition. The functionality of the “children’s place” is also gradually fading.
Degrees of maturity
There are four degrees of maturity of the “children's place”. Zero degree corresponds to the initial stage of placental functioning. If the doctor claims that the degree of maturity is 0, this means that the “children’s place” is young, full of strength and opportunity and fully provides the child with everything necessary for his growth and further development.
The first degree of maturity means that changes have already begun in the placenta - it has stopped growing and increasing in thickness. On ultrasound, such a placenta is determined to be smooth, with a slight wavy membrane and isolated echogenic inclusions.
Causes of premature aging
If the placenta ages within the time limits established in obstetrics, then aging is called physiological, that is, completely natural. If the “baby place” has matured ahead of schedule, we are talking about premature aging of the placenta, and this is a very alarming pathology that requires mandatory medical care.
The reasons for the premature maturation of the “children's place” can be different. Most often, this happens in pregnant women who could not or did not want to give up bad habits - smoking and addiction to alcohol - at least for the duration of pregnancy. Also at risk for premature ripening of the placenta are women who have had infectious diseases during pregnancy, including ARVI and influenza.
Quite often, the placenta ages prematurely in women with a negative Rh factor who are carrying their Rh-positive babies against the background of a developed Rh conflict, as indicated by the titer of antibodies in the blood of the pregnant woman. Early aging of the “children’s place” often accompanies pregnancy in women with diabetes, as well as those who are accustomed to taking medications for any reason without the consent of a doctor.
Expectant mothers who are exposed to harmful substances (household chemicals, toxins, paints and varnishes, solvents) or radioactive radiation are also at risk. Doctors are inclined to believe that the stages of placental maturation proceed faster than the normative periods in women living in large cities, where the environmental situation leaves much to be desired.
The factor of premature aging often depends on heredity - the daughter runs the risk of repeating the scenario of her mother's pregnancy. The cause of aging may also be some anomalies in the structure of the placenta itself, which formed during the formation of this temporary organ.
Also, the most common causes of premature aging of the “children’s place” are:
- gestosis, late toxicosis in the expectant mother;
- hypertension, changes in blood pressure;
- the presence of evidence of abruption at different stages of pregnancy, placenta previa;
- multiple pregnancy;
- hormonal disorders in the body of the expectant mother.
Causes of pathological immaturity
Another deviation from the norm is pathological immaturity of the placenta. It occurs much less frequently, but is no less dangerous. If a woman is 35 weeks pregnant, and the placenta remains immature and its degree is determined by ultrasound to be 0 or 0-1, then the doctor has every reason to believe that such a “baby place” also cannot cope with the functions assigned to it by nature.
An immature placenta cannot provide the growing baby with the necessary amount of oxygen and nutrients, which leads to the birth of a baby with low weight and developmental delay, as well as fetal hypoxia.
As the baby grows, the placenta and umbilical cord “pump” an increasing amount of blood both from the baby with metabolic products and to him - enriched with oxygen and vitamins. An immature placenta cannot provide uninterrupted blood flow in this mode. It retains the baby's waste products, as well as carbon dioxide, which negatively affects the condition of the child and the health of the placenta itself.
The prognosis is less favorable than for premature aging of the placenta, since medicine cannot always influence the maturation processes of this temporary organ. Stillbirth cannot be ruled out, as well as the birth of children with severe mental disabilities, paresis and paralysis, and disorders of the central nervous system due to chronic hypoxia during pregnancy.
The reasons that can lead to slow maturation and development of the placenta are also quite diverse. Most often, this disorder occurs in women who suffered from diabetes before pregnancy, as well as in expectant mothers who were diagnosed with gestational diabetes while pregnant. Pregnant women who smoke and drink are second on the list of likely patients diagnosed with “pathological immaturity of the placenta.”
Nicotine and alcohol, especially when used systematically, slow down natural processes and suppress the production of necessary sex hormones.
An immature “baby place” is often diagnosed in women who are carrying a child against the background of exacerbation of chronic diseases of the liver, kidneys, heart and blood vessels. Hemostasis (blood clotting) disorders are also a risk factor.
If placental immaturity is detected, a woman is necessarily recommended to undergo additional diagnostics aimed at identifying the risks of having a child with chromosomal and genetic pathologies, as well as severe malformations of internal organs. It is this “inhibited” behavior of the placenta that is characteristic of pregnancies with sick and terminally ill babies.
Treatment
First of all, a woman should calm down and pull herself together - nervous shock and prolonged stress create no less dangerous preconditions for placental pathologies than contact of a pregnant woman with chemicals or viral illnesses. In case of premature aging of the “baby place”, the doctor usually decides in favor of hospitalizing the expectant mother in a gynecological hospital. If the pregnancy has not exceeded 36 weeks, then she will be given maintenance therapy and the baby’s condition will be monitored.
For treatment, drugs are used that improve uteroplacental blood flow, as well as antispasmodics so that the uterus is less likely to become toned. Vitamin preparations for the baby are also administered by drip.
The woman is recommended to take oxygen cocktails. The condition of the placenta is carefully monitored, repeating ultrasound every few days with a mandatory assessment of the speed and intensity of blood flow in the uteroplacental vessels.
If the gestational age at the time of detection of premature aging of the “baby place” exceeds 36 weeks, the doctor may suggest early delivery. This will depend on the specific situation and level of maturity. Sometimes a decision is also made to hospitalize and monitor the child’s condition on a daily basis.
The expectant mother undergoes CTG every day to make sure that the baby does not show signs of oxygen starvation. If such signs appear, maintenance therapy is canceled and early delivery or cesarean section is performed.
If late maturation of the placenta is detected, if the degree of its maturity does not reach the norm, the woman is also recommended to be inpatient. Treatment is prescribed after establishing the absence of fetal malformations. If genetic tests or amniocentesis confirm that the baby is healthy, and an expert ultrasound does not reveal signs of structural anomalies of its organs, then the treatment is the same as for premature aging - vitamins, drugs to improve blood flow in the uterus and placenta, as well as mild sedatives to calm down.
If the child turns out to be sick, the woman is offered to terminate the pregnancy. If the baby refuses, the baby is kept with standard therapy.
If hormonal imbalances are the cause of immaturity, the woman may be recommended hormonal treatment, which should accelerate the growth of placental tissue and the dilation of blood vessels in it.
The specific drug and dosage are determined by the attending physician; it is advisable to undergo such treatment under the supervision of specialists in a hospital setting.
The baby’s condition is also monitored through ultrasound, ultrasound and CTG (after 28-30 weeks). If signs indicating severe discomfort and suffering of the baby in the womb are detected, a decision is also made on early delivery to save the child’s life. Typically, a caesarean section is performed and the premature baby is subsequently cared for by experienced neonatologists in a well-equipped intensive care unit.
What is considered a deviation?
A deviation should be considered a significant difference in the state of the pregnant placenta from the normative values. If a woman is 30 weeks pregnant, and an ultrasound showed 0-1 degree of maturity of the “baby spot,” this is a conditional norm. And if the degree is already first or first or second, then the woman needs to go to the hospital as soon as possible to begin treatment.
The most stringent requirements are imposed on the standards at the transition of 1-2 and 2-3 degrees. With grades 1-2, the child usually cannot live independently yet or may be born very premature. By saving such a baby from the mother’s womb, where he lacks nutrition and oxygen, doctors take risks, because the baby may not survive due to his own immaturity and unpreparedness for life in this world.
Any deviation should be assessed by a doctor, and not by the pregnant woman herself. Only the doctor will say in what situation and with what accompanying diagnoses the degree of maturity will be normal or turn out to be a pathology. The decision is also made taking into account the individual characteristics of the gestational period.
Prevention
A woman cannot always influence the processes occurring in the placenta, but she can completely reduce the risks of premature aging or pathological immaturity. To do this, you need to give up bad habits, not take pills and syrups without the doctor’s knowledge, as well as eat a healthy and balanced diet and breathe more fresh air. Harmful chemicals should be kept away.
For information on the degree of placenta maturity by week, see the following video.
The placenta is a “temporary” organ that develops and grows specifically for the needs of pregnancy. The placenta provides nutrition and breathing to the baby, without which its normal development and growth is impossible. As the child grows and develops, the placenta also undergoes certain changes in its structure and size. By the time the baby is born, the placenta becomes old and comes out, tearing away from the walls of the uterus after the baby is born. Thus, we can conditionally say that during 9 months of pregnancy the placenta goes through all stages of life - birth, maturation, aging and death. The degree of maturity of the placenta reflects precisely the process of its aging, which reaches its culmination by the time the child is born to term (by the 37th week of gestation).
Based on certain signs of aging of the placenta, four degrees of maturity are distinguished, which are designated by the numbers 0, 1, 2 and 3. The degree of placenta maturity 0 reflects the conditional “youth” of the organ, when there are no changes in it characteristic of the aging process. Placental maturity level 0 is usually observed before the 30th week of pregnancy. That is, until the 31st week of gestation, the norm of placental maturity is zero. In the same way, other degrees of placental maturity are characteristic of certain periods of pregnancy.
The discrepancy between the degree of maturity of the placenta and the gestational age indicates the presence of pathology. For example, if a pregnant woman is less than 27 weeks pregnant and has a placental maturity level of 1, then we are talking about pathology. Typically, such a discrepancy between the degree of maturity of the placenta and the gestational age is called “premature aging of the placenta.” Very often, premature aging of the placenta indicates the development of fetoplacental insufficiency, which requires treatment in the pregnancy pathology department. With fetoplacental insufficiency, the fetus suffers, as it receives an insufficient amount of nutrients and oxygen, and therefore its growth and development are impaired. That is why it is important to determine the degree of maturity of the placenta at different stages of gestation.
The degree of maturity of the placenta is determined during an ultrasound examination. Usually the doctor writes the following in the conclusion: “The degree of maturity of the placenta is 0 or 1, or 2, or 3.” However, sometimes the conclusion may contain a description of the zero degree of maturity, in which the following concepts are key: the basement membrane is smooth, and the structure of the organ is homogeneous and does not contain inclusions. If the doctor left such a description of the structure of the placenta in the ultrasound report, then we are also talking about maturity degree 0.
If a woman is diagnosed with a zero degree of placental maturity before 30 weeks of pregnancy, then everything is normal. From 31 weeks to 36, the degree of maturity of the placenta should be 1.
Seven days after fertilization, the human embryo, freely located in the uterus, begins to sink into its mucous membrane. Having attached itself to the posterior (less often to the anterior) wall of the uterus with its villous membrane, chorion and allantois, the embryo enters the so-called fetal period of its development. At this time, a temporary organ is formed - the baby's place or placenta.
What role does this structure play in the process of intrauterine development of the unborn child, what does the degree of maturity of the placenta mean - these and other questions will be discussed by us in this article.
Why is a placenta needed?
Everything that grows and develops must eat and breathe. And the future baby is no exception. From the mother's blood, glucose, amino acids and, of course, oxygen enter his cells. It turns out that the blood vessels of the fetus and mother are not anatomically connected to each other. This fact is of cardinal importance, otherwise ballast substances from the maternal bloodstream would clog the blood of the embryo. On the other hand, fetal proteins that are foreign to the mother’s immune system would provoke serious disturbances in her homeostasis. So, it is the placenta that creates the necessary barrier, at the same time providing through its special structures - cotyledons - a passive exchange of plastic compounds and gases between the organisms of the mother and her unborn child. During embryogenesis, complex metamorphoses occur not only in the development of the fetus, but the degree of maturity of the placenta also changes from week to week. The table presented below will reveal to us the dynamics of these changes.
The fetal part of the baby's place
As we have already found out, the placenta is formed as a temporary organ, starting from 3-6 weeks of pregnancy. The fertilized egg - the zygote - begins to fragment and becomes covered with a villous layer called the chorion. At 10-12 weeks, the early placenta forms, and the chorionic villi grow into the endometrium of the uterus.
At first, the structure of the placenta is amorphous, but from the 12th week, the baby's place gradually takes on the appearance of a flat disc. By the end of pregnancy, its diameter reaches 20 centimeters and its weight is 0.5 kg. The surface of the baby's place facing the embryo is called fetal. The histological structure of the amniotic membrane and the chorion that forms it indicates a direct connection with the body of the embryo, which is carried out through the umbilical cords and ring entering the epithelium (skin) of the developing child.
Functions of the placenta
Together with the maternal part, represented by the endometrium, the baby's place performs a number of important functions: trophic, respiratory, barrier, excretory, endocrine. We examined the first three earlier; we recall that thanks to such processes the embryo receives the necessary nutrients, vitamins, and solutions of mineral elements in the form of compounds.
The respiratory function of the placenta is carried out by the diffusion of oxygen and carbon dioxide molecules circulating in the blood vessels of the umbilical cord. The barrier property of the placenta prevents the penetration of antigens into the body of both the mother and the fetus. The ability of the child's place to produce hormones such as progesterone and prolactin gives rise to the idea of the placenta as an endocrine gland. The excretory function of the baby's place is to evacuate toxic products from the blood of the embryo through the umbilical veins: creatine, urea and excess salts.
Parameters of a normally developing fetus
Regular ultrasound examination of the unborn child allows you to determine what degree of maturity of the placenta should be, based on the woman’s gestational age. The shorter the period, the more processes of biosynthesis of carbohydrates, proteins and lipids are carried out by embryonic cells and the more intense metabolic processes occur between the blood of the mother and the fetus.
The structure of tissues and metabolism of the child's place during this period corresponds to 0 degree of placental maturity by week. The table, compiled based on the results of diagnosing a normal pregnancy and presented below, shows that a period of up to 30 weeks is characterized by the following physiological norm for the state of the child’s place: an almost smooth surface of its fetal part, uniform tissue structure and the absence of calcium salt deposits in them. However, even if the obtained ultrasound results fully correspond to the above parameters of the normal development of the placenta, the decisive indicators will be the heart rate and the provision of oxygen to the organs and tissues of the fetus.
Aging of the placenta: normal or pathological?
The baby's place is a temporarily functioning organ, so its tissues gradually become coarser (their consistency becomes denser), which leads to a deterioration in the processes of diffusion and osmosis, as well as a decrease in the speed of blood flow in the placental vessels. The most significant period for elucidating the mechanisms of aging of the placenta is the 34th week. The degree of maturity of the placenta during this period increases greatly, and by the 39th week of pregnancy the afterbirth becomes very dense, and its functioning decreases.
This is a genetically and physiologically normal phenomenon that occurs during pregnancy. The dependence of the state of the baby's place on the trimester of pregnancy is determined as the degree of maturity of the placenta by week. The table presented below provides visual information showing the correlative relationship between the period of fetal development and the histological picture of the placental structures.
Why is the children's place getting old?
In some cases, the rate of aging of the organ connecting the maternal and child organisms may increase. For example, based on the results of an ultrasound, the doctor assigns placenta maturity level 2, although the gestational age is less than 32 weeks. There may be several reasons: a previous viral infection, regular intoxication as a result of smoking, chronic diseases of the woman herself (hypertension, diabetes, thrombophlebitis) or Rh conflict.
The extent to which this will affect the development of the fetus is determined by the attending physician, who will choose the correct treatment strategy. Usually it includes both additional diagnostic procedures and examination in a hospital setting.
Relationship between gestational age and placenta condition
As you can see, quite a lot of different factors can influence the degree of maturity of the placenta. The standards given in the table will help the expectant mother compare them with her own ultrasound readings.
Early aging of the placenta is not necessarily a symptom that poses a threat to the life of the mother and fetus. For example, if the 3rd degree of placental maturity, detected at 34-36 weeks of pregnancy, is not associated with disturbances of blood circulation in the vessels of the uterus and child's place, or with a diagnosed disorder of embryogenesis, or with Rh conflict, then there is no reason for concern. Otherwise, the pregnant woman will be offered a course of treatment in a hospital, and, as a last resort, an artificial birth.
How pregnancy pathologies affect the early maturation of the placenta
Let us remind you once again that the child’s place is the most important temporary functioning structure connecting the organisms of the mother and the unborn baby. The placenta unites the circulatory systems of the pregnant woman and the embryo, thanks to which nutrients and oxygen from the maternal blood diffuse into the organs and tissues of the fetus. Thus, all disturbances in general blood flow will have multiple negative consequences. For example, gestational hypertension (increased blood pressure in a woman) from the 20th week of pregnancy can lead to the formation of defective blood vessels in the placenta. This inevitably entails processes of decompensation of the arteries of the placenta, which leads to its premature aging, not to mention the threat of the development of hypoxia in the fetus.
In this article, we found out how different stages of pregnancy and the degree of maturity of the placenta are interrelated by week. A table compiled based on the results of Doppler ultrasound diagnostics will help expectant mothers obtain the information they need.