The placental membrane is an important organ connecting the maternal body with the fetus. It provides protective, trophic, respiratory and hormonal functions during pregnancy. Ultrasound of the placenta is an integral part of every ultrasonographic screening, since the course and outcome of pregnancy depends on the condition of this organ.

How to prepare

Features of preparation for placentography depend on the method of ultrasound diagnostics and, as a rule, do not differ from generally accepted rules.

With the transabdominal examination method:

• A few days before the procedure, a woman must exclude all foods that contribute to gas formation (peas, beans, bread, raw vegetables and fruits, etc.).
• If you experience frequent flatulence, it is recommended to drink a packet of Smecta or 3 capsules of Espumisan a couple of hours before the examination.
• On early stages pregnancy, in order for the doctor to clearly see the placenta, fetus and surrounding organs, the patient must fill the bladder well with liquid (5-6 glasses of clean and still water).

If the placenta is examined using the transvaginal method, then preparation consists only of following a simple diet aimed at preventing excessive gas formation in the intestinal tube. Ultrasound screening through the vagina is performed with an empty bladder.

How and when it is carried out

Ultrasound scanning of the placental membrane is carried out already from 10-12 weeks of pregnancy during each routine ultrasound examination. However, it is possible to finally judge its functional state, localization, thickness and the presence or absence of pathology only after the third screening ultrasound. It is at these stages of pregnancy that the placenta reaches its maximum development and the best way visualized.

As mentioned above, ultrasound of the placental membrane can be performed in two ways:

1. Transvaginal, when a sensor-converter of high-frequency ultrasonic waves is inserted directly into the vaginal cavity, but before that a disposable diagnostic condom is put on it and a transparent gel is applied. Maximum proximity to the uterus allows you to obtain the clearest and most accurate echo picture of the condition of the placenta. The procedure is painless and harmless, despite some discomfort.
2. The transabdominal method is more suitable for examining the placenta by ultrasound at 21 weeks of pregnancy and at a later date. The technique is that the procedure is performed through the outer abdominal wall, which is absolutely atraumatic and painless. The woman lies down on the couch in a position that is comfortable for her and the doctor, after which the latter installs the sensor in the suprapubic area and begins the diagnosis.

Thus, ultrasonographic scanning of the placenta is not a separate procedure, but is considered a mandatory step in every routine screening with special emphasis in late pregnancy.

What is being assessed

Each examination is aimed not only at assessing general condition, location and maturity of the membrane, but also to exclude pathology of the placenta.

Indicators that are assessed during ultrasound of the placental membrane:

1. Localization. This parameter plays important role during scanning, since abnormalities in the location of the placenta are quite common.
2. Echostructure, that is, the severity and thickness of the contours of the organ, homogeneity, the presence or absence of any inclusions.
3. Shell thickness.
4. Degree of maturity. This parameter indicates a woman’s readiness for childbirth and indicates the development of pathology.
5. The state and speed of blood flow in the vessels of the placenta. Assessed using color Doppler mapping.

The mature placental membrane has the appearance of a cake, thickness from 25 to 35 mm and weight no more than 550-600 grams. Its structure can normally be either homogeneous or have hyper- or isoechoic inclusions located in the basal layer. By the end of pregnancy, anechoic thin septa along the entire thickness, calcifications and sometimes cysts are identified.

Degree of placenta maturity by week:

	Echostructure	Chorionic zone	Presence of calcifications
Until the 30th week (grade 0)	Homogeneous	Completely smooth	No or very little
27-36th week (1st degree)	A small amount of compaction is noted	Has a wavy surface	Visible only under a microscope
35-39th week (2nd degree)	Seals available	Has some indentations	Visible on ultrasound
More than 36 weeks (grade 3)	Cysts are visualized	The grooves reach the basement membrane	A large number of

The thickness of the membrane also varies depending on the stage of pregnancy:

Possible deviations

To accurately determine the location, or presentation, of the placenta, ultrasound is performed in several planes and sections. She may be:

1. Central, when the shell overlaps internal os the uterus completely.
2. Regional, when one of the sides of the internal pharynx overlaps.
3. In the case when the lower edge of the organ is located near the internal os, the conclusion is “low attachment of the placental membrane.”

In any case, its location changes throughout the entire period of pregnancy and, if there are no signs of placental abruption, this is considered normal.

Common pathology:

1. A ring-shaped placenta is a fairly rare anomaly in the structure and development of the membrane, resulting from poor differentiation of the chorion in the early stages of embryogenesis. The ring-shaped placenta is primarily characterized by a wide attachment area and small thickness (no more than 10 mm). May cause bleeding, fetal death or developmental delay.
2. Additional share. As a rule, it has a vascular pedicle and does not pose a particular threat to pregnancy. In rare cases, it leads to postpartum hemorrhage.
3. Thickening of the shell. During pregnancy, the thickness of the placenta is usually measured inaccurately, but an increase in this indicator may indicate Rh conflict, fetal diabetes mellitus, intrauterine infection and the onset of placental abruption.
4. Thinning. This pathology often indicates a severe course. diabetes mellitus in the mother or about intrauterine infection of the fetus.
5. Placental abruption on ultrasound may be indicated by the formation of a retroplacental hematoma (anechoic formation), as well as by the woman’s subjective sensations (abdominal pain, bleeding from the genital tract).
6. Tumors of the membrane: hamartoma (from germinal tissues), hemangioma (vascular origin), chorioangioma. As a rule, they differ in echogenicity and have uneven contours.

Thus, examination of the placenta is an important stage of ultrasound screening during pregnancy, allowing timely detection of pathology of the membrane, which is the most significant organ for the fetus.

The placenta plays a huge role during pregnancy.

With the help of this organ, which is formed immediately after implantation of the egg into the wall of the uterus, a connection is made between the maternal and child’s organisms, the former delivers nutrients and oxygen to it, and the placenta produces the necessary hormones and prevents dangerous viruses from entering the baby’s body. But the placenta cannot always fully perform its functions. Let's consider these unfavorable situations.

Pathological location

The baby's place can begin to develop on the anterior wall of the uterus, the back, in the fundus of the uterus and in the area of ​​the internal pharynx. An unfavorable option is the location of the placenta during pregnancy in the lower part of the uterus, less than 6 cm from the internal os. One good thing is that in 95% of cases the placenta rises higher by the third trimester. This is due to the rapid growth of the uterus. But 5% still remain... These women have an increased risk of uterine bleeding due to abruption. A low placenta during pregnancy always has a greater risk of abruption. And this can be dangerous not only for the life of the baby, but also for his mother. Another unpleasant point is that a child with placenta previa is more comfortable with a pelvic or transverse presentation, which, accordingly, is a relative and absolute contraindication to natural childbirth.

As for the specific location of the baby's place, a more favorable option is if the placenta is located at a close distance to the cervix, so that only one end is adjacent to it, that is, the main part of the placenta is still located on the wall of the uterus. In this case, the risk of bleeding is less, and natural childbirth can be resolved.

If the detachment is small and heavy bleeding has been stopped, plus the condition of the mother and child is satisfactory, they try to maintain and prolong the pregnancy. The woman is admitted to the hospital, prescribed bed rest, prescribed progesterone drugs if necessary, regularly monitors the blood condition (checking coagulation, hemoglobin, etc.), and performs an ultrasound to monitor detachment. And in many cases everything ends well.

I would like to wish all women to take care of their health even before pregnancy, to use proper protection, avoiding abortions, not to develop gynecological diseases and quit bad habits. All this will facilitate the onset and course of your future, planned pregnancy and will play a big role in the birth of a healthy child.

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If you are pregnant and registered with antenatal clinic, then the gynecologist will definitely refer you to an ultrasound of the placenta. It is done 3 times when each of the 3 trimesters ends. During the examination, the doctor will receive important information about the condition of the fetus. The procedure is safe, nothing for the baby or mother.

Ultrasound from 10 to 14 weeks

Doctors who observe them refer expectant mothers for their first ultrasound from 10 to -14 weeks. It is important for the doctor to find out whether the baby is developing normally in the womb, or whether there are developmental pathologies? The specialist will measure the CTE or how big the fetus is from the tailbone all the way to the crown. Does the size fit into medium? This means that the embryo develops well in the womb.

The specialist will also evaluate the TVP or the thickness of the collar space. This will help to understand whether everything is normal in the fetus at the chromosomal level? First of all, they investigate whether the baby has Down syndrome? If the doctor sees pathologies on the ultrasound screen, he will ask you to take a blood test again.

From the 12th week to the 14th week, the fetus develops almost all internal organs. Therefore, on ultrasound, pathologies in any of the organs are noticeable, for example, in the heart or brain, kidneys. If the pathologies are really severe, the doctor recommends that the woman have an abortion, guided by medical advice. indications.

Scanning

2 hours before the examination, the patient needs to drink 1-1.5 liters of still water. The uterus will be perfectly visualized on the screen. In order to thoroughly examine the fetal placenta, it is necessary to make transverse and longitudinal, and additionally oblique sections.

The placenta is normal

By week 16, the placenta in the uterus will occupy 50%. From 36 to 40 weeks, what does the placenta look like and how much space does it take up? From 1/3 to 1/4 of the area in the uterus. If during the examination the uterus contracts, then in order to obtain correct information about the placenta, you need to wait 5 minutes.

The patient has bleeding from the uterus, is there a suspicion that the fetus has pathologies? It is necessary to determine where the placenta is attached in the uterus. If you are late in pregnancy, find out the cause of the bleeding.

"Advice. Don't drink a lot of water. The fluid will distend the bladder and may give a false sonographic picture of placenta previa. The doctor may ask you to empty your bladder a little and scan your uterus again.”

Where is the placenta located?

The placenta is easy to visualize starting at 14 weeks. To examine the placenta located along the posterior wall, you need to make oblique sections.

Ultrasound at 21 weeks of gestation:

The location of the placenta is assessed based on its relationship to the uterine walls with the axis of the cervical canal. The placenta can be located: at the left or right side walls, in the middle. It happens that the placenta is attached to the anterior wall and lies on the bottom of the uterus, or it is also attached to the back, moving to the bottom. Research will show this.

About placenta previa

Does your doctor suspect placental previa? It is important to visualize the cervical canal. On the screen it is depicted as an echogenic line, which is surrounded by 2 rims: hypo- or anechoic rims, and sometimes completely hypoechoic.

Depending on how full the bladder is, the cervix and its lower part are visible differently. The fetal head can cast shadows to the sides, and the pelvic bones with the urinary tract can cover some important segments of the uterus. When the bladder is partially full, the cervix will appear more vertical and perpendicular to the area you are scanning.

If the bladder is empty, the cervix is ​​difficult to visualize, but it is less displaced. But the location of the cervical canal with the placenta in relation to each other is noticeably better.

"Advice. If the doctor, with a full bladder, determines that you have placental presentation, then let him confirm this when you partially empty the bladder.”

How can the placenta be located?

1. When the placenta covers the os of the uterus, located inside, then such a presentation is called central.
2. Has the placental edge blocked the os of the uterus located inside? This placental presentation is called marginal. And the cervix of the uterus is still completely blocked by the placenta.
3. When the lower placental edge is located next to the internal os, the placenta is considered to be low attached. This diagnosis is difficult to establish due to the fact that only partially the uterine os is covered by placental tissue.

When carrying a baby, the placenta changes its position. Did the patient come for the scan with a full bladder? She will be asked to partially empty it and will do it again.

The doctor can detect placental presentation in the first months of pregnancy and not notice it in the last months. Does the placenta occupy a central position in the uterus? By doing an ultrasound, you can find out at any time. The specialist will understand that the marginal value is from the 30th week, then it will not change significantly.

Do you have any bleeding in the second trimester? You can postpone the 2nd planned ultrasound until 36 weeks. And only then can it be confirmed or not that there is a presentation. If in doubt, the doctor will perform a second ultrasound at 38 weeks or just before birth.

What placental echostructure is considered normal?

The basal layer of the placenta can be homogeneous or have hyperechoic and isoechoic foci. IN last weeks During pregnancy, an ophthalmologist can determine where the echogenic septa are in the placental layer.

If a patient has thrombosis with excessive fibrin accumulation, anechoic areas will be found below her chorionic plate. Are there few of them? Then this is within normal limits.

Ultrasound analysis will show that there are anechoic sectors inside the placental tissue. These are the veins through which blood flows. Covering a small part of the child's place, they do not affect the clinical picture.

When there is venous outflow, retroplacental canals are located under the basal layer. They are hypoechoic and located near the uterine wall. Do not confuse them with hematoma (retroplacental).

What pathologies can be present in the placenta?

Blistering skid. It can be determined by echography. She's like a "blizzard." If this pathology affects placental body partially, the fetus is alive.

The placental body is enlarged and thickened

How thick is the fetus’s placenta, is there any detachment? The specialist’s assessment is subjective, and accuracy depends on experience:

1. If the fetus has hydrops or Rhesus conflict, then the placental body may be thickened.
2. When the mother has mild diabetes, placental thickening is diffuse.
3. If the expectant mother suffered from acute respiratory viral infection, etc., while carrying the baby, then the ultrasound specialist will observe a thickening.
4. When placental abruption occurs on ultrasound, it is visually expressed as thickening.

The placental body is thinner than normal

1. In insulin-dependent diabetes expectant mother, the placental body of the fetus will be thin.
2. A decrease is also observed in preeclampsia - intrauterine developmental delay in the baby.

An ultrasound of the placenta is performed by a specialist. To correctly assess her condition, the experience of the uzologist and his professional instinct are important. During pregnancy, the placenta changes and most often this does not negatively affect the fetus. If the doctor notices any changes close to pathological, he must understand that the pregnant woman is at risk, but everything can end well.

The placenta is a temporary organ that develops in a woman’s body during pregnancy. The baby's place has a complex structure; it connects mother and child without mixing their circulatory systems. The placenta is formed from chorionic villi from the moment the fertilized egg attaches to the wall of the uterus, provides the fetus with nutrients, supplies oxygen, removes metabolic products, and protects against infections. One of the key functions is the creation of a fetoplacental barrier.

This kind of filter protects the unborn child from everything bad. Beginning to fully function by 12 weeks, it allows some substances to pass through and delays the transport of others that are dangerous to the embryo and fetus. The baby's place produces hormones necessary during pregnancy and provides immunological protection for the fetus.

Development and maturation

These parameters can be determined by ultrasound. Three dimensions are measured: longitudinal and transverse, forming two perpendicular segments drawn through the points of the edges that are most distant from each other, and thickness (depth).

Typically, the placenta completes its formation by the 16th week of pregnancy, with a normal course without pathologies, and grows until the 37th week, reaching its maximum size by this time.

The first measurement of the child's seat parameters is carried out at 20 weeks. Further - according to indications. By the end of the gestation period, the thickness of the baby's place decreases. This size also has its indicators within the normal range, in accordance with the stage of pregnancy. It can vary within certain limits as long as there is no danger of disruption of basic functions.

In addition to the physiological thickness of the placenta, important feature The normal course of pregnancy is considered to be the degree of maturity of the child's place. Thickening in combination with premature aging (involution) usually indicates pathology during pregnancy. A decrease in the functional capacity of this organ, which is important for the full intrauterine period of a child’s life, is called fetoplacental insufficiency.

Periods of development

As the child matures, it goes through a number of stages. They are tied to the time of pregnancy and at a certain period must meet certain parameters. There are 4 degrees of maturity:

• Zero degree – an organ of a homogeneous structure is formed, with a normal course of up to 30 weeks.
• The first is the growth and development of the organ, with the appearance of echogenic inclusions from 27 to 34 weeks.
• The second is a mature placenta, changing structure, multiple inclusions, period from 34 to 39 weeks.
• The third is the time of aging of the placenta, which occurs after the 37th week, the structure becomes lobed, and calcifications appear.

Normal thickness on average in millimeters is close in value to the gestational age by week, at 20 weeks average value thickening is 20 mm. Normally, on an ultrasound examination at 20 weeks, the thickening of the placenta ranges from 16.7 to 28.6 mm.

If the thickening has large parameters, we can talk about pathology. A thick placenta does not cope with its tasks so well and often leads to disruptions in life support and development of the fetus, and the hormonal levels of the pregnant woman.

Placental hyperplasia

The diagnosis of placental hyperplasia will alarm a woman both at 20 weeks during the first measurement of parameters on an ultrasound, and at any other time.

Hyperplasia or thickening of the placenta is a serious pathology during pregnancy, it can lead to chronic placental insufficiency.

Excessive growth of tissues, and not necessarily functional ones, disrupts the supply of oxygen and nutrition to the child. The excretory function also suffers. This can lead to slower fetal development, oxygen starvation, weight loss and complications of childbirth.

What is the threat of pathology?

Excessive hyperplasia of the placenta indicates rapid growth and premature aging of the organ with loss of its basic functions. The placenta changes its structure to lobulated, calcifications appear, which disrupts the normal supply of oxygen and essential nutrients from mother to fetus.

The child begins to suffer from oxygen starvation and malnutrition, and lags behind in development. In severe pathologies, there may be intrauterine fetal death and premature placental abruption.

The endocrine function of the organ is disrupted, which can cause pregnancy failure or premature birth.

Reasons for appearance

Any deviations from the norm in the body of a pregnant woman do not occur without a good reason and require study. This thesis also applies to placental hyperplasia. Most often, this condition is provoked by the following factors:

• Anemia during pregnancy, especially severe forms. Here we are talking about a compensatory mechanism.
• ARVI diseases. Viruses easily enter the placenta, destroy cells and disrupt their function.
• Diabetes. Glycosylated hemoglobin and other proteins are not able to adequately perform the tasks assigned to them, and the metabolism changes greatly.


• Chronic venereal and TORCH infections.
• Preeclampsia on later. Exposure to toxins often leads to damage to areas of the placenta and replacement of normal tissue with scar tissue.
• Multiple pregnancy. This is more or less a variant of the norm: in order to provide several children with everything they need, they have to increase in size.
• Low or overweight mother.
• Rh conflict between the blood of the mother and the fetus. A very serious reason. Indirectly indicates that the fetoplacental barrier is damaged, there is contact between the mother’s blood and the embryonic blood and there is a risk of fetal death.

If the mother has diabetes mellitus, there is another factor in the thickening of the placenta: pregnant women with this pathology are characterized by the development large fruit. To provide him with everything he needs, the child’s place is also forced to increase.

Gestational trophoblastic disease

One of the flow options is sometimes called incomplete hydatidiform mole. Occurs when one egg is fertilized simultaneously by two sperm, which leads to a genetic abnormality of the embryo. Occurs infrequently, but requires special attention, as it can cause cancer.

Chromosomal abnormalities in 90% of cases lead to early interruption pregnancy, but in 10% pregnancy does not stop. The placenta thickens in places, the size of the uterus corresponds to the duration of pregnancy. The fetal heartbeat can even be heard.

The diagnosis is made only by ultrasound examination and the sooner the better. The only option for help is curettage.

Clinical manifestations and diagnosis

External symptoms of placental hyperplasia of any origin are usually absent. Symptoms do not appear in the early stages; the diagnosis is established at the next ultrasound examination, starting from the 20th week of pregnancy. The thickness of the placenta is measured at its widest points.

There are no symptomatic manifestations of abnormal thickening of the placenta in the early stages up to 20 weeks.

This organ has no pain nerve endings, therefore, you can independently suspect hyperplasia only by indirect signs:

1. At later stages, when movement is already heard, at 18–20 weeks, a change in fetal movements is noted from activation to deceleration.
2. The appearance or increase in the intensity of gestosis, especially in the early stages.
3. Almost always there is a disturbance in the heartbeat when listening to cardiotocography.

Based on survey results. the doctor finds out the reasons, prescribes further examination for the pregnant woman (if necessary) and carries out symptomatic treatment based on the reasons that caused the thickening.

Ultrasound diagnostics

To determine the thickness of the baby's place, ultrasound is performed starting from 18–20 weeks. There is no point in delaying this study, since placental abnormalities detected early are easier to compensate for. The most important indicators:

1. Correspondence of the degree of maturity of the placenta to the gestational age.
2. Uniformity of structure.
3. Physiological tissue density.
4. The presence or absence of additional segments.

If the structure is preserved and the placenta is slightly thickened, no measures are required; dynamic monitoring is carried out.

The most important indicator is the condition of the fetus and what effect thickening of the placenta has on its growth and development, and whether it affects the normal course of pregnancy.

There is no more informative method for identifying placental pathology than ultrasound. Therefore, the timing of research cannot be neglected.

Prevention of complications

If a thickening of the placenta is detected by ultrasound before 20 weeks, there is no need to panic: the doctor will find out the reasons and give recommendations for the prevention of fetoplacental insufficiency. If necessary, treatment will be provided.

The woman herself can contribute well to the prevention of complications:

• You need to be outside more often.
• To refuse from bad habits.
• Eat well and eat well.
• Avoid contact with viral infections.
• Treat chronic infections at the planning stage of pregnancy.
• Control your weight and vitamin intake.
• Prevent anemia by getting tested on time.
• Regularly attend an antenatal clinic for early identification of causes that can be eliminated.

If the placenta is too thick and the reasons are clarified, the specialist prescribes therapy in accordance with the period in order to improve metabolism and support the fetus in the current conditions. Timely measures taken significantly increase the chances of giving birth to a normal child, even with significant thickening of the placenta.

Ultrasound examination of the placenta (echoplacentography) during pregnancy is an informative diagnostic method for assessing the degree of maturity of the organ, its structure and location. Ultrasound diagnostics allows you to determine the presence of formations, presentation, and also identify complete or partial placental abruption.

Depending on the quality of the “baby place”, the degree of development and condition of the fetus are determined, among other things. If there are any pathologies of the placenta and its malpresentation or detachment, we can talk about insufficient functioning of the “mother-placenta-fetus” system, and therefore about a possible delay in the development of the child and the formation of certain pathological phenomena.

What is the placenta?

The placenta is a complex organ that is formed only during pregnancy, which is the connecting link between mother and baby and provides the fetus with vital functions:

1. respiratory - oxygen intake and carbon dioxide removal;
2. nutritional - transport of nutrients from the pregnant woman to the baby;
3. protective - a barrier between the fetus and substances dangerous to it in the blood of a pregnant woman;
4. endocrine - providing necessary hormones;
5. excretory - removal of waste products of the child.

The mature organ has the shape of a “cake” measuring 15-20 cm, thickness from 2.5 to 3.5 cm and weighing up to 600 g. In the case of a favorable pregnancy, there is a direct relationship between the height and weight of the fetus and the mass and thickness of the “baby place”. Thus, until the 16th week, the development of this important organ is noticeably faster than the development and growth of the fetus. By the 38th week of pregnancy, the “baby place” reaches its maturity, it “grows old”, i.e. at this time, the formation of new chorionic villi and feeding vessels stops.

The growth and development of the baby in the womb occurs due to the placenta, to which the fetus is connected via the umbilical cord. After fertilization, the placenta actively develops along with the fetus and can be seen on ultrasound. Based on the characteristics of this organ, one can also judge the rate of development of the unborn baby itself.

Functionally and anatomically, the “baby place” is associated with the amniotic (water) membrane, which surrounds the baby in the womb. The amnion is the thinnest membrane lining the surface of the placenta on the baby's side. This membrane at the point of attachment of the umbilical cord seems to merge with skin fetus at the level of the umbilical ring. The amniotic membrane is directly involved in many metabolic processes and performs a barrier function.

The fetus is connected to the “baby place” through the umbilical cord, in which 3 vessels are localized: 1 vein and 2 arteries. Oxygen enriched blood is flowing through a vein from the placenta to the fetus, blood flows back through the arteries. The placenta, together with the umbilical cord and amniotic sac, is the afterbirth, which is excreted after the birth of the baby.

Assessment of placenta maturity during diagnosis

The degree of maturity of the placenta is monitored by ultrasound, with the help of which certain indicators are assigned to the organ. Normally, maturation is assessed in 4 degrees:

• 0 degree of maturity is typical until 27-30 weeks of pregnancy. The structure is homogeneous, smooth, there are no calcifications.
• 1st degree of maturity - from 27 to 35 weeks. A heterogeneous structure may be noted due to a small amount of compaction, the chorionic part being wavy. Fine calcium deposits may be present.
• 2nd degree of maturity - from 34 to 37 weeks. The part of the placenta adjacent to the fetus has indentations. The state of the organ itself is compacted, there are visible calcifications.
• 3rd degree of maturity - from 37 weeks until birth. Placental cysts form in the structure of the “baby place”, a large number of calcium deposits. The onset of the third degree of maturity before 35-37 weeks is regarded as premature aging (maturation) of the organ. Such placental insufficiency requires monitoring the baby’s condition.

During an ultrasound, the doctor must evaluate the degree of maturity of the placenta, using a special scale of 4 steps and correlating the indicators with the gestational age. This makes it possible to predict complications during childbirth and think through delivery tactics.

What to do if the placenta ripens prematurely?

It is imperative to take into account the fact that the “aging of the child’s seat” during pregnancy itself does not threaten either the mother or the unborn child. Only with a complex combination of several pathological signs can we talk about a threat to health, among them:

• disruption of uteroplacental-fetal blood flow;
• signs of intrauterine retardation in the development of the child;
• hypertension (persistent increase in blood pressure) in the mother;
• maternal diabetes;
• presence of Rh conflict.

All these conditions are dangerous in themselves and require careful monitoring. However, the “prematurely aged child’s place” is a reason for additional diagnostics - Doppler blood vessels of the placenta and cardiotocography (CTG). If these studies show normal blood flow and heart rate values, there is no need to worry about the fact that the placenta is “overripe”. If studies reveal severe fetal hypoxia, strict monitoring or, in some cases, emergency delivery is required.

Thickness and location of the placenta on ultrasound

Using ultrasound diagnostics during pregnancy, the thickness of the placenta and its presentation are determined, and cysts and calcifications (calcium deposits in the tissues of the organ) are excluded. The thickness of the “baby place” constantly increases until the 32nd week of pregnancy, and is normally about 30 mm.

Thickening or, on the contrary, decreasing the thickness of the “children’s place” is a direct consequence and indicator of its premature aging. An increase in thickness (more than 4 cm) may occur due to Rh conflict, an infectious disease, or be a consequence of maternal diabetes.

Using ultrasound, the exact location of the organ’s attachment to the uterus is assessed to exclude its presentation. The localization of the “baby place” is determined during each screening ultrasound examination, starting from 10 weeks, but only at the third planned ultrasound procedure will it be possible to finally see the features of the location, and in the case of a pathological condition, determine the low attachment of the placenta - its previa:

1. if there is a complete overlap of the internal os of the uterus, then they speak of a central presentation of the “baby place”;
2. if the internal pharynx is blocked only by the edge of the organ - about marginal presentation;
3. if close to the internal uterine os - low presentation.

There are often cases when placenta previa is diagnosed at the second ultrasound, but by the end of pregnancy, if placenta abruption does not occur, the localization of the “child’s place” again becomes normal - above the internal uterine os. That is why final conclusions about the level of localization of the organ should be made only by the end of the 3rd trimester.

The placenta blocking the entrance to the uterus is called presentation and is a pathology. If it is detected, the doctor must diagnose the form of presentation - marginal, low or central. Final results can be obtained only after the 3rd trimester, when the placenta has already acquired a stable position and has matured

Placental abruption and other pathological conditions

An important stage of an ultrasound examination is the diagnosis of pathologies: calcifications, infarctions, cysts, tumors and signs of placental abruption. Thus, ultrasound signs of cysts are echo-negative fluid formations with clear edges, while tumors have unclear boundaries. Heart attacks can be diagnosed on ultrasound in the form of irregularly shaped foci with hyperechoic contours. Also, pathologies of the “children’s place” are such deviations in its structure as an additional lobe, ring-shaped or fenestrated shape.

The space of low echogenicity between the uterus and placenta is a sign of premature detachment. Additional signs of detachment are:

• hyperechogenicity of one of the lobes of the organ, resulting from bleeding;
• the formation of a blood clot adjacent to the “baby spot”.

Ultrasound of the placenta - the most important stage diagnostics of a pregnant woman throughout gestation. Ultrasound diagnostics allows you to track in time pathological conditions and prescribe the necessary control and correction measures.