Placenta maturity
The word "placenta" literally means "baby's place". The organ is attached to the wall of the uterus at the site where the fertilized egg was implanted. The placenta is formed from the primary chorion, from which the mechanism of gas exchange between the blood of the mother and the fetus "borrows". The placental vessels are more developed, have a branched structure and a kind of filter - a barrier from the penetration of harmful substances to the fetus that circulate in the mother's blood.
Depending on the state of the vessels of the child's place, the degree of maturity of the placenta is determined, which must clearly correspond to the gestational age and indirectly indicate the state of health of the fetus. The maturity parameter is determined only on ultrasound examination, it is an additional diagnostic sign of intrauterine development of the fetus, as well as the state of health of the mother. According to the degree of maturity of the placenta, the onset of labor is predicted, including the threat of termination of pregnancy. In total, there are three degrees of development of a child's place:
- Zero;
- First;
- Second;
- The third stage of development is conventionally determined, which is regarded as the degree of aging of the placenta and means full readiness for childbirth.
Placenta maturity 0
A zero degree indicates the complete formation of the placenta as an organ and is determined during pregnancy from the moment of organ formation (16-18 weeks) to 30 weeks.
At this time, an echographic image of the placenta shows its homogeneous structure. When the maturity of the placenta is 0, it performs the functions:
- Gas exchange - the supply of oxygen to the fetal blood and the removal of carbon dioxide into the maternal bloodstream;
- Delivery of nutrients to the fetal bloodstream;
- Removing the elements of the fetus;
- Protective - does not allow bacteria, toxins and other harmful substances into the child's blood;
- Immune - filters the mother's antibodies to the fetus, which protects against the rejection of the embryo as a half foreign genetic material;
- Endocrine - synthesizes and secretes chorionic gonadotropin, prolactin, placental lactogen and other hormones necessary for the development of pregnancy and the fetus.
When the maturity of the placenta is 0, it performs all basic functions, with the exception of preparing the mother's body for childbirth. The next stages in the development of the placenta indicate an increased functional load, that is, they do not reflect the qualitative characteristics of the organ, but indicate the intensity of the work of the child's place.
When, within a period of up to 30 weeks, 1 degree of maturity of the placenta or the next stage of organ development is detected, this condition indicates an increased load. It is provoked in cases where the mother's blood contains harmful substances, to combat which the placenta works two to three times more intensively. Toxins from tobacco smoke, alcohol, drugs and medicinal substances always lead to premature maturation, which is defined as the degree of aging of the placenta, regardless of the gestational age. It should be noted that this process is completely reversible subject to the termination of the intake of harmful substances into the mother's body and timely treatment.
1 degree of maturity of the placenta
From a morphological point of view, during pregnancy up to 36 weeks of gestation, the placenta is in the growth stage. There is an increase in the mass of the organ and the growth of the villous tree. The total area of the villi is constantly expanding due to the branching of the vessels, each process of which is divided into several new ones. At the 1st degree of maturity of the placenta, the surface of contact of the villi with the mother's blood is 6-8 square meters!
The echographic picture of the child's place shows the branches of the villous tree up to the II-III order. The structure of the placenta during this period of pregnancy is homogeneous, the basement membranes of the chorion fit tightly to the walls - a clear line is visible at the border that does not have zigzags. Morphological changes in the structure of the child's place occur after 30 weeks of pregnancy.
2 degree of maturity of the placenta
From 30 weeks and almost until the very birth, the structure of the placenta undergoes various changes. 50-60% of the branches of the chorionic tree stop dividing, terminal villi are formed, inside which various processes take place that ensure the functions of the organ. These are specialized villi, a kind of settling tanks, in the cavities of which toxic substances are neutralized. So at the 2nd degree of maturity of the placenta, not only the fetus is protected, but the maternal organism. The border of the basement membrane acquires a zigzag shape, which significantly increases the area of contact of the vessels in the mother-fetus system.
The ultrasound image becomes non-uniform, dots, commas, and dotted lines appear. In some cases, the formed cavities filled with fluid are visible - cysts. Biochemical reactions take place inside these tanks. The appearance of cavities at the 2nd degree of maturity of the placenta in the recent past was considered a sign of pathology, however, to date, the accumulated experience of diagnostic doctors allows us to conclude that cysts in the structure of the placenta are functional or reversible changes. By 36-37 weeks of pregnancy, the growth of the child's seat is completed, and the increased thickness of the placenta indicates the developing edema. The effusion of the liquid component of blood into the space around the vessels, squeezes them, hindering blood flow in the mother-fetus system.
Placenta maturity grade 3
The third stage of development of a child's place is essentially preparation for the rapid rejection of the placenta in the third stage of labor. On ultrasound, morphological changes are determined, indicating the extinction of the functions of the organ. The vessels expand, their walls become thinner. In places of physiological expansion, calcifications are formed. If this happens before 36-37 weeks of pregnancy, we are talking about the degree of aging of the placenta, which occurs prematurely. With timely diagnosis and adequate treatment, this process is also reversible. Successful therapy of gestosis, as a rule, translates the degree of maturity of the placenta 3 into the second stage of development.
At 37-40 weeks of pregnancy, the growth of the baby's place stops and involution begins. Many functions of the placenta stop because their work is canceled by the endocrine organs of the fetus, which produce the necessary hormones. From the point of view of morphology, the degree of maturity of the placenta 3 is the terminal stage of the vital activity of the temporary organ. Under normal conditions, this does not require any medical intervention. If an early stage of aging of the placenta occurs, it is necessary to take all measures to stop the process of involution of the child's place.
Since the structure of the placenta can only be determined by ultrasound, the clinical diagnosis of the degree of maturity of the placenta is not included, but serves as one of the important diagnostic signs.
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