- This is a unique organ whose life expectancy is only 40 weeks - the gestation period. We can say that the placenta is a temporary organ that is absolutely necessary exclusively for growth and development in the womb. After childbirth, the placenta is no longer needed, so it is also removed from the uterus. However, like any other organ, the placenta goes through all stages - from birth to death. The death of the placenta is the moment of separation from the walls of the uterus after the birth of the child. But the life stages of the placenta - birth, growth, maturity, aging and death - occur within 40 weeks.
The term “degree of maturity” of the placenta reflects a certain stage of development and physiological changes in this organ. In fact, the degree of maturity is the stage of aging of the placenta. Each degree of maturity corresponds to certain structural features of the placenta and thickness. There are currently four grades maturity of the placenta, designated by Arabic numerals 0, 1, 2 and 3. In this case, the youngest placenta corresponds to the degree of maturity 0, and the oldest - 3.
Aging of the placenta occurs gradually, with each of the four degrees of maturity corresponding to a certain stage of pregnancy. This can be compared to the fact that the body at a certain age shows signs of aging of organs and systems. If such signs appear earlier than the age for which they are characteristic, then they speak of premature aging. The same is true for the placenta, its age is simply calculated by weeks of pregnancy.
Thus, at each stage of gestation, the placenta must be of a certain degree of maturity. Today, clear standards have been defined for the correspondence between the degrees of maturity of the placenta and the timing of pregnancy:
- Before 30 weeks of pregnancy, placental maturity should be 0;
- From the 27th to the 36th week of pregnancy, the degree of placental maturity is 1;
- From the 34th to the 39th week of pregnancy, the degree of placental maturity is 2;
- From the 37th to the 40th week of pregnancy, the degree of maturity of the placenta is 3.
If the degree of maturity of the placenta at any stage of gestation is greater than it should be (for example, at the 26th week of pregnancy there is 1st or 2nd degree of maturity), then doctors talk about premature aging (maturation) of the organ. Such premature aging of the placenta is a sign of fetoplacental insufficiency, which leads to a deficiency of nutrients and oxygen delivered to the fetus and, accordingly, to a delay in its development. In addition, placental insufficiency can cause the threat of premature birth, intrauterine fetal death and other serious complications of pregnancy. Therefore, premature aging of the placenta requires treatment in a pregnancy pathology department.
The placenta is a temporary organ that acts as a connecting link between mother and fetus throughout the entire period of pregnancy. The importance of this organ lies in the fact that through it the fetus receives all the necessary substances for development. The placenta has a second, more popular name - the baby's place. After birth it is rejected because its function is completed.
In more detail, placenta is translated from Latin as “cake.” This strange name comes from its shape – disc-shaped and flattened.
What is the functionality of the placenta?
- The placenta has a respiratory function, namely, it delivers oxygen to the fetus and removes carbon dioxide.
- Nourishes the fetus, helping to transport nutrients from the mother's body to the fetus.
- Helps remove waste products from the unborn baby.
- Acts as a barrier, that is, it prevents the entry of harmful substances from the maternal blood.
- It produces hormones that help pregnancy develop.
Almost nine weeks pass from the moment of conception when the early placenta begins to form. Before this, the fetus in the fourth week is surrounded by the chorion, or, in more accessible language, by a special villous tissue. Exactly the early placenta is formed from the remains of the chorion.
At the end of pregnancy, the baby's place grows into a half-kilogram organ. In the last weeks, the diameter of the placenta will be almost twenty centimeters.
With each month of development, the fetus needs oxygen and a large amount of nutrients, so the placenta membrane becomes more permeable and thin. The number of vessels in the placenta itself increases. After the development of the fetal place stops and aging begins.
Throughout the entire period of gestation, a woman goes through. There are parameters by which a specialist determines the degree of maturity of the fetal site. And to determine the aging placenta, the doctor will need to examine its thickness and the presence of cysts. Although ultrasound provides detailed information, additional diagnostics will be required to determine the maturity of the placenta.
Just a few years ago, the fact of premature aging of the placenta was considered or antenatal death of the fetus. After lengthy studies, this hypothesis was not confirmed, and pregnant women with the third degree of maturity are simply under increased surveillance.
Table of placenta maturity by week
- 0 degree of placenta maturity. If pregnancy proceeds normally, then degree zero will remain until . This will indicate that the placenta is fully functioning. At this stage of development, the child's place has a homogeneous structure.
- 1 degree of maturity of the placenta. After this, the placenta begins to smoothly transition to the first stage. At this stage, the fetus is actively supplied with substances useful for vitality. According to the visual characteristics, inclusions and barely noticeable waves appear on it. In a normal pregnancy, the 1st degree of maturity will be up to.
- 2 degree of placenta maturity. Until the 2nd degree of maturity is established. The placenta becomes prominent, and the convolutions of the membrane are clearly expressed. If stage 2 placental maturity is diagnosed earlier than 32 or , then additional examination is required.
- 3 degree of maturity of the placenta. This is a sign of a full-term pregnancy. The functions of the placenta are significantly reduced. At this stage, the placenta is characterized by waves, depressions that reach the basal layer. If the degree of maturity does not correspond to the prescribed period of pregnancy, then this threatens premature birth.
Premature aging of the placenta during pregnancy
What are the causes of early aging of the placenta:
- Hypertension (with increased pressure, in order to supply the fetus with oxygen, the placenta works as actively as possible, which leads to its rapid aging).
- Infections (the placenta has to act as a filter and eliminate any viruses from the blood).
- Excess calcium (if a pregnant woman uncontrollably takes vitamins containing calcium, then calcifications accumulate in the placenta and premature aging occurs).
What are the dangers of premature aging of the placenta?
An early ripened placenta poses no threat to either the baby or the health of the mother. But, if this phenomenon is combined with complicating factors, then the likelihood of a health threat is high.
Hazardous factors:
- uteroplacental blood flow is impaired;
- intrauterine development of the fetus occurs with delays;
- hypertension;
- diagnosed;
- mother is sick.
In such cases, the woman in labor requires special attention and possible treatment. And in the worst case – premature delivery.
If by the end of pregnancy the second or third degree of maturity has not been established, then the placenta is considered immature. This phenomenon is diagnosed extremely rarely.
Most often there may be medical errors. For example, when a mother has a Rhesus conflict with her fetus, the state of the placenta will be similar to zero degree of maturity. In general, an immature placenta does not pose a danger, but it can hide serious complications.
- Doppler ultrasound. Doppler sonography confirms the normal course of pregnancy. The method evaluates blood flow through the placenta. If everything is normal, then the blood resistance in the vessels should decrease. Therefore, with the help of Doppler ultrasound, it is determined how well the placenta copes with its task, and whether signs of premature aging are showing.
- CTG. This method helps assess the condition of the fetus and how well it is developing at this stage. Thanks to cardiotocography, heart rate, fetal movement activity and registration of uterine contractions are monitored. These indicators help detect abnormalities in the placenta. After ultrasound reveals signs of aging of the placenta, the pregnant woman is sent for CTG.
Do not forget that when diagnosing premature aging of the placenta, pregnant women require more vigilant monitoring.
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.
Pregnancy develops, and at the same time specific changes occur in the placenta. Each period of pregnancy is characterized by a certain degree of maturity of the placental tissue. Our article will tell you in more detail what the third degree of placental maturity means, and what week of pregnancy it normally corresponds to.
What does it mean?
Experts distinguish several degrees of maturity of placental tissue. So, the placenta can be from zero to third degree of maturity. This indicator is determined during a routine ultrasound examination, which is performed on the expectant mother.
Placental tissue performs many very important functions during pregnancy. Thus, through the placenta and the blood vessels located in it, the baby developing in the uterus receives all the necessary nutrients and oxygen for its growth. With excessively early maturation of the placental tissue, this balance is disrupted, and the intrauterine development of the fetus is no longer so physiological.
The reasons that can lead to excessively early maturation of the placenta are very diverse. For example, vascular diseases that the expectant mother suffers from can lead to the appearance of specific changes characteristic of stage 2 placental maturity.
Arterial hypertension or severe gestosis can lead to disruption of the functioning of the placenta and its early maturation, which can negatively affect the further course of pregnancy.
Norm
Towards the end of the third trimester of pregnancy, specific changes begin to occur in the placenta. They are completely normal and indicate that the female body is gradually beginning to prepare for the upcoming birth. The closer the baby is born, the more changes occur in the placenta. Once the baby is born, it will no longer need to receive nutrients and oxygen through the placenta. His body will already be able to breathe atmospheric air on its own.
In the final trimester of pregnancy, the placenta begins to change its appearance. All characteristic changes indicate that the placental tissue has already fully matured. Natural aging of placental tissue corresponds to stage 3 of placental maturity. This condition is usually diagnosed normally at 37 weeks of pregnancy or later.
Often in obstetric practice there are cases when the final maturation of placental tissue occurs much earlier. Thus, stage 3 placenta maturity can be detected at 35-36 weeks of pregnancy.
An expectant mother who experiences this should not panic. Minor deviations in the maturation of the placenta in this situation are quite acceptable.
The mature placenta remains virtually unchanged before birth. This means that all changes that appear in the structure of the placental tissue persist until the immediate birth of the placenta.
After its birth, doctors, using histological examination, can study the structure of the tissue and identify various possible defects and anomalies in the development of the organ that formed during pregnancy.
How is it determined?
Determination of the degree of maturity of the placenta is carried out using ultrasound. This examination is painless and quite informative. Using a special sensor, an ultrasound specialist examines the placenta in detail. It determines the thickness of the tissue, its size, the presence of compacted areas and cysts, and also evaluates the presence of various anatomical defects.
The finally formed and mature placenta has a rather uneven surface. It is all covered with grooves that penetrate deep into the placental tissue. The previously smooth and even surface of the tissue becomes bumpy and even rough by the 37th week of pregnancy.
Another characteristic feature of the placenta of the 3rd degree of maturity is the presence of compacted areas in it - calcifications. In their density they differ from ordinary fabric. Calcifications appear in the placenta due to its physiological aging. This process is completely normal and indicates that labor is imminent.
In some cases, maturation of the placenta occurs with severe calcification. The presence of calcifications in the placental tissue in the early stages can be dangerous due to the development of a number of complications, one of which is intrauterine fetal hypoxia. A child who experiences hypoxia in the womb cannot fully exist. Oxygen deficiency, which occurs during intrauterine hypoxia, leads to increased stress on the baby’s heart and blood vessels. In this case, the fetus, as a rule, changes the functioning of all vital organs.
A change in the general condition leads to the fact that the baby in the mother’s womb changes the heart rate and increases motor activity. In this case, mandatory medical intervention is required. In such a situation, the expectant mother may be hospitalized in a hospital for therapy aimed at correcting the disorders that have arisen.
If the placenta, due to excessively early maturation, does not function well enough, which leads to a deterioration in the overall well-being of the baby, then mandatory treatment is required.
In such a situation, therapy is usually also carried out in a hospital. A pregnant woman is prescribed complex drug therapy, bed rest, and careful medical supervision. If the placenta matures too early, there is a high risk of premature birth. A pregnant woman will give birth under close medical supervision.
If, during an ultrasound examination, degree 3 of placental maturation was detected much earlier than the 37th week of pregnancy, then additional studies are required. One of them is Doppler ultrasound. It is usually performed immediately after the ultrasound, usually on the same day.
By performing Doppler ultrasound, doctors can evaluate blood flow in the vessels that supply blood to the fetus. If the placenta matures early, its functioning may be impaired. One of the main functions of placental tissue is to provide the fetus with nutrients. A decrease in uteroplacental blood flow can lead to the threat of intrauterine hypoxia.
Another diagnostic method that is used for early detection of stage 3 placenta is cardiotocography. This simple examination can assess the fetal vital signs.
If they are violated, then therapy and a choice of tactics for further pregnancy management are required. In some cases, hospitalization in a hospital may be required, where, under certain indications, the expectant mother can stay immediately until the birth.
About premature maturation of the placenta, see the following video.
It is characterized by earlier development of the placenta (aging), which entails possible conditions that threaten the health of the fetus. Most often they talk about fetal hypoxia, that is, insufficient oxygen supply, which leads to oxygen starvation. At the same time, due to insufficient supply of nutrients to the unborn baby, disturbances in brain function are possible, and for the birth process - its premature onset and severe course.
Causes of premature aging of the placenta:
- diabetes mellitus and other hormonal disorders in the mother’s body;
- abortions that a woman had before the onset of a real pregnancy;
- endocrine diseases of the expectant mother (thyroid disease);
- late toxicosis - gestosis;
- maternal smoking or alcohol consumption;
- chronic disorders of the cardiovascular system;
- hepatitis and other liver diseases;
- diseases of the urinary system;
- infections of the genital tract and uterus.
However, despite such alarming data, a woman who is diagnosed with stage 2 placental maturity at less than 33 weeks should not panic. The doctor will definitely prescribe additional tests and studies on the blood flow of the fetus. If no pathology is detected, then the woman has nothing to worry about. If a real threat to the normal functioning of the fetus is confirmed, effective treatment in a hospital is prescribed. As a rule, the drug course is aimed at restoring the functions of the placenta to fully supply the child with all nutrients. 
substances.
2 degree of placental maturity at a period that does not correspond to the norm does not always mean the presence of pathology. If the doctor does not notice a real threat of premature birth, then, most likely, a course of treatment with Curantil or other appropriate medications at home will be prescribed. In any case, a woman should strictly adhere to the doctor’s recommendations and come for appointments regularly.
