The placenta is a kind of house of the fetus. Performs the following functions:
The main role of the placental barrier is to protect the child from the effects of negative factors awaiting him from the outside.
The normal location of the body allows for a favorable intrauterine stay.
An afterbirth attached to the lateral or posterior uterine wall is considered normal.
What is placenta previa
Placenta previa is an obstetric pathology in which the placenta is located in the lower part of the uterine segment.
It is not possible to influence its formation and determine the place of attachment from the outside. Presentation is of several types: regional, low and full location.
Low placentation during pregnancy is the result of the placement of the baby in the lower part of the uterus. What is a threatening condition, both for the fetus and for the mother.
Complications expect a pregnant woman in the period of carrying a child and at the time of childbirth.
This localization covers the internal pharynx, which subsequently leads to the development of bleeding during childbirth and adversely affects the baby (hypoxia, the risk of early labor and a high probability of death).
The pathological process does not have a bright clinical picture up to 20 weeks of the gestational period.
This period is considered the equator of pregnancy, a number of studies are appointed, including an ultrasound scan, where the diagnosis will be determined.
What is dangerous
The low location of the placenta conceals a large number of hazards, but depending on the type, the tactics of management of the pregnant patient is selected.
- With rear location the probability of movement of the placenta is high, the birth canal is fully open.
- Front - causes difficulties in carrying a large child. The risk of entanglement with the umbilical cord increases.
- Total or central placenta previa - The most dangerous condition for a child. The cervical canal is completely closed, the possible development of hypoxia. Pregnant women with such a diagnosis are prepared for operative delivery.
Due to the low placentation, the blood supply to the embryonic afterbirth is deteriorating, there is a shortage of necessary microelements and oxygen starvation.
- Hemorrhagic anemia,
- Frequent bleeding due to poor hemoglobin,
- Deterioration of uteroplacental blood flow,
- Placental insufficiency,
- The threat of interruption, even over long periods,
- Disruption of the fetal oxygen supply,
- Incorrect positioning of the child in the womb (occipital presentation),
- Placenta detachment is a pathological condition that threatens the life of the child and the mother,
- Incomplete omission of the head due to the closure of the birth canal, as a result of complicated labor and negative consequences,
- Possible late preeclampsia,
- Most blood loss during cesarean section.
If the process is severe, the pregnant woman is allowed to give birth before 40 weeks (37-38 weeks of gestation).
Symptoms and causes of low placentation
Causes of abnormal location of the placenta:
- Gynecological diseases
- Scraping the uterus in history,
- Diseases or neoplasms in the uterus: its cavities and walls,
- Multiple pregnancy
- Surgical interventions, including ACS,
- Uterine scar,
- Late pregnancy or first pregnancy over 35,
- Frozen and undeveloped pregnancies in history,
- A large number of natural childbirth (regardless of the timing of gestation),
- Unhealthy lifestyle of a woman: alcoholism and smoking increase the risk of developing an abnormal location of the placenta 4 times.
Symptoms of low placentation:
- Bloody issues,
- Pain in the lumbosacral region, comparable to labor pains,
- Pulling pain in lower abdomen
- Loss of appetite,
- Dyspeptic syndrome: nausea, vomiting, severe toxicosis.
The main signs of low previa do not appear before 20 weeks. Alarming "bells" appear in the form of pulling pains and bloody discharge.
Treatment of low previa
The main diagnostic methods confirming the diagnosis:
- Ultrasound study - the main method.
- Routine inspection combined with complaints and clinical manifestations is an additional method.
Treatment of placenta previa depends on the type of process, severity and duration of gestation.
1 term - absence of symptoms, placenta is not formed - treatment is not carried out.
2 term - specific treatment is not required. It is recommended to comply with bed restraint, limit physical exertion.
3 term - with the rapid development of the pathological process from the 28th week of gestation, the treatment is carried out:
- Drugs that eliminate muscle spasm - Papaverine (suppositories and tablets), But-Shpa,
- Antianemic drugs: Ferumlek, Aktiferrin, Maltofer,
- Hormone therapy to adjust the level of steroids Utrozhestan,
- Hematopoietic preparations: Curantil,
- Folic acid in a complex with vitamins of group B.
Shows bed rest, limiting sexual intercourse and activities that require increased physical activity.
For any change in well-being for the worse, urgently seek help in the hospital.
Presentation is fraught with complete detachment of the placenta - a threatening condition for the life of the baby.
Childbirth at low placentation
Natural childbirth is not a contraindication for low-lying afterbirth. Regular medical supervision and a full examination increases the chances of an independent generic process.
However, before "letting" pregnant in childbirth, doctors consider several conditions:
- The exact attachment area of the child seat.
- The course of pregnancy.
- Complications resulting from gestational period.
ACS (cesarean section) is indicated with full closure by the placenta of the cervix.
According to statistics, in 91% of cases, delivery with presentation is quite successful. Subject to continuous monitoring, and only 40% of them are CS.
It is also worth considering that the abnormal location of the placenta is fraught with other complications. For example, germination of the embryonic organ in neighboring tissues and organs.
Recommendations for future mothers with low placenta previa
Tips for moms with low previa:
- Intimacy is forbidden.
- Excitements, worries, stresses and irritations are forbidden.
- Restriction of visits to public places and public transport.
- In the case of a difficult bowel movement, taking medications permitted during the period of carrying a child.
- Refusal of physical work.
- YES: walks in the fresh air, use of vitamins, visiting the pool in the absence of a ban from the doctor.
- Stay in a hospital if necessary and on the recommendation of a specialist.
- Timely treatment of gynecological pathologies.
- Contraception for the prevention of unwanted pregnancy.
- Observance of a healthy lifestyle.
Low fetal head position: causes, consequences
Low fetal previa is a very common diagnosis made by gynecologists. Is it premature to drop the baby's head in the pelvis or is it not a pathology and should not be disturbed?
Normally, the baby falls to the exit of the uterus towards the end of pregnancy, 1-4 weeks before birth. The doctor can determine this by palpation of the uterus, when the head of the fetus is low and immobile, or weakly mobile. The woman herself may notice that the uterus has descended a little, it has become easier to breathe, the heartburn has decreased. This is all the norm. But often women are told about the low position of the head of the fetus already in the second trimester. In this case, many doctors put women at risk of abortion. Although for such a diagnosis, only a low presentation of the fetus is not enough. A woman must have complaints. This can be a long and painful tone of the uterus, for example. Or the cervix must be shortened (no more than 2 cm) - a transvaginal probe is detected on an ultrasound scan. In this case, the treatment is carried out in the hospital, the goal is to prolong the pregnancy as much as possible and, if necessary, to prepare the lungs of the fetus for life outside the womb of the mother. Before a certain time, cervical closure can be performed or a special ring can be used.
If low headache presentation of the fetus is the only symptom of a possible threat of termination of pregnancy, but it worsens the well-being of the woman, the doctor may recommend various methods of treatment and prevention. Often with a strong pressure of the head of the child, the woman may experience an exacerbation of hemorrhoids. To prevent this from happening, the doctor explains to the woman how to eat properly so that there is no constipation. First of all, the recommendations relate to the frequent use of foods rich in fiber, as well as the use of a sufficient amount of fluid and adequate physical activity. In addition, the wearing of a bandage plays a very positive role, it simultaneously reduces the pressure of the fetal head, and also reduces the incidence of uterine tone.
And what about the increased urination? It is more difficult, but also solved. For example, you can accustom yourself not to drink immediately a lot, as well as limit yourself a little to drink just before the night's sleep.
It remains to find out what causes the low location of the fetus, whether this can be avoided. Unfortunately, it is impossible to avoid, since the anatomical features of the mother's pelvis become the culprits. But there is also a pleasant moment - in spite of these features, many women don’t wear their children without a problem before the delivery date set by the doctor.
Fetal position longitudinal with head previa
Presentation of the fetus determines the method and method of delivery. To make an accurate diagnosis, it is necessary to conduct an ultrasound. The prevalence of the fetus by an experienced doctor can determine the twenty-second week. But before the birth, this situation may change. Finally, the fetal position of the fetus is established at the thirty-sixth week.
The most correct and optimal is the longitudinal headache of the fetus. It is the most common, and with it the baby’s head lies down in the direction of the exit from the uterus. In such a presentation with qualified medical care, childbirth will be successful and with the least painful sensations.
Childbirth with longitudinal cephalic presentation in most cases pass naturally. Except when the fetus is too large (more than 3,600 g) or the size of the pelvis of the expectant mother does not allow the head of the child to pass. Such situations can be an indication for cesarean section.
In determining what the head presentation of the fetus means, it is important not to confuse this concept with the position of the fetus. The longitudinal position of the fetus in the head presentation can have two positions:
- 1 position of the head previa - the back of the baby lies to the left uterine wall,
- 2 position of the head previa - the back of the fetus facing the right uterine wall.
Also distinguish the types of positions: the front, in which the back is facing anteriorly, and the rear view of the head previa - in which the back is facing backwards.
Low headache previa
To determine the low location of the fetus can be from the twentieth to the thirty-sixth week. Then, as the lowering of the fetus during the normal course of pregnancy occurs on the thirty-eighth week. This diagnosis should not lead to panic. This situation can provoke premature birth, but if you follow all the recommendations of the doctor, then the birth will take place safely and on time.
If a pregnant woman has a low headache presentation of the fetus, it is recommended to wear a special antenatal bandage. limit physical exertion, do not run and rest more often.
During the normal flow of labor with the longitudinal head presentation of the fetus, the birth canal first goes through the head, and then slips out the whole body. Women who are at risk of childbirth with pathologies are recommended to be hospitalized, where they will be under the supervision of specialists.
Presentation of the fetus
Pelvic presentation of the fetus is its particular position when the legs or buttocks are below. The specific position of the fetus depends on the number of pregnancies, polyhydramnios, uterine abnormalities and physical exertion.
As a rule, pelvic presentation of the fetus occurs in no more than 5% of pregnant women. It is known that the baby changes its position several times during the day. However, after 22 weeks from the moment of conception, he should be oriented head down. This situation lasts up to 35 weeks.
How to determine the presentation of the fetus? It can be installed using a conventional ultrasound or examination of the uterus.
Causes of pelvic presentation:
- Often there are obstacles, and the head can not be installed in the normal position. It depends on the shape of the pelvis, the location of the placenta, etc.
- Increased mobility of the fetus. Occurs in the case of polyhydramnios or premature pregnancy,
- Malovodie or abnormal development of the uterus. As a result, the mobility of the fetus is reduced and there is a likelihood of it turning down legs.
For the prevention of pregnant women, antispasmodic medications and a special diet are prescribed. It is also recommended to use gymnastics in order to establish the headache presentation of the fetus, as shown in the photo.
So, delivery using caesarean section is prescribed if the baby weighs more than 3,500 grams, in a narrow pelvis or if there is a transverse presentation of the fetus (it can occur if the umbilical cord is wrapped around it, there is a partition in the uterus or low placenta).
Breech presentation of the fetus is characterized by the fact that the child’s buttocks are located at the entrance to the pelvis. When the breech presentation of the fetus, the legs are bent in the hip joints, in the knees and stretched along the body, the principle is shown in the photo.
The most unfavorable previa is rightly considered foot-both feet of the fetus facing the entrance to the small pelvis. There are two types: full - 2 stops facing the small pelvis, and incomplete - one foot.
Low location, as a rule, creates a greater risk of miscarriage, because the baby’s head is very close to the entrance to the uterus.
In such cases, it is recommended to perform special exercises and taking medications prescribed by the attending physician.
Finally, with the head presentation of the fetus, the baby’s head is located at the entrance to the pelvis. Facial presentation is of two types when the chin is in front or behind. This can be seen on the existing photo:
It is worth noting that improper presentation of the fetus occurs if the uterus has a reduced tone or its ability to contract decreases. In these cases, oblique presentation of the fetus may occur.
The consequences of improper location: birth trauma, asphyxia and other diseases.
For pelvic presentation, a series of exercises should be performed.
Consider their most popular complex:
- Turns - lying on your back you need to turn from one side to another 4-5 times with an interval of 10 minutes. Perform this exercise should be 3 times a day. Literally in the first week, the fruit should turn,
- & Gravity & Methods: pelvic tilt - this exercise should be performed on an empty stomach. You need to lie on an inclined surface with your back, while raising your pelvis 20-30 cm higher than your head. In this position, you need to be no more than 15 minutes. You can start this exercise from 32 weeks, 2 times a day. The method is effective in 95% of cases
- knee-elbow position - you need to stand on your elbows and knees, place your pelvis above your head. In this position, you need to spend 15-20 minutes, 3 times a day.
Watch your health!
Sources: //www.missfit.ru/berem/nizkoe-predlezhanie-ploda/, //womanadvice.ru/polozhenie-ploda-prodolnoe-s-golovnym-predlezhaniem, //moya-vselennaya.com/predlezhanie-ploda/
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