Chorionic presentation: causes, danger, treatment. Regional placenta previa: how to avoid complications

Before pregnancy, many women did not even know about the existence of chorion, its significance, and even more so about chorion presentation. So, first, let's find out what chorion is. The chorion is the outer embryonic membrane, which, having passed through the early stage individual development The fetus turns into the placenta, which is secured by a “large sucker” with the help of numerous villi into the inner lining of the uterus.

Note that the villous membrane - the chorion - performs early stages During pregnancy there are several vital functions for the fetus:

respiratory - provides excretion carbon dioxide, and the supply of oxygen from mother to fetus;
trophic – ensures the delivery of nutrients from the mother;
excretory – with the help of the chorion, metabolic products are removed; protective - protects the fetus from external influences.

What does chorion presentation mean?

In order to understand why it is dangerous low position chorion, let's define what a presentation is. So, chorion presentation is a pathology of pregnancy in which it is located in the lower part of the uterus. In this case, the chorion partially or completely covers the internal os.

Chorionic presentation - causes

The reasons for chorionic villus presentation are not clear, but some factors are known that influence chorionic villus presentation: uterine fibroids, uterine developmental anomalies, postoperative scars on the uterus chronic inflammation uterus, chorionic presentation in previous pregnancies, frequent abortions. Chorionic presentation along the anterior wall or previa can also occur due to polyps or multiple fibroids. That's why frequent visit gynecologist at preventive examinations And healthy image life will help to avoid problems associated with possible presentation and its consequences during pregnancy.

Why is chorion presentation dangerous?

This classification of chorion presentation is accepted. Complete chorion presentation is dangerous due to complete overlap internal pharynx cervix. It is also called central chorionic presentation. This arrangement is dangerous due to severe bleeding due to placental abruption, and hypoxia is dangerous for the child at this time, due to which he can die in a matter of minutes.

Partial chorion presentation means that only part of the internal os is blocked. Low chorion presentation means that the chorion does not cover the internal os, but is located at a distance of less than 3 cm from it.

During pregnancy, the placenta migrates all the time, so even complete placenta previa may become normal before delivery. Chorionic presentation is an indication for caesarean section, natural childbirth in this case excluded.

Chorionic presentation - treatment

There is no cure for breech presentation as such, the main thing is to stick to it. preventive measures acceptance. The best prevention is a healthy lifestyle and regular visits to the doctor, identifying and controlling the appearance of fibroids and polyps before onset of pregnancy. If, however, chorionic villi presentation was detected during pregnancy, it is necessary to stop sexual relations and reduce to a minimum physical exercise, exclude stressful situations and limit mental stress, take a complex and medications to reduce the tone of the uterus, as well as iron supplements to prevent anemia.

Regular ultrasound examinations will help to qualitatively control the current situation, and maybe in the third trimester the placenta will migrate safely and become established in safe place which will lead to natural childbirth.

"- similar diagnosis can be found in medical card pregnant quite often. In the first half of pregnancy, the “embryo” and “chorion” are medical terms, personifying the child and the placenta, respectively. Chorionic presentation indicates the site of attachment of the future placenta to the uterine wall, which may suggest further development fetus in the uterine cavity. In order to accurately consider the issue, such medical terms should be analyzed in detail.

Internal position of the chorion

The chorion is a continuation of the umbilical vein of the embryo. It attaches to the wall of the uterus, as a result of which the embryo, and later the child, will receive all the necessary and beneficial nutrients that directly affect the development of the fetus.
The chorion attachment is formed in three places:

to the fundus of the uterus;
to the side walls;
in the cervical area, where central, marginal, and incomplete chorion presentation are distinguished.

Normal attachment of the chorion is its attachment to the bottom or sides of the uterus. In 10-12% of cases, the chorion is attached to the cervix. This position is called presentation. Depending on the location of attachment, there are also several varieties of the presented diagnosis.

Chorionic presentation at 12 and 13 weeks

At the end of the first semester, the pregnant woman is assigned the first. Here you can find a similar diagnosis of the attachment of the future placenta. It is necessary to consider the presented medical terms in more detail.

Chorionic presentation at 12 or 13 weeks

It should be noted that chorion presentation at 12 weeks does not mean its permanent location until birth. Very often a kind of migration occurs. Similar processes are carried out until week 20. Sometimes you can observe migration at quite later- almost before the birth itself.

Chorionic presentation at 13 weeks indicates the place of attachment in the cervical cavity. Such features of the development of pregnancy have practically no effect on the development of the fetus, however, one should not deviate from general rules maintaining pregnancy. Typically, chorionic presentation at 13 weeks prohibits sexual intercourse for pregnant women, as well as any heavy lifting. You should not expose yourself to stress and physical activity.

IN otherwise the woman is facing profuse bleeding with detachment of placental tissue. Therefore, a woman should take care of herself and her child, because heavy bleeding can provoke hemorrhagic shock, from which expectant mother may die. Even the slightest bleeding threatens the baby's loss required quantity oxygen and nutritional components.

Regional chorionic presentation at 13 weeks

As already described above, chorion presentation has several varieties. They, in turn, influence the further development of the fetus, as well as the result of the form of delivery - natural or cesarean section. Regional presentation of the chorion at 12 weeks is the most favorable outcome that can develop with the presented pathology. This type of pathology can “eliminate on its own” as a result of migration within a few days or weeks.

Regional presentation of the chorion is characterized by partial overlap of the cervix. The presented species is divided into two subspecies. Thus, they distinguish between marginal presentation of the chorion at the 13th week, where the future placenta covers no more than 1/3 of the cervix, and incomplete attachment, which entails more dangers and difficulties, since this diagnosis is made in the case of overlap of 2/3 of the cervix. Both subspecies have the ability to migrate, so the expectant mother should not worry. Most women give birth on their own, even if they were once diagnosed with marginal chorionic presentation at 12 or 13 weeks.

Internal position of the chorion

to the fundus of the uterus;
to the side walls;
in the cervical area, where central, marginal, and incomplete chorion presentation are distinguished.

Chorionic presentation at 12 and 13 weeks

Chorionic presentation at 12 or 13 weeks

Chorionic presentation at 13 weeks indicates the place of attachment in the cervical cavity. Such features of the development of pregnancy have virtually no effect on the development of the fetus, however, one should not deviate from the general rules for maintaining pregnancy. Typically, chorionic presentation at 13 weeks prohibits sexual intercourse for pregnant women, as well as any heavy lifting. You should not expose yourself to stress and physical activity.

Otherwise, the woman faces heavy bleeding due to detachment of the placental tissue. Therefore, a woman should take care of herself and her child, because heavy bleeding can provoke hemorrhagic shock, from which the expectant mother can die. Even the slightest bleeding threatens the child with the loss of the required amount of oxygen and nutritional components.

Regional chorionic presentation at 13 weeks

Types of presentation

Typically, the first ultrasound during pregnancy monitoring is scheduled at the end of the trimester, the 13th week of pregnancy. Then you can see the diagnosis of chorion presentation at 13 weeks. The chorion is a continuation of the umbilical vein of the embryo, ensuring attachment of the fetus to the wall of the uterus. A few more weeks will pass, and it will already be called the placenta. The nutrition that the baby receives depends on its development. The location of the chorion in the uterus can be varied. It can attach to the fundus of the uterus (this is her top part) to the side walls, or in the cervical area. The place where the uterus meets the cervix is called the internal os. If the chorion is located in the area of the bottom or side walls, then such localization is considered normal. In 10-12%, the chorion is attached to the wall next to the internal os, and can even overlap it; this arrangement is considered chorion presentation. Depending on the exact location of attachment, there are:

Central chorion presentation. The chorion is attached to the opening located at the border of the body and the cervix. It covers the internal pharynx completely.
Incomplete chorion presentation. The chorion is attached along the edge of the internal pharynx, and partially covers it.
Low chorion presentation. The chorion is located within a three-centimeter zone from the internal os of the uterus and does not overlap it.

As the fetus grows, the uterus increases in size, so the place of attachment of the chorion changes. By the time of birth, placenta previa is observed in only 0.5% of cases. This is sometimes called "migration" of the placenta. Therefore, the diagnosis of chorion presentation at 12-13 weeks of pregnancy is not always as scary as expectant mothers imagine.

If, during chorion presentation, no more than one third of the internal pharynx overlaps, then they speak of marginal presentation of the chorion. Unlike central presentation, which requires observation in a hospital, marginal chorionic presentation is one of the most favorable forms. Most often, the placenta migrates towards the end of pregnancy.

Causes

It is believed that chorion presentation can occur against the background of:

Inflammatory processes of the uterus. They lead to deformation of its walls.
Abortion and surgical interventions. May also cause scar tissue to form in the uterus.
Repeated birth, especially if chorionic presentation was also observed in the previous case.
Anomalies in the development of the uterus or the development of the embryo itself.

Symptoms

Usually, chorionic presentation is detected by a doctor during an ultrasound. But sometimes a pregnant woman herself turns to a gynecologist if she detects spotting or bleeding different intensity. Usually its appearance is associated with physical stress (hot bath. sex life).

Complications

There are a number of complications that can result from marginal chorion presentation, although they are much less common than if the chorion presentation is central. Miscarriage, fetal death, developmental anomalies that occur against the background of hypoxia are complications that can occur in a child. Most a common complication A pregnant woman may experience blood loss and anemia. Chorionic presentation may be an indication for caesarean section. If a pregnant woman diagnosed with marginal chorionic presentation starts bleeding after 12 weeks, she should urgently visit a doctor.

Treatment

In cases not complicated by bleeding, marginal chorionic presentation does not require treatment. But if bleeding occurs, the pregnant woman needs to be monitored in a hospital. An important role is given to the prevention of complications in chorion presentation. Pregnant women with this diagnosis should be more attentive to themselves and avoid:

Physical and mental stress.
Monitor your diet.
Limit sex life.

There is no need to worry and worry if an ultrasound has revealed marginal placenta previa, especially considering that emotional balance is necessary not only for you, but also for the baby. The likelihood of complications occurring is low if you follow the gynecologist's recommendations and are more attentive to your well-being.

Heredity plays a role, as does the mother’s behavior during pregnancy, her diet, daily routine, the presence of infectious diseases, and congenital developmental abnormalities.

But not all pregnant women know that the success of bearing a child depends on the nature of the attachment of the fetus to the wall of the uterus.

Most often, expectant mothers who are faced with a diagnosis of chorion presentation find out about this.

What is chorion

Chorion is one of the membranes that surrounds the baby in the uterus and provides communication with the mother’s body. This structure provides nutrition and breathing to the child, as well as the removal of its metabolic products.

It is also a kind of barrier that protects the small organism from harmful influences.

The period of active functioning of the chorion is the first trimester; later it is replaced by the placenta, which will ensure the connection between mother and child until the moment of birth.

How the chorion attaches to the wall of the uterus

The chorion has many outgrowths called villi, which are embedded in the wall of the uterus. They are penetrated by a dense network of capillaries and come into contact with the mother’s blood vessels.

Normally, the chorion is attached to the fundus of the uterus or its walls in the upper part.

This arrangement is the most favorable: when the uterus stretches during the baby’s growth, neither the chorion in the first trimester nor the placenta in subsequent stages will be damaged or exfoliated, and blood vessels will maintain integrity and ensure uninterrupted nutrition and breathing of the baby.

What is chorionic presentation

In some women, the chorion is attached to the lower part of the uterus. In this case, they talk about presentation. Based on the nature of its localization, they are distinguished:

1 Low position– the chorion is attached to the lower segment of the uterus, but does not block the cervical canal (that is, it does not block the path along which the baby will move during childbirth).

2 Partial presentation- in this case, it is moved down so much that it partially blocks the cervical canal of the uterus. This is fraught with complications during pregnancy and childbirth.

3 Full presentation means that the lumen of the cervical canal of the uterus is completely blocked, the course of pregnancy is significantly complicated, and natural methods are contraindicated.

Sometimes the location of the chorion, and then the placenta in the uterus, changes randomly during pregnancy. This phenomenon is called placental migration.

For women who are diagnosed with breech presentation in the early stages, this the best option development of events, since the place of attachment of the membranes moves upward, and the problem resolves itself.

Complications of pregnancy with chorionic presentation

In cases where migration does not occur, and the incorrect location of the placenta in the uterus remains for the entire period of pregnancy, the woman should be prepared for some difficulties in bearing a child:

1 As the baby grows and the walls of the uterus stretch, the connection with the placenta may be disrupted. In this case, the blood vessels rupture, and bleeding of varying intensity periodically occurs.

2 This situation often provokes.

In this case, severe bleeding may occur, feeding and breathing of the fetus becomes impossible. Recommended.

3 Constant violations connections between the placenta and the maternal body can cause fetal hypoxia (oxygen starvation), delayed growth and development, in severe cases- death.

4 Although a low-lying placenta is considered the least dangerous for mother and baby among all presentation options, it can cause complications during labor.

5 With complete placenta previa, natural childbirth provokes heavy bleeding, which can lead to death of the mother and fetus.

Therefore, a caesarean section would be the only reasonable solution.

6 In case of complete and partial presentation, vaginal examination is not recommended during gynecological examination, because it can cause bleeding.

Thus, placenta previa, especially complete, is indeed dangerous phenomenon, which causes a lot of difficulties.

But if this problem is detected on time, in the early stages of pregnancy, the woman has a high chance of having a baby. healthy baby. However, control over the condition of the expectant mother and her child should be more careful.

Causes of chorionic presentation

The doctor may not be able to determine the factor that played a decisive role in the incorrect location of the placenta. The most common causes of presentation are:

1 Congenital anomalies structure of the uterus, scars and defects in its wall that arise due to previous surgical operations, caesarean section or frequent inflammatory processes.

2 Presentation occurs more often in women who have a large number of children, or those who have encountered this problem in a previous pregnancy.

3 A woman's age over 35 years is also a risk factor; the likelihood of placenta previa increases if a woman has bad habits(smoking is especially dangerous).

What awaits a pregnant woman if she is diagnosed with chorionic presentation

The expectant mother should be aware that in the case of placenta previa, she must be more careful and attentive. Most likely, you will have to spend some time in the hospital.

Some women with this diagnosis are forced to spend quite a lot of time in the hospital. long time, but the child’s health is more important, so you’ll have to be patient.

This diagnosis cannot be eliminated by treatment. If the placenta itself does not change its location during pregnancy, then no external factors will not be able to influence him.

All medications that are prescribed to a woman for breech presentation are designed to eliminate complications (for example, stop bleeding) or support the condition of the mother and her baby (multivitamins are often recommended, which can reduce the risk of decreased development).

Throughout pregnancy, a woman should follow a more gentle daily routine, rest more, and avoid physical and mental stress that can cause bleeding. Sexual contacts are often prohibited. If bleeding occurs, it is recommended bed rest.

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Home " Problems " Can the chorion change its position? Chorionic presentation - causes, symptoms, treatment

Chorionic presentation can be recognized already at the end of the first trimester of pregnancy, when the first ultrasound is performed. The chorion is the name given to the placenta in the first weeks after conception. Chorion is vital for the development of pregnancy and the child itself. After all, it is through it that the connection with the mother’s body is carried out. Through it the baby breathes and receives nutrition. The chorion produces hormones and is an endocrine organ.

What is low chorion presentation, and why is it dangerous? This location of the baby's place is said to be if it is located at a distance of less than 6 cm from the internal os of the uterus. This threatens with several consequences at once: detachments (and consequently bleeding), pelvic or oblique presentation of the fetus, which can lead not only to a cesarean section, but also to a miscarriage. Heavy bleeding can lead to fatal outcome, if it is not stopped quickly. Complete chorion presentation threatens placental abruption over a large area, which is dangerous because of bleeding for the mother, and the child at this time experiences acute hypoxia, which can cause death in a matter of minutes. That is why such pregnant women are preferred to be taken to inpatient conditions. This location of the placenta is also called central chorionic presentation, that is, children's place closes the internal os.

But not everything is so scary, the placenta migrates during pregnancy, simultaneously with the growth of the uterus. Thus, in many cases, even complete placenta previa can become normal by the third trimester.

As for operative delivery, then it absolute reading in the event that there is a complete or partial marginal presentation of the chorion (that is, the placenta at one end is in contact with the internal os). If the distance from the internal os to the placenta is at least 2-3 cm, childbirth can take place naturally, and as statistics show, they are not more problematic than those that occur when the placenta is high in the uterus.

What are the causes of low chorion presentation, and can it be avoided using any preventive measures? The best prevention is regular visits to the gynecologist and early detection and treatment gynecological diseases, and reliable contraception if pregnancy is not yet desired. This is very important, since the cause of this pathology is precisely inflammatory diseases as a result of curettage and abortion. The uterine tissue is damaged, and the egg cannot be implanted in the most physiological place for it (the back or front wall of the uterus). In addition, chorion presentation back wall or anterior may occur due to multiple neoplasms of the uterine cavity (multiple fibroids), due to polyps. Therefore, all women with fibroids should consult a gynecologist before pregnancy regarding the likelihood of a successful pregnancy outcome with existing tumors. In some cases, it is recommended to remove them (but then you can become pregnant no earlier than 1.5-2 years after the operation), and in some, on the contrary, to postpone the operation. It is also necessary to take into account that during pregnancy, fibroids tend to increase due to the growth of the hormone estrogen. Usually a sharp increase neoplasms are observed in the first trimester of pregnancy.

Women over 35 years of age and multiparous women have an increased risk of low chorionic presentation. But often it occurs without obvious reasons. The main thing in this situation is the correct, very careful way of life until the placenta rises. It is recommended to stop sexual relations and reduce physical activity, be sure to regularly visit a gynecologist and do ultrasound examinations. In this way, complications can be identified in time and placental abruptions can be prevented.

Ultrasound examination helps diagnose certain pathologies associated with an unfavorable pregnancy. Already during the very first planned ultrasound, incomplete chorion presentation can be detected.

Many women would like to know why incomplete chorion presentation occurs, what it is and why it is dangerous. Only narrow specialists can answer this question. The chorion is the outer shell of the embryo. It is covered with numerous villi. Over time, the chorion turns into the placenta. In the early stages of pregnancy, it is the villous membrane that transports nutrients to the embryo, protects the embryo, and also performs excretory and respiratory functions.

If pregnancy proceeds without pathologies, the chorion develops in the area of the uterine fundus. Usually this is exactly what happens, with the placenta subsequently attaching predominantly to the back or front wall. When presenting, the chorion is located in the lower part of the uterus. The internal pharynx is partially blocked.

There are many reasons why this pathology develops. These include:

Availability inflammatory diseases genital area;

Uterine fibroids;

Irregular structure of the uterus;

A large number of births in the anamnesis.

How dangerous is partial presentation? Doctors consider this a rather serious pathology, but it all depends on how severe it is. In this situation, the chorion covers only the area of the internal os of the uterus. With marginal presentation, there is a chance that in the future the placenta will begin to form a little higher and the pregnancy will proceed without complications.

Central incomplete chorionic presentation usually leads to full presentation placenta. This pathology serves as an indication for cesarean section. When the internal uterine os is blocked, natural childbirth is simply impossible.

Incomplete chorion presentation not only leads to improper formation of the placenta. A woman may encounter a number of complications not only during childbirth, but also during pregnancy. different stages pregnancy. The most common and very dangerous complications include:

Termination of pregnancy is spontaneous;

Hypoxia;

Intrauterine fetal death;

Bleeding;

Often, it is during partial presentation that a woman notices a scarlet discharge from the genital tract. Sexual intercourse or taking a hot bath can provoke the development of bleeding.

Install this diagnosis is possible only after the woman has undergone an ultrasound diagnosis. Unfortunately, this pathology not treated. It is simply impossible to move the chorion to another part of the uterus. After diagnosing incomplete presentation, all efforts of doctors and the patient herself should be aimed at maintaining the pregnancy. If pain or bleeding occurs, gynecologists usually suggest to the expectant mother hospital In such a situation, it is very important to strictly observe bed rest and be under medical supervision around the clock. Iron supplements may be prescribed to prevent anemia. In case of incomplete chorion presentation, sexual intercourse is strictly prohibited, as well as performing heavy loads, heavy lifting and overwork. This can lead to very sad consequences.

If a woman is pregnant with incomplete presentation chorion were already present, the risk of pathology with repeat pregnancies rises. Unfortunately, it is very difficult to prevent such developments, but it is possible with a competent approach to conception planning.

Incomplete chorion presentation is quite serious and dangerous pathology. It is very important to diagnose it on time and take all measures aimed at preserving such a pregnancy. Best results can be achieved during hospital treatment.

Chorionic presentation: causes, danger, treatment. Regional placenta previa: how to avoid complications

What does chorion presentation mean?

Chorionic presentation - causes

Why is chorion presentation dangerous?

Chorionic presentation - treatment

Internal position of the chorion

Chorionic presentation at 12 and 13 weeks

Chorionic presentation at 12 or 13 weeks

Regional chorionic presentation at 13 weeks

Other types of chorionic presentation

Internal position of the chorion

Chorionic presentation at 12 and 13 weeks

Chorionic presentation at 12 or 13 weeks

Regional chorionic presentation at 13 weeks

Other types of chorionic presentation

Types of presentation

Causes

Symptoms

Complications

Treatment

What is chorion

How the chorion attaches to the wall of the uterus

What is chorionic presentation

Complications of pregnancy with chorionic presentation

Causes of chorionic presentation

What awaits a pregnant woman if she is diagnosed with chorionic presentation