22.04.2019

Chorionic presentation at 16 weeks of pregnancy. Chorion presentation: low, central, incomplete position

During pregnancy and examination, women may encounter the expression chorion by back wall" What does this mean, when does it occur during pregnancy, is this condition dangerous and what can be done about it, what does it mean? marginal presentation, we will tell you in this article.

What is chorion?

Chorion is one of the membranes that makes up the baby’s placenta during pregnancy. There are 3 shells in total - allanotis, aminion and chorion. During pregnancy and the formation of an embryo, a placenta is created, which attaches to the wall of the uterus. It turns out that the chorion along the back wall of the uterus is a type of attachment.

In its normal state, the placenta is attached to the fundus of the uterus or its body at the posterior wall, adjacent to the sides. There are varieties when the placenta is attached low, either to the anterior wall of the uterus, or to its lower segment, when the pharynx partially or completely blocks the cervical canal.

Reasons for location on the rear wall

It turns out that chorion along the posterior wall is a common situation that does not cause concern. This term is one of the types of placenta attachment, which will be indicated to you on your card after the ultrasound.

The chorion attached to the back affects the size of the tummy - it will be small compared to the front wall - the belly will be large and noticeable even in the first trimester. The chorion tends to migrate inside the body of the uterus, so that in one trimester it can be attached to the back wall, and at 12-13 weeks - already to the front. Anterior or posterior localization is detected by a doctor using ultrasound at 12-13 weeks.

But you should know that the norm for the location of the chorion is if it is located above the internal pharynx by more than 3 cm, it should not be low. Another scenario is considered a deviation - it could be a marginal presentation, incomplete, central.

Placenta previa

Simultaneously with the diagnosis of chorion on the posterior or anterior wall, pregnant women at 12-13 weeks have the opportunity to see chorion or placenta previa in their chart. This term means: the placenta is located non-standardly - it is attached not to the uterus itself, but to its lower segment.

The first trimester may also be marked by the fact that you can also experience complete or partial closure of the pharynx cervical canal, but as the baby grows at 12-13 weeks, the chorion moves and the pharynx becomes open again. But this may not happen in every case.

Low

Low presentation implies that the fertilized egg has attached below the cervix. This happens very rarely - in about 5 cases out of 100, and is determined by ultrasound. The first and second trimester can be characterized by this position, but almost always subsequently the chorion takes on normal position due to the growth of the uterus and stretching of the placenta.

Along the back and front wall

Posterior presentation is considered the most common option and is not considered abnormal. This is a predominantly harmless pathology. The placenta in this embodiment can capture the walls from the side. Anterior presentation is considered less rare, without going beyond the norm. Anterior presentation is characterized by the fact that the placenta migrates more quickly to its normal state.

When the placenta does not rise at 12-13 weeks, but the localization of the pharynx is not blocked, then pregnant women are prescribed timely examinations and complete rest without stress.

Partial

Partial presentation during pregnancy is characterized by overlap of the cervix up to 60 percent. One of the cases of this option at 12-13 weeks is marginal presentation, when the percentage of overlap is no more than 30. Such presentation is dangerous due to the threat of miscarriage, bleeding and fetal hypoxia. To treat this deviation, complete rest and sedatives, treatment is carried out at home, examinations are regularly carried out in the hospital.

Complete

Complete presentation during pregnancy is otherwise called central, when the pharynx is completely blocked. Having discovered such a pathology, already at 12-13 weeks the pregnant woman will be put on preservation due to the risk of bleeding and loss of the child. There is even a threat to the mother's life, so hospitalization is mandatory. With this scenario, a cesarean section is most often indicated, and adverse outcomes occur in only 5 cases out of 100.

Why does presentation occur?

Causes of breech presentation during pregnancy may include:

deviation from the norm in the condition of the internal walls of the uterus and the inability of the embryo to attach to them;
previous abortions or infectious diseases;
uterine deformation due to myomectomy;
diseases of the cardiac system, liver and kidneys that cause stagnation;
second birth of a woman after 35 years;
predominant anomaly of the ovum;
the placenta is too dense.

Despite all the threats, all of the above pathologies can be successfully treated with careful examination and monitoring by doctors. Therefore, when you see a diagnosis of anterior or posterior placenta, whose localization confuses the doctor, do not be alarmed, trust the doctors, and you can give birth to a healthy child!

The first weeks are decisive for pregnancy. During this period, life is born inside the expectant mother, vital important organs child. The woman’s body is being rebuilt to an enhanced operating mode for successful pregnancy.

Pregnancy does not always go smoothly; expectant mothers may experience some problems and complications. All pregnant women are sent for a routine ultrasound, which is performed in the first trimester. It is this ultrasound examination that is of great importance; developmental pathologists are identified. As a result of the examination, the pregnant woman may hear the conclusion: “Chorion presentation.”

What does chorion presentation mean?

Before you panic, it’s worth understanding what chorion is and what role it plays in the course of pregnancy. The chorion is an organ that is the connecting link between the body of the mother and the fetus. This is the initial stage of placental development, so this term is usually used during the first trimester. In the second trimester, the name “placenta” is already used.

The chorion is attached to the wall of the uterus, and on the other side it is attached to the fetus. When the location is different from normal, there may be various kinds violations.

According to its structure, the uterus communicates with the vagina and external genitalia through the cervix. Inside the cervix there is a cervical canal, the opening of which is called the pharynx, which opens into the uterus. The chorion (future placenta) is attached to the bottom of the uterus or its lateral surfaces, which should not overlap the cervical os. But medicine knows cases when the chorion blocks this hole, and a violation occurs - chorion presentation.

Types of chorion presentation

The complexity of the presentation state is determined by the degree of closure of the cervical canal by the chorion:

If the doctor concludes “chorionic presentation”, do not panic. The developing placenta can be pulled away by the growing uterus.

Even central presentation can eventually turn into marginal or partial, and then completely disappear. According to statistics, 90% of presentations during pregnancy go away completely. Therefore, such a diagnosis, as a rule, means a temporary location of the chorion. A pregnant woman does not need to be nervous, the main thing is to undergo examinations on time and monitor her condition.

Why does previa occur?

The reasons for the attachment of the chorion in such a dangerous place are not reliably known to medicine. However, some patterns associated with certain conditions and diseases of women have been noticed.

Abortion with “cleaning”, removal of fibroids surgically and caesarean section. As a result of such interventions, adhesions and scars appear on the surface of the uterus; these formations can cause incomplete attachment of the chorion.
Numerous births. How more births was a woman, the higher the likelihood of malpresentation of the developing placenta. This phenomenon is due to the fact that after pregnancy, at the site of attachment of the placenta, the structure of the endometrium changes. The next time the chorion can no longer gain a foothold in the same place, after numerous births in correct position there are no more places. That is why it is mounted in a dangerous area.
Deformation of the uterus. This feature can affect the position of the chorion.
Diseases of the kidneys, heart and liver. At similar diseases Often there is stagnation of blood in the pelvic area, which provokes low attachment of the placenta.

Chorionic detachment

As a result of complete presentation, placental abruption may occur. This is quite dangerous for a pregnant woman; bleeding may occur. In a child, this condition causes hypoxia, which can result in death. Therefore, pregnant women similar diagnosis treated in inpatient conditions.

How chorionic detachment manifests itself, the main symptoms

There are several signs by which you can understand that placental abruption is occurring:

Sharp, cramping pain in the lower abdomen;
Dizziness;
A pregnant woman feels tinnitus;
Blood pressure drops sharply and severe weakness is felt;
Opening of bleeding. Even with slight bleeding, you should immediately seek medical help;
Loss of consciousness.

Placental abruption can be complete or partial. Partial detachment means a slight accumulation of blood at the edge or center. With complete detachment, blood fills the space between the placenta and the wall of the uterus.

Total detachment is very dangerous and cannot be treated. On later pregnancy, the doctor will try with all his might to save the fetus, but in the first trimester the result may be a miscarriage. If the detachment is complete, maintaining the pregnancy will threaten the life of the mother, and severe internal bleeding may occur.

How is presentation and chorionic detachment treated?

In the first trimester, it is impossible to correct a condition such as chorionic presentation. Only prevention of complications is carried out. If any appear, in the second trimester of pregnancy the woman is treated in a hospital.

One of the complications is placental abruption, but also for its treatment effective methods medicine doesn't know. It is worth noting that if partial detachment occurs in the first trimester of pregnancy, the result will not necessarily be a miscarriage; it can be saved.

Depending on the reason for the detachment, the doctor prescribes medications. For uterine tone, these are tocolytic drugs, for heavy discharge hemostatic agents and for progesterone deficiency - Utrozhestan.

During pregnancy with such complications, a woman must follow a sleep regime and not subject her body to physical stress. Must be avoided emotional stress and you will have to completely exclude sexual contact. Give Special attention nutrition, it must be correct and regular, do not forget about taking vitamins.

It is worth thinking about going on maternity leave early; mental stress and stress can cause no less harm to a pregnant woman than physical activity.

If a pregnant woman has been diagnosed with such disorders, do not despair, because most pregnancies with such abnormalities end in successful births. The main thing is to carefully monitor your health, listen to your body and at the first warning signs (sharp pains, weakness, bleeding) call an ambulance immediately.

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. Severe 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 managed in a hospital setting. This location of the placenta is also called central chorion presentation, that is, the baby’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, can it be avoided with the help of any preventive measures? The best prevention is regular visits to the gynecologist and early detection and treatment gynecological diseases, as well as 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, 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 along the posterior or anterior wall 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 have ultrasound examinations. In this way, complications can be identified in time and placental abruptions can be prevented.

The chorion is the villous membrane of the fertilized egg that ensures its growth and development. At normal course During pregnancy, it is implanted into the inner lining of the uterine fundus, and then onto the anterior, posterior and lateral walls. Chorionic presentation implies its incorrect location. It is not attached to the body of the uterus, but captures its lower segment. Sometimes there is complete or partial blocking of the internal os of the cervical canal coming from the uterus. This diagnosis most dangerous on early stages pregnancy. Usually, as the fetus grows, the placenta moves up, but in some cases this does not happen.

When does presentation occur?

Reasons for the development of this pathological condition have not been fully studied. However, several factors have been identified that contribute to the incorrect location of the chorion. Among them are chronic inflammatory diseases of the uterus, postoperative scars, fibroids, uterine developmental anomalies and a large number of history of childbirth.

Symptoms of improper placement of the chorion

Usually, this pathology diagnosed during a routine ultrasound in the absence of any complaints from the woman. There are cases when presentation is accompanied by bleeding from the genital tract against the background of complete well-being. Usually their development is facilitated by such external factors such as excessive exercise, sexual intercourse and taking a hot bath.

Possible complications

Chorionic presentation is one of the most serious obstetric problems that can lead to a number of complications for the fetus and mother. These include termination of pregnancy, intrauterine growth retardation and fetal death, severe anemia in a woman with frequently recurring bleeding.

Treatment of chorionic presentation

There is no specific treatment for this pathology. Therapeutic measures are aimed at preventing miscarriage and treatment possible complications. When diagnosing chorionic presentation during an ultrasound, a woman is offered a set of therapeutic measures in a hospital setting. She is advised to be strict bed rest, ultrasound monitoring, taking medications to reduce uterine tone and vitamins for pregnant women. When discharged home, a pregnant woman should avoid physical activity, stressful situations and sexual intercourse. The appearance of bloody discharge is a reason for emergency treatment to the gynecological department and prescribing hemostatic drugs. In case of massive bleeding that threatens the woman’s condition, the pregnancy is terminated.

In order to understand why a low position of the chorion is dangerous, 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 abnormalities, 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 for 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 the complete occlusion of the internal os of the 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 is excluded in this case.

Chorionic presentation - treatment

There is no cure for breech presentation as such, the main thing is to stick to it. preventive measures. The best prevention- a healthy lifestyle and regular visits to the doctor, identifying and monitoring the appearance of fibroids and polyps before pregnancy. If, however, chorionic villi previa was detected during pregnancy, it is necessary to stop sexual relations, reduce physical activity to a minimum, eliminate 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.

Contents:

Normal maturity of the placenta at different weeks of pregnancy.

Maturity level	Weeks of pregnancy
Zero (0) degree	20-30
First (1) degree	30-34
Second (2) degree	34-37
Third (3) degree	37-39

Determining the degree of placental maturation is necessary in order to understand whether the placenta is capable of supplying a sufficient amount of nutrients to the developing baby.

What is the significance of the thickness of the placenta?

As pregnancy progresses, the thickness of the placenta increases. This is a normal process. The thickness of the placenta is determined using ultrasound (see. Ultrasound during pregnancy).

The normal thickness of the placenta is different dates pregnancy is presented in the table below.

Gestational age	Normal thickness placenta in millimeters
Week 20	16,7-28,6
21 weeks	17,4-29,7
Week 22	18,1-30,7
Week 23	18,8-31,8
Week 24	19,6-32,9
Week 25	20,3-34,0
Week 26	21,0-35,1
Week 27	21,7-36,2
Week 28	22,4-37,3
Week 29	23,2-38,4
Week 30	23,9-39,5
31 weeks	24,6-40,6
32 week	25,3-41,6
Week 33	26,0-42,7
34 week	26,8-43,8
Week 35	27,5-44,9
Week 36	28,2-46,0
Week 37	27,8-45,8
Week 38	27,5-45,5
Week 39	27,1-45,3
Week 40	26,7-45,0

Like the degree of maturity, the thickness of the placenta is important for assessing how adequately the placenta supports the development of the child.

What is premature aging of the placenta? How dangerous is this?

This paragraph was added after receiving the question:

« ... I'm 36 weeks pregnant. At week 33, the placenta was diagnosed as having 1-2 degrees of maturity, did a cardiotocography (CTG), and was told that the blood flow was normal and the baby was feeling well. I recently went for an ultrasound and they once again confirmed that the placenta is prematurely aging, the degree of maturity is 2-3, the thickness of the placenta is 32 mm, reduced.
Structural features of the placenta: lobulated with many calcifications. And so basically everything is fine with the baby, cephalic presentation, we weigh 2,300, fully developed, I haven’t had a CTG yet.
The due date is set at approximately March 17-18, but both in the maternity hospital at 33 weeks, and at the ultrasound at 36 weeks, experts say that it is very possible that I may not reach the expected due date. I'm very worried
I was at an appointment with my doctor, she reacted absolutely calmly to it, as if everything was normal, it was even strange, I thought she would tell me at least something, but she was just silent like a partisan, or maybe this silence is from ignorance?!
Please help me resolve this issue!»

Aging of the placenta is said to occur in cases where calcifications appear in the tissues of the placenta (deposition of calcium salts in areas that have “already exhausted their resource” and do not function). Calcifications are clearly visible on ultrasound, and it is this examination that is used primarily to determine the degree of maturity of the placenta.

To a certain extent, the gradual “switching off” of placental tissues and the deposition of calcifications in them is a normal process (normal, physiological maturation placenta). It is believed that the placenta should reach its maximum degree of maturity (grade 3) at 37-40 weeks.

ABOUT premature ripening(aging) of the placenta is said in cases where multiple calcifications (3rd degree of maturity) appear in the placenta in women who have not yet reached 37 weeks. Usually, women learn about the premature maturation of their placenta after the next ultrasound performed after the 30th week of pregnancy.

Quite often the reasons premature aging placentas remain unknown. However, it is known that the development of this disorder can be facilitated by arterial hypertension , gestational diabetes and smoking.

What complications can premature aging of the placenta cause? Does premature aging of the placenta always mean a threat to the development of pregnancy?

Despite the fact that signs of premature aging of the placenta are rarely detected in women who have not yet reached 40 weeks of pregnancy, the detection of multiple calcifications in the placenta (3rd degree of maturity) does not always mean a threat to the development of pregnancy or the health of the pregnant woman. One study conducted in 2011 showed that the likelihood of developing complications largely depends on the stage of pregnancy at which premature aging of the placenta was detected.

As part of this study, the development of pregnancy in women from three groups was monitored:

the first group included 63 women in whom premature aging of the placenta (3rd degree of maturity) was detected before 32 weeks of pregnancy;
the second group included 192 women in whom premature aging of the placenta (3rd degree of maturity) was detected in the period from 32 to 36 weeks of pregnancy;
the third group included 521 women in whom no calcifications were detected in the placenta during the period from 28 to 36 weeks of pregnancy.

The results of the study showed that women in group 1 had complications such as premature birth, low birth weight of the child, premature placental abruption, bleeding after childbirth, and stillbirth were observed much more often than in women from group 3. At the same time, among women from group 2, the risk of developing any problems during or after childbirth was the same as in group 3.

The results of this study suggest that the appearance of calcifications (grade 3 placental maturity) before 32 weeks of pregnancy does increase the risk of various complications, while the identification of signs of premature aging of the placenta after 32 weeks means that there is no serious reason to expect any complications that may be related to this.

Currently, to assess the condition of the fetus in late pregnancy, doctors often prescribe Doppler ultrasound, with which the doctor can assess the condition of the placental vessels and the rhythm of the fetal heart and, accordingly, the degree of supply of oxygen and nutrients to the fetus.

In terms of assessing the ability of the placenta to support fetal development, Doppler ultrasound gives more information than conventional ultrasound, which can only assess the structure of the placenta. Many experts believe that if Doppler ultrasound readings are normal, the presence of calcifications in the placenta should not be a cause for concern.

What should I do if I have premature aging of the placenta?

As mentioned above, if signs of premature aging of the placenta appear before 32 weeks, fetal development may be disrupted and the risk of other complications may increase. In this regard, if you have discovered signs of premature aging of the placenta, the doctor may prescribe you a series of repeated ultrasounds during which the rate of fetal development and its development will be checked. general state. If doctors notice signs that the fetus is actually receiving less oxygen or nutrients than it needs, they may recommend a cesarean section or induction of labor.

What happens to the placenta after childbirth?

Immediately after the birth of the child, the placenta (baby place) begins to quickly peel off from the wall of the uterus and approximately 15-30 minutes after birth it is completely removed from the uterine cavity. This process is called “birth of the placenta.” Due to the fact that the size of the placenta is significantly smaller sizes newborn baby, the birth of the placenta in most cases occurs easily and painlessly.

Immediately after the birth of the placenta, the gynecologist carefully examines it to determine whether part of the placenta remains in the uterine cavity. Preservation of even small fragments of the placenta in the uterus can cause severe postpartum bleeding, and in the future can cause infection and even malignant tumor(see Chorionepithelioma).

What is the attachment of the placenta and chorion?

The development of pregnancy begins with the attachment of a fertilized egg to one of the walls of the uterus (see also how does conception occur?). As already mentioned at the beginning of the article, in the first stages of pregnancy, the fetus is attached to the wall of the uterus with the help of the chorion; at the end of the 1st trimester of pregnancy, the placenta forms in place of the chorion.

The uterine cavity can be schematically described as a cube. The developing embryo can attach to the upper, posterior, one of the lateral (right or left) or lower walls of the uterus.

Chorionic previa (placenta) is an incorrect location of the placenta when, instead of the body of the uterus, it captures partially or completely the lower uterine segment. Chorion is synonymous with placenta in the early stages of development. By the end of pregnancy, in most patients the chorion rises, but there are exceptions. If the localization of the chorion is posterior, then it will rise more slowly, if it is anterior, then faster.

Causes of the disease

Accurate and credible reasons The occurrence of this disease is unknown, but there are a number of factors that contribute to the development of this disease. In particular, chorionic presentation can develop due to:

after the caesarean section;
Scar after myomectomy;
The patient has a large number of births;
Age over 35 years;
Chorionic presentation during previous births;
Chronic;
Tumor of the uterus (fibroids);
Anomalies and pathologies during organ development;
Smoking.

In addition, we can say that chorionic presentation is quite common in the early stages of pregnancy, statistically this is up to 30% of cases.

Symptoms of the disease

The main symptom of the disease is the appearance of bleeding, which appears due to the fact that the placenta is not capable of stretching, so when the uterus stretches, it peels off and causes bleeding. Bleeding can appear spontaneously, then disappearing, then appearing again, while the pain disappears. The low location of the chorion contributes to heavy bleeding. In addition, bleeding can be triggered by factors such as physical activity, vaginal examination, sexual intercourse, hot bath, sauna, and also constipation.

Complications that can cause chorionic presentation

The main complication that this disease gives is unplanned termination of pregnancy or premature birth. With this disease, the child develops normally, but patients experience characteristic hypotension, so even slight blood loss leads to anemia. If the bleeding began spontaneously, then sometimes it is necessary to take the last measure in order to save the life of the mother and baby.

Diagnosis of the disease

Diagnosis of presentation usually does not cause difficulties in a patient who is normally observed in the hospital. This disease can be easily diagnosed with a routine ultrasound examination. It is not recommended for pregnant women.

If the patient has not undergone an ultrasound examination, then this disease can be recognized by the fact that it is not accompanied by painful sensations, as well as by the high position of the uterine fundus.

Treatment of the disease

First of all, it must be said that all medications for this pathology are absolutely useless, because they cannot in any way affect the location of the chorion. If suspicious symptoms appear and the disease is diagnosed, it is necessary to completely exclude any physical activity, as well as completely avoid sexual contact. In addition, the patient needs constant supervision by a specialist, so she is hospitalized in the hospital.

In the event that there is no constant bleeding, the patient may well stay at home, while resting more often and eating properly, choosing a diet to prevent constipation. It should be noted that this is especially important, because with this pathology any laxatives are contraindicated.

If the patient full presentation chorion, then natural childbirth is contraindicated for her and is required. During natural childbirth there is a high risk, resulting in large blood loss, which will threaten the health of both mother and child.

The first weeks of pregnancy for the expectant mother are probably one of the most difficult periods throughout the entire period of bearing a child. At this time there are several “ critical periods“in the life of the future little man, his mother is mentally and physically rebuilt for a successful pregnancy. Unfortunately, this period does not always pass without complications and problems, so routine ultrasound examinations should be carried out. A woman’s first ultrasound is scheduled for the end of the first trimester, and it is at this time that this pathology is most often detected.

How dangerous is chorionic presentation at 12 weeks, and how to prevent complications?

Chorionic presentation during pregnancy - what does it mean?:

The chorion is a special organ that provides communication between the body of the mother and her unborn child. In fact, this is an early stage of the development of the placenta, therefore the term “chorion” is used only during the first three months of gestation, after which the word “placenta” is already used. One surface of the chorion faces the fetus, and the other is attached to the wall of the uterus. And it is precisely when the location of the chorion is atypical that various disorders can occur.

As you know, the uterus communicates with the vagina and external genitalia through the cervix, inside which there is a special cervical canal. The internal opening of this canal, which breaks off into the uterus, is called the os of the cervical canal. The chorion or placenta is normally attached to the bottom or lateral surfaces of the uterus and does not overlap the pharynx in any way. But in some cases they can partially or completely close the internal opening of the cervical canal - it is in this situation that a disorder called "Chorion presentation"

Types of presentation:

The closure of the cervical canal by the chorion does not have to be complete, therefore there are several types of presentation that characterize the complexity of this condition:

Partial chorion presentation. In such a situation, the developing placenta covers at least two-thirds of the lumen of the cervical canal.

Regional chorionic presentation . This is a variation and, one might say, an easier version of partial presentation, since only one third of the lumen of the pharynx is covered.

Central chorion presentation. In this case, the lumen of the pharynx of the cervical canal is completely closed by the future placenta, which significantly complicates the course of pregnancy and poses a threat to both the unborn child and the life of the mother.

Low location of the chorion . The forming placenta can be located next to the opening of the cervix, but does not block it. If it is attached near the edge of the pharynx closer than three centimeters, then it is said to be low. This is not dangerous, but poses a potential threat to pregnancy.

Chorionic presentation at week 12 can be in any of these forms.

As pregnancy progresses, the growing uterus can pull back the placenta, so central presentation can turn into partial and marginal, and then disappear completely. According to obstetricians, more than 90% of cases of one or another chorionic presentation completely disappear over time, so if you were diagnosed with it in the first weeks of pregnancy, this is not a reason to panic. But you will have to monitor your condition and not neglect examinations by a specialist.

Causes of presentation:

Why exactly the developing placenta is attached in such dangerous proximity to the pharynx of the cervical canal is completely unknown. However, several main factors have been noted that contribute to more likely development of this complication during pregnancy. Especially often various options Chorionic presentation develops in women who have had in the past or currently have the following diseases and conditions:

Inflammatory lesions of the uterus, abortions, especially using the curettage method, surgical interventions for fibroids or cesarean section. All these factors are united by one consequence - after this, inner surface The uterus may leave scars and adhesions, which make it difficult for the chorion to attach to the “right” place.

Diseases of the liver, kidneys or heart. It would seem, how can these conditions affect the position of the fetus and its placenta in the uterus? But with pathologies of these organs, blood stagnation may occur in the pelvic area, which contributes to lower attachment of the chorion.

Multiple births in the past. If you are pregnant not for the first time, then your chances of improper attachment of the chorion significantly increase. Most physiologists see the reasons for this phenomenon in the fact that after each pregnancy, in the area of the uterus where the placenta was attached, the structure of the endometrium changes. Therefore, at the next conception, the chorion can no longer attach there. Over time, such places on the inner surface of the uterus become less and less, which leads to the attachment of the placenta in the danger zone.

Uterine deformities, acquired (for example, after surgical interventions) or innate nature, can also lead to chorionic presentation.

Is chorionic presentation dangerous?:

Most pregnant women are frightened by such a conclusion from the first ultrasound examination. Although in fact, chorionic presentation during pregnancy of 10-13 weeks is observed in approximately 5% of cases, that is, in every twentieth woman. In later stages, this condition becomes increasingly rare, observed before childbirth in no more than 0.5% of women in labor. main reason This lies in the fact that the growing uterus is able to “pull” the point of attachment of the chorion from the pharynx of the cervical canal to a more safe zone. Therefore, according to pediatricians, chorion presentation during the first trimester can be regarded as a feature of the course of pregnancy, but not a complication.

Difficulties begin if the presentation continues to persist after the third month of pregnancy. Being dangerously close to the pharynx of the cervical canal, the placenta can be easily injured, which leads to bleeding varying degrees expressiveness. With marginal or partial presentation, the first spotting occurs closer to the sixth month. They are practically painless, and blood may be released in thin streaks in the discharge, or give the impression of menstruation. Central presentation can manifest itself with such symptoms as early as the second or third month. In fact, this is the main consequence and danger of chorion presentation, which entails whole line disturbances in the course of pregnancy and the health of the mother and her unborn child:

The constant loss of small amounts of blood leads to anemia in a pregnant woman. You may experience weakness, dizziness, skin become pale. When heavy bleeding may decline arterial pressure, your vision becomes dark, you can even lose consciousness.

Disruption of connections between the uterus and placenta also leads to malnutrition of the unborn baby. Its development slows down, and against the background of reduced oxygen delivery (due to a damaged placenta and anemia in the mother), intrauterine fetal hypoxia occurs.

If the mother’s blood loss reaches significant levels, this can lead to miscarriage, intrauterine fetal death and a number of other terrible consequences.

In addition to the problems described, presentation is often complicated by incorrect positioning of the fetus, which leads to difficulties during the birth process. Therefore, if such a condition is diagnosed in you in the sixth month or later, then you need to mentally prepare yourself for the fact that you may have to have a caesarean section rather than give birth on your own.

Treatment of chorionic presentation:

Unfortunately, at the moment, doctors do not yet know how to correct such a condition as chorionic presentation, so all treatment comes down to preventing complications and eliminating their consequences. As a rule, if there is a central presentation in the fourth month, they prefer to place the girl in the position in a hospital for preservation. The same is done with partial forms of presentation, if they are complicated by bleeding, hypertonicity of the uterus and other factors that may threaten termination of pregnancy. In a hospital setting you will be provided with the following treatment:

To begin with, strict bed rest and restriction physical activity, which is one of the most important factors prevention of bleeding with placenta previa. In addition, you will need to avoid emotional stress, as this can also lead to negative consequences.

Regular examination by a doctor and diagnostic tests ultrasound examinations. Being under 24-hour medical supervision, you greatly reduce the risk of sudden complications, since they will be identified and corrected as soon as possible. Most deplorable and even tragic situations with chorion presentation are caused by delayed medical intervention.

Maintenance treatment, which includes all the vitamins necessary for the pregnant body.

Proper and regular nutrition, which helps normalize work gastrointestinal tract. If you have diarrhea or constipation, you may strain your abdominal muscles, which increases pelvic pressure and may become trigger factor bleeding.

If you develop anemia due to bleeding, it can be treated in a hospital setting by taking iron supplements, including those given by injection.

Treatment is also prescribed to eliminate other factors that threaten the course of pregnancy - for example, antispasmodics for uterine hypertonicity.

With partial chorion presentation, which does not manifest itself severe symptoms, you don’t have to go to bed for conservation, but you need to take certain precautions to prevent possible complications. These primarily include:

Exercise stress. Leisurely walks and walking around the house is the maximum for a girl in such a situation. Lifting heavy objects, walking up stairs, and running are strictly contraindicated.

It is necessary to completely avoid sexual contact. During pregnancy, in principle, sexual intercourse is not prohibited at almost any stage, but during presentation it can cause severe bleeding.

Mental stress or stress affects the pregnant body no better than lifting weights. Therefore, they also need to be excluded, and even with sedentary and predominantly mental work, it will be time for you to go on maternity leave.

Also, as with preservation, it is necessary to eat properly so as not to cause changes in stool and at the same time provide the body with all the necessary nutrients. You also need to agree on the choice with your doctor. vitamin complex, which will be very useful in such a situation.

And most importantly, if you have been diagnosed with chorion previa and at some point you notice the release of even a small amount of blood in the absence of pain, weakness and other symptoms, then you need to urgently consult a doctor. And if the bleeding is accompanied by pain in the lower back and lower abdomen, palpitations, weakness or fainting, then you need to call an ambulance as soon as possible, as you risk losing your child.

"- 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 a late stage - almost before birth.

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.

Otherwise, the woman faces profuse bleeding upon detachment 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

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.