Premature aging of the placenta: what it means, signs, what threatens

Placental aging is a serious condition that can occur during pregnancy. Premature aging of the placenta can result in the baby not receiving the nutrients it needs to survive, requiring the baby to be born before the due date. But don't panic, you need to understand the causes of the pathology to know the prognosis and treatment tactics.

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Causes early aging of the placenta

To talk about the mechanisms and causes of this problem, we must first understand what placental aging means and why it is needed during pregnancy?

The placenta is an organ that develops in your uterus during pregnancy. The placenta and its health are vital to the health of pregnant women and the development of the fetus. The blood-rich placenta attaches to the uterine wall and is connected to the baby via the umbilical cord. This organ provides oxygen, nutrients, and filters fetal waste during pregnancy. It also plays an important role in hormone production and protects the fetus from bacteria and infection.

The placenta produces a number of hormones that are essential during pregnancy, such as lactogen, estrogen, and progesterone. It keeps the mother's blood separate from the baby's blood to protect the baby from infections. The placenta often develops low in the womb, but moves to the side or up as the uterus stretches. The position of the placenta will be checked at your 18-week ultrasound.

It is widely believed that during normal pregnancy, the placenta gradually grows and is on the verge of transition to morphological and physiological aging. This occurs closer to the date of birth, which is accompanied by a slight decrease in placental function. The norm of placental aging implies this process.

Physiological aging of the placenta is considered one of the integral and progressive parts of its development, which leads to an irreversible loss of the functional ability to maintain homeostasis and reduce damage. But in certain cases, this happens earlier than necessary, which accordingly affects the child.

Placental growth and DNA synthesis in its cells ceases around the 36th week of pregnancy, and any subsequent increase in placental size is due to an increase in the size of the cells, not an increase in the number of cells. Placental growth does, of course, slow down, but does not stop, during the last few weeks of pregnancy, although this slowdown in growth is permanent and irreversible. If any factor is at work, the aging process may begin early, which means that both the barrier function of the placenta and the hormones synthesized are reduced. All this slows down fetal growth or stimulates premature labor.

The causes of premature aging of the placenta are sometimes unknown. But there are some possible causes. Smoking during pregnancy can cause calcification of the placenta. As this calcification occurs, the placenta begins to grow faster as parts of it die off. Research has shown that small bacteria known as Nannobacteria can also cause calcification of the placenta. As calcification occurs, the placenta ages prematurely, putting both mother and baby at risk. Other risks of premature aging of the placenta include diabetes and high blood pressure in the mother.

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Risk factors

Risk factors for placental disorders, including aging of the placenta, vary based on ethnicity, lifestyle, and medical history. Various factors can affect the health of the placenta during pregnancy, some modifiable and some not. One example is maternal age. Some placental problems are more common in older women, especially after age 40. High blood pressure can affect your placenta.

Aging of the placenta is more common in twins. If you are pregnant with more than one baby, you may have an increased risk of certain problems with your placentas.

Bleeding disorders: Any condition that either impairs your blood's ability to clot or makes your blood more likely to clot increases your risk of certain placental problems.

Previous uterine surgery. If you've had previous uterine surgery, such as surgery to remove fibroids, you're at increased risk for certain placental problems.

Previous problems with the placenta. If you had a placental problem during a previous pregnancy, you may be at increased risk of becoming infected again.

Alcohol or drug abuse: Premature aging of the placenta is more common in women who smoke or use illegal drugs during pregnancy.

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Pathogenesis

The pathogenesis of placental aging is most often the formation of calcifications, which disrupt the structure and, accordingly, the functions of the placenta. Calcification of the placenta from 37 weeks is considered normal and is not a cause for concern. Calcification of the placenta before 37 weeks becomes more dangerous for the child. The younger the child when calcification occurs, the more severe the condition.

An aging placenta does not work as well as it should, and this may mean that it is not delivering enough oxygen and nutrients to the baby. Calcium deposits in the placenta can cause parts of the placenta to die or be replaced by fibrous tissue, which is the useless tissue in the placenta.

Calcium deposits can also increase the risk of blood clots in the placenta. They can harden the blood vessels in the placenta and slow blood flow to the baby. All of these changes may underlie the aging of the placenta.

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Symptoms early aging of the placenta

The symptoms of placental aging primarily affect the baby. Therefore, the first signs of this pathology are difficult for a mother to identify only by her own feelings. If we are talking about placental aging in the third trimester, when the baby is already active, then the symptoms will manifest themselves precisely with a violation of its activity. When a woman begins to feel the baby's movements, this corresponds to the 20th week. By the 30th week, it is already very active. When the placenta ages, blood circulation is disrupted, which leads to hypoxia. Hypoxia reduces active brain activity, so the baby may stop moving actively. This may be one of the first manifestations, when a previously active baby begins to move less. Placental aging does not affect the well-being of the woman herself, so the woman should be wary first of all of her mutual feelings with the baby.

Low water and aging of the placenta are often combined, since a decrease in the amount of amniotic fluid can be a factor in development and aging. In this case, the signs develop in the second trimester. When the woman's abdominal circumference should increase according to the term, this does not happen, since the content of amniotic fluid is low. This is one of the main manifestations of pathology. As a rule, this symptom forces you to do an ultrasound, and according to its results, the aging of the placenta is already accurately determined. Premature aging of the placenta with calcifications is also only a sign of ultrasound, and confirms the diagnosis of aging.

The time of placental aging corresponds to the development of this organ. There are stages of placental aging that should also occur under normal conditions during physiological pregnancy.

1. The first stage or zero degree is the process of placenta formation itself, the growth of its cells, DNA synthesis in cells, an increase in the amount of tissue and the functional activation of lobules. This stage begins with the beginning of placentation and lasts until the twenty-eighth to thirtieth week. At this stage, the placenta should be fully formed and should actively perform its functions.
2. The second stage or 1st degree is the process of active growth corresponding to the growth of the fetus. At this stage, the placenta begins to synthesize some specific hormones and substances necessary for the child at this stage, for example, surfactant. This stage lasts until the thirty-fourth week.
3. The third stage or 2nd degree is the period of maturity of the placenta, which provides all vital signs of the child until the very period of labor, that is, it lasts until the thirty-ninth to fortieth week of pregnancy, until labor occurs. If labor does not occur, then the aging process begins physiologically.
4. The fourth stage or 3rd degree is the physiological aging of the placenta, which can begin from the 37th week or later. In any case, a few days or weeks before birth, aging is a normal process.

The period of aging of the placenta by weeks during the physiological process is limited to the period of thirty-seven weeks and forty-two weeks - the period when labor should occur.

Early preterm placental aging is when signs of calcification or cessation of placental growth are observed less than 37 weeks.

What is the danger and threat of placental aging? The question of whether placental calcification is a manifestation of pathology or its complication is still being discussed. But it is certain that it can be considered a consequence of this aging process. Placental calcification refers to calcium deposits that appear on the placenta. These calcium deposits can lead to the death of some small parts of the placenta. They can also harden or block the mother's blood vessels. This will lead to fetal hypoxia, and most likely to a delay in the child's development, which is one of the complications.

Childbirth with premature aging of the placenta is often premature, since this normally occurs before childbirth and is one of the factors in the onset of labor. It can also be considered one of the complications.

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Diagnostics early aging of the placenta

How is placental aging determined? Instrumental diagnostics are the first priority here, and this diagnosis can only be established based on ultrasound data. Therefore, it is important to undergo routine examinations and take tests.

At each routine ultrasound examination of the fetus, the quality of the placenta is assessed. Placental classification refers to a system of ultrasound assessment of the placenta based on its maturity. The classification system is as follows:

Class 0 – pregnancy period less than 18 weeks:

• uniform echogenicity;
• smooth chorionic plate.

Class I – pregnancy period 18-29 weeks:

• random parenchymal calcification (single hyperechoic areas);
• fine depressions of the chorionic plate.

Class II – pregnancy term more than 30 weeks:

• occasional basal calcifications (hyperechoic areas);
• deeper depressions of the chorionic plate (does not reach the basal plate).

Class III – pregnancy term greater than 39 weeks:

• significant calcification of the basal lamina;
• chorionic plate interrupted by depressions (often calcified) that reach the basal plate;
• early progression to stage III placental development

Such ultrasound signs should be normal; if there are deviations, they can be classified as premature aging of the placenta.

When calcifications are detected early in pregnancy, it may indicate that the placenta is aging faster than it should. For most women with placental calcifications, careful monitoring of the baby's growth is necessary.

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Differential diagnosis

The differential diagnosis of placental aging should be made with chronic placental insufficiency. From time to time, the placenta may not function properly. When this happens, it may not deliver enough nutrition, causing placental insufficiency. But this process is chronic, unlike placental aging. Therefore, placental insufficiency often leads to fetal growth restriction and low birth weight in infants. Whereas with aging, growth is not affected, and premature labor often occurs.

Treatment early aging of the placenta

How to stop and what to treat the aging of the placenta? It must be said that it is very difficult to stop this process. Therefore, in the treatment they use drugs that improve blood flow in the placenta area and improve the blood circulation of the fetus.

1. Curantil is used in placenta aging as a means of reducing the risk of thrombosis. Often, when the placenta ages, calcifications are formed, on which blood clots can form. To avoid this, Curantil is used as a medicine in complex therapy. The method of application can be oral. Dosage - starting from 75 milligrams per day, if necessary, the dose can be increased. Side effects can be in the form of the onset of bleeding of various localizations, increased pressure, a feeling of heat. The drug is not contraindicated in pregnancy, but precautions - use with caution in case of a threat of miscarriage.
2. Actovegin is also used as a symptomatic remedy for placental aging. It is a cellular energy activator, which improves blood circulation and nutrition of cells in the placenta area. The method of administration of the drug is also oral in the form of dragees. The dosage for women is one dragee three times a day. Side effects may be in the form of severe urticaria. Precautions - use with caution in the early stages.
3. Phlebodia is a venotonic drug that improves lymph drainage from tissues and improves blood circulation in capillaries. It can be used in the case of placental aging, especially if this is combined with edema in women or varicose veins. The drug is taken orally. Dosage: one tablet once a day. Side effects may include headaches. Precautions: the drug should be discontinued ten days before delivery.

Vitamins can be very relevant in the treatment of placental aging, as they improve tissue trophism and can activate fetal growth and normalize placental function. You can use complex vitamins for pregnant women.

Nutrition plays an important role in premature aging of the placenta, since the diet should include iron-containing products. After all, preventing anemia in the mother improves blood circulation in the fetus.

Folk remedies and homeopathy are not used.

Surgical treatment is also not relevant, only in the case of acute fetal hypoxia against the background of aging of the placenta and other factors, a cesarean section is possible.

Prevention

Preventing premature aging of the placenta involves correcting risk factors. Women may be at higher risk for premature placental calcification if they have risk factors. It is important for women to ensure that they are getting enough antioxidants through prenatal vitamins and food. It appears that antioxidants may help prevent premature aging of the placenta. Vitamins E, C, and beta-carotene are particularly important and may need to be taken in higher doses.

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Forecast

The prognosis for placental aging is favorable, almost all babies are born healthy, sometimes there may be 1st degree prematurity. The prognosis for the life of the child is also favorable.

Placental aging is an early process of stopping the normal functioning of this organ. This certainly poses risks to the child, so it is better to prevent this condition. In this case, a healthy lifestyle, nutrition and timely examinations will be of paramount importance.

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