What does complete presentation of the chorion mean. Chorionic presentation: is it worth it to be afraid

A pregnant woman is a whole world of new sensations, duties and knowledge. After all, while carrying her child, she learns a lot about the formation of the child, medical terms and conclusions that doctors introduce. One of these new concepts is chorion previa. What is it, who gets it and what does it affect? Let's figure it out.

Why and when?

The state of pregnancy for obstetrician-gynecologists is associated with a certain terminology that is not characteristic of other diseases and gynecological abnormalities. One of these terms "chorion" is used by doctors to refer to the placenta in the first trimester of pregnancy. Therefore, in the cards of patients in the early stages, records of "chorion previa" may appear. An unknown expression in combination with the word "diagnosis" can alert the expectant mother. You should not be afraid of anything, but it is better to make it a habit to ask the doctor in detail about everything incomprehensible and suspicious. Do not be afraid to ask again or clarify, because in such a situation, shyness in the doctor's office should be forgotten.

So, this diagnosis in medical language means the wrong location of the placenta. That is, a situation where the placenta is not attached to the body of the uterus, but captures the lower segment of the uterus. Sometimes there is a partial or complete overlap of the internal pharynx of the cervical canal. Chorionic presentation is most relevant for the first trimester of pregnancy, and with the development of the fetus, the chorion rises. But sometimes this doesn't happen.

Types of presentation

Low presentation means the attachment of the fetal egg a few centimeters lower. According to statistics, this presentation occurs in 5% of pregnant women, and this diagnosis can only be made during an ultrasound examination. In the case of low presentation, there is every chance of normalizing the situation. So, in 90% of cases, the chorion rises to the desired position with an increase in the size of the fetus. This is facilitated by the pulling up of the tissues of the uterus, behind which the placenta also stretches. That is, in this situation, everything returns to normal without any medical treatment.

There is also a presentation along the back wall of the uterus. This option is very common and normal. The placenta can also pass to the side walls of the uterus, and this is also not a cause for concern. In the case of anterior wall presentation, the migration of the placenta occurs even faster - and this is the norm.

Sometimes it happens that the placenta did not rise. In this case, the overlap of the internal pharynx is not observed. Then the pregnant woman is recommended complete rest and observation by a gynecologist.

If the presentation is partial, then the placenta can cover even 2/3 of the cervix. One of the varieties of this type is the marginal presentation. With it, the overlap of the opening of the uterus is no more than 1/3. These options are a little more disturbing, but the hopelessness of the situation is not worth talking about. The risk of miscarriage increases, bleeding may begin.

The most threatening doctors call a complete or central placenta previa. In such a situation, there is a complete overlap of the internal pharynx of the cervical canal. With a central presentation, a woman is shown hospitalization, because there is a risk of heavy bleeding. To avoid it, a pregnant woman should be under the constant supervision of a doctor. Although full presentation is often associated with a caesarean section, there are chances of maintaining a pregnancy. A favorable outcome is observed in 95% of cases.

Causes of chorion presentation

The main reason for such a violation of the course of pregnancy is the pathology of the inner walls of the uterus. This results in difficulties with the attachment of the embryo to the uterus. Such a pathology occurs after an abortion, may be the result of infections or deformation of the uterus. The risk group also includes women with severe forms of heart, kidney or liver disease, because these diseases cause congestion in the uterus. It should be noted that chorion presentation is more common in second-borns and women over 35 years of age.

Consequences of chorion presentation

The most common complication of chorion previa is bleeding. Its abundance depends on the degree of presentation. During full presentation, bleeding can occur as early as 2-3 months, lateral bleeding can cause bleeding after 6 months, during childbirth.

The outpouring of blood comes out. Thus, the appearance of hematomas between the uterus and the chorion can be avoided, but the danger to the mother and child is not reduced.

The peculiarity of such bleeding is suddenness, but the pregnant woman does not experience pain at this time. This distinctive feature allows you not to confuse bleeding with.

Against the background of presentation, the embryo is often in a transverse or gluteal position. Then it is recommended to do in order to avoid all risks.

Expectant mothers should remember that chorion presentation is not yet a sentence. Following the recommendations of the doctor, you can endure and give birth to a healthy child. Believe that it will be so!

Specially for Elena TOLOCHIK

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

Note that the villous membrane - the chorion - performs several vital functions for the fetus in the early stages of pregnancy:

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

What does chorion previa mean?

In order to understand why the low location of the chorion is dangerous, let's define what 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 overlaps the internal pharynx.

Chorionic presentation - causes

The causes of chorion previa have not been elucidated, but some factors that affect chorion previa are still known: uterine fibroids, abnormal development of the uterus, postoperative scars on the uterus, chronic inflammation of the uterus, chorion previa in previous pregnancies, frequent abortions. Chorionic presentation along the anterior wall or presentation can also occur due to polyps or multiple fibroids. Therefore, frequent visits to the gynecologist for preventive examinations and a healthy lifestyle will help to avoid problems associated with possible presentation and its consequences during pregnancy.

Why is chorion previa dangerous?

Such a classification of chorion presentation is accepted. Complete presentation of the chorion is dangerous by the complete overlap of the internal os of the cervix. It is also called the central presentation of the chorion. Such an arrangement is dangerous with 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 presentation of the chorion means that only part of the internal os is blocked. Low chorion presentation means that the chorion does not overlap 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 a complete placenta previa for childbirth can become normal. Chorionic presentation is an indication for caesarean section, natural childbirth in this case is excluded.

Chorionic presentation - treatment

Treatment of presentation as such does not exist, the main thing is to adhere to preventive measures. The best prevention is a healthy lifestyle and regular visits to the doctor, identifying and controlling the appearance of fibroids and polyps before the onset of pregnancy. If, nevertheless, chorionic villus presentation 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 drugs to reduce uterine tone, as well as iron preparations to prevent anemia.

Regular ultrasound examinations will help to qualitatively control the current situation, and in the third trimester the placenta may safely migrate and gain a foothold in a safe place, which will lead to natural childbirth.

During the obligatory ultrasound after 12 weeks, among other things, the location of the chorion is assessed. Sometimes an uzist will diagnose chorion previa. What does this mean and how dangerous is it?

What is chorion previa and why does it occur?

Until the placenta is formed, the embryo is surrounded by a villous membrane that grows into the uterine mucosa. Until the 16th week of gestation, this is the chorion (from the 17th week - the placenta), which performs the following main functions:

• Nutrition of the embryo;
• Respiration - delivery of oxygen and removal of carbon dioxide;
• Isolation of metabolic products;
• Embryo protection.

In the normal course of pregnancy, the chorion is attached to the bottom of the uterus, grows along the anterior, posterior and lateral walls, but this is not always the case.

Chorion presentation is its incorrect location, in which there is a complete or partial overlap of the internal pharynx of the cervical canal.

Why this condition occurs is not entirely clear. But a connection has been established with some factors:

• chronic inflammation of the uterus;
• transferred operations;
• nomal development of the uterus;
• a large number of pregnancies and childbirth;
• low implantation of the placenta in a previous pregnancy.

Types of location of the chorion

Based on the attachment of the chorion relative to the internal pharynx, presentation happens:

• Complete - a condition in which the chorion completely covers the internal pharynx. Subsequently, this will turn into placenta previa.
• Incomplete - characterized by overlapping of part of the uterine pharynx. If the villous membrane extends up to a third, then this is called marginal presentation.
• Low - the chorion is located at a distance of 3 cm or less from the pharynx, but does not overlap it.

Chorion previa at week 12 is not a final verdict. As the uterus and fetus grow, its migration may occur, and the condition will return to normal. A more favorable prognosis is noted for the posterior arrangement of the chorion and presentation along the anterior wall.

Complete overlap of the chorion of the uterine pharynx is a dangerous type of pathology that threatens with massive bleeding.

How is chorion previa manifested?

Most often, pathology is detected during ultrasound.

Bloody discharge can also be triggered by presentation, especially if a hot bath, sauna, sexual intercourse took place shortly before. In this case, you need to urgently consult a doctor.

Complications

Pathology is dangerous:

• premature miscarriage;
• uterine bleeding;
• intrauterine death of the child.

Chronic blood loss leads to the development of anemia and fetal hypoxia. While maintaining the complete overlap of the pharynx, childbirth in a natural way is impossible.

Treatment of chorion previa

Partial chorionic presentation without bleeding does not require hospitalization. The isolation of any amount of blood is an indication for treatment in the hospital.

It is impossible to artificially change the location of the villous membrane, so the main task facing doctors is to preserve pregnancy. In the hospital, a medical and protective regime is created:

• The woman is in a calm environment, observes bed rest;
• Physical activity is limited;
• A balanced diet is provided with the exclusion of foods that fix or relax the stool.

Medical treatment is as follows:

• Candles with Papaverine, Drotaverine tablets to relieve uterine tone;
• Iron preparations, for example, Totem, Maltofer - for the prevention or treatment of anemia.

In the presence of bleeding, the hemostatic drug Etamsylate sodium is additionally used. At the beginning of therapy, it is administered intravenously or intramuscularly. Then the transition to tablets is possible.

Massive bleeding that cannot be treated with conservative methods is an indication for termination of pregnancy.

After discharge from the hospital at home, it is necessary to adhere to a measured lifestyle, eliminate stress and increased stress. It is forbidden to have sex, because. this can cause new bleeding and miscarriage.

What is the prognosis for pathology?

Chorionic previa at 8-14 weeks can transform into a normal placenta or persist as a low placenta.

If the presentation did not disappear, but turned into anomalies in the location of the placenta, then by the time of delivery the child may be in the uterus transversely or with the buttocks to the bottom. In such cases, in order to reduce the risk, it is recommended to give birth through.

Prevention

Women should take care of their reproductive health as early as possible:

• Hypothermia should be avoided, inflammatory diseases of the genital area should be treated in a timely manner.
• Do not resort to abortion, this is not a method of family planning.
• It is important to eat properly and fully, to lead a measured lifestyle.

If you follow these simple rules, you will not have to get acquainted with pathologies from personal experience.

Yulia Shevchenko, obstetrician-gynecologist, specially for the site

Useful video

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

Many women would like to know why there is an incomplete presentation of the chorion, what it is and why it is dangerous. Only narrow experts 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 a placenta. In the early stages of pregnancy, it is the fleecy membrane that transports nutrients to the embryo, protects the embryo, and also performs excretory and respiratory functions.

If the pregnancy proceeds without pathologies, the chorion develops in the region of the uterine fundus. Usually everything happens this way, and the placenta is further attached mainly to the back or front wall. In presentation, the chorion is located in the lower part of the uterus. The internal pharynx is partially blocked.

There are many reasons why such a pathology develops. These include:

The presence of inflammatory diseases of the genital area;

uterine fibroids;

Incorrect structure of the uterus;

A large number of births in history.

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 chorion previa usually results in complete placenta previa. This pathology is an indication for a caesarean section. When the internal uterine os is blocked, natural childbirth is simply impossible.

Incomplete chorion previa not only leads to improper formation of the placenta. A woman can face a number of complications not only in childbirth, but also at different stages of pregnancy. The most common and very dangerous complications include:

Termination of pregnancy spontaneous;

hypoxia;

Fetal death in utero;

bleeding;

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

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

If a woman has already had pregnancies with incomplete chorion presentation, the risk of pathology during repeated pregnancies increases. Unfortunately, it is very difficult to prevent such a development of events, but it is possible with a competent approach to planning conception.

Incomplete presentation of the chorion is a rather serious and dangerous pathology. It is very important to diagnose it on time and take all measures aimed at maintaining such a pregnancy. The best results can be achieved with treatment in a hospital.

During the period of bearing a baby, the female body undergoes numerous changes. They begin with a change in hormonal levels. Further changes occur in the reproductive organ itself. During this period, the woman is not even aware of her new position. This article will focus on the term "chorion". You will learn about what it is and where this education is located. You can also get acquainted with the problems that may arise with the chorion.

conception process

To begin with, it is worth saying a few words about fertilization. In a healthy woman, the follicle ruptures once a month. At this point, the female gamete is released, ready for fertilization.

If sexual intercourse takes place at this moment, then the male cells will be able to freely meet with the egg. When two gametes merge, continuous division and movement of cells begins. When the formation reaches the reproductive organ, the ovum is attached. It tightly grows into the inner lining of the uterus and remains there for a long time.

Chorion - what is it?

The chorion is the outer fetal membrane of the embryo. It is worth noting that it consists of two important components: amnion and chorion.

The outer part (chorion) is the most important part. It is she who borders on the inner shell of the uterus. Localization of the chorion may be different. You will learn about the most popular of them below.

Chorion is a component of a normal pregnancy. Without it, the fetus will not be able to develop normally and will simply die. This shell appears approximately one week after fertilization and remains until the formation of the placenta. Many doctors say that the chorion is the placenta. To some extent, this statement is true. It is at the junction of the upper shell of the fetus with the endometrium that the placenta is formed.

Chorionic diagnosis

This formation cannot be determined by vaginal examination. The chorion is a formation that can only be seen with an ultrasound examination. Always in the ultrasound protocol, the specialist describes the state of this structure, its location and features.

Types of chorion

Medicine knows several varieties of the upper shell of the fetal egg. It is worth noting that all of them depend on and can change greatly over time. It is possible to determine the type of chorion only when

Pregnancy up to 6 weeks from conception

At this stage of the development of the fetal egg, the annular chorion can be found. What it is?

On examination with the help, you can find a fetal egg. It is worth noting that the embryo at this time is not yet visible. The upper shell of the fetal egg is attached to the endometrium over its entire area. It is in this case that we can say that there is an annular chorion.

Pregnancy up to 8 weeks from conception

Often in the protocol of an ultrasound examination, women find an entry: "Chorion circular." What does it mean?

A similar condition of the upper fetal membrane is characteristic of early pregnancy. This kind of formation is transformed at about 8 weeks from the moment of fertilization.

villous chorion

This type of shell is absolutely normal. Many women ask the gynecologist: “Villous chorion: what is it?”

The shell got its name due to the fact that it has the so-called villi. It is with their help that it is attached to the inner wall of the reproductive organ. The villous chorion is always described in the ultrasound protocol. Its location is also noted.

Localization of the chorion

There are several common options for attaching this structure. Doctors still do not know why the fetal egg chooses one or another place. Let's take a look at each possible option.

Posterior localization

This condition is the most common. In most cases, in the first trimester of pregnancy, a chorion is found along the back wall of the reproductive organ. In this case, it is necessary to take into account the structural features of this shell.

Front location

If your chorion is not located on the back wall, then it is attached to the front of the uterus. This condition is also the norm, however, special precautions must be taken.

With anterior localization, there is a risk of detachment of the membranes of the fetus. If you follow all the instructions of the doctor, then, most likely, it will be possible to avoid such complications. Do not panic when receiving such information. The chorion is able to move and migrate.

Lateral arrangement

Chorion during pregnancy may be on the side. This position is always reduced to the front or rear. This indicates that the chorion is located, for example, in front and on the right.

Chorion presentation

Many pregnant women have to deal with this diagnosis. To begin with, it is worth clarifying what "previa" means.

If the fetal egg is attached low in the reproductive organ, then the resulting chorion will overlap or simply be located very close to the exit from the uterus. This condition is a pathology, but the treatment for it has not yet been invented.

Do not be upset because of this arrangement of the chorion. He can migrate. The formed placenta can also move up or sideways. Thus, placenta previa, which was detected during the second screening, often disappears at the third examination with an ultrasound probe.

What can threaten the presentation of the chorion?

This condition usually resolves on its own. However, there is a category of women in whom the chorion and placenta remain in their place and do not move anywhere. What is the risk?

With this outcome of events, doctors can choose a non-standard delivery. If the placenta completely blocks the entrance to the uterus, then it is carried out in the case when the chorion doctor takes into account the distance between the cervical canal and the edge of the membrane. If the gap between the cervix and the placenta is more than five centimeters, then the woman is allowed to give birth on her own. In other cases, a planned additional ultrasound is performed a few days before the birth and, if necessary, a caesarean section is prescribed.

Chorionic presentation: precautions

If you are diagnosed with this diagnosis, the doctor will give several recommendations. It is worth listening to the advice and taking all precautions. Otherwise, spontaneous bleeding may occur, which leads to the most unexpected consequences.

Keeping physical rest

With the presentation of the chorion, complete physical rest is always prescribed. A woman needs to give up physical education and sports exercises. Also, you can not lift heavy objects and make sudden movements.

In some cases, it is even forbidden to sneeze, since a sharp contraction of the uterus can lead to a partial detachment of the chorion.

sexual rest

In addition to physical rest, sexual rest is also necessary. It is worth abandoning all contacts until the chorion rises to a safe distance from the cervical canal. Otherwise, involuntary contractions of the genital organ can cause bleeding.

Taking medicines

With chorion previa, the doctor may prescribe certain medications. They relax the uterine muscle and prevent it from contracting. In the early stages of pregnancy, these can be Dufaston tablets, Papaverine rectal suppositories, No-Shpa tablets. At a later stage in the development of the embryo, other means may be prescribed: injections or tablets "Ginepral", vitamins "Magnelis B6".

It is worth noting that taking such medications is necessary only on the recommendation of a doctor. In some cases, you can even do without them. Also, the doctor may recommend wearing a bandage. This device will support the stomach and facilitate the general condition of the pregnant woman.

Summarizing

While waiting for the baby, women undergo various studies. Including ultrasound. With such an examination, the doctor always examines the chorion and notes its localization. This takes into account the size of the shell, the presence of detachments and other problems.

Always follow your doctor's advice for chorion presentation. Only in this case, the pregnancy will end with a successful delivery.