The position of the placenta in relation to the internal os

An important factor in pregnancy that can impact the health of the mother and the unborn child is the placenta’s position. It’s critical to comprehend the potential effects on delivery and the pregnancy as a whole of the placenta’s positioning with respect to the internal orifice, or opening of the cervix.

One important point of reference for tracking the placenta’s position is the internal organ. Complications may arise if the placenta covers or is too near to this area. The placenta’s positioning aids in healthcare providers’ planning for a safer delivery and early resolution of any possible problems.

We will discuss the meaning of the placenta’s position, its importance, and how it may affect the course of pregnancy and delivery in this article. This material will give you more insight into prenatal health, whether you’re expecting or just interested in learning more about it.

An optimal placenta-internal os relationship is essential for a safe pregnancy and delivery. Placenta previa, which can cause bleeding and interfere with the baby’s delivery, is one of the complications that can arise from the placenta being positioned too low, near, or over the cervix. Knowing this position makes it easier to plan appropriate care and keep an eye out for potential risks, ensuring the health of the mother and unborn child throughout the pregnancy.

What is it?

Placental tissue appears at the beginning of the second trimester of pregnancy. It actively functions for several months of pregnancy until the very birth. The normal location of the placenta is an important clinical sign. If the placental tissue is located abnormally, then this can be dangerous due to the development of complications during pregnancy. In order to understand how the placenta can attach, you should touch on anatomy a little. The uterus is the main female reproductive organ in which the baby develops during pregnancy. It connects to the vagina through its cervix. The outer border of this connection is called the external os. The cervix is ​​separated directly from the uterus itself by the internal os.

Many alterations take place in a woman’s reproductive organs following childbirth. The cervix’s mucous membranes turn a deeper shade of blue following fertilization. The mucous membranes also undergo a density change, becoming more elastic and dense. During pregnancy, the internal os normally stays closed. This is essential for the baby’s complete intrauterine development. The fetal bladder is shielded from infection and fetal retention in the uterus by the closure of the internal os.

Pregnancy may have serious complications if the internal os tone shifts for any reason. Generally speaking, there is a much higher chance of a spontaneous miscarriage in such situations.

Normal location

The formation and location of placental tissue largely depends on the initial site of attachment of the fertilized egg. Optimal if it occurs near the bottom of the uterus. In this case, the placenta will be formed physiologically in the future. If for some reason the fertilized egg attaches low, closer to the cervix, then in this case the location of the placenta will also change. Doctors evaluate the location of the placental tissue at different stages of pregnancy. In this case, the norm of its location to the os is determined by the weeks of pregnancy. So, in the 2nd trimester, the normal height of the placenta from the internal os is 5 cm. If the lower edge of the placenta is only 3 cm or less above the internal os, then this condition is called low attachment. As a rule, doctors diagnose it only by the 12th week of pregnancy.

The normal distance in the third trimester of pregnancy is 7 cm from the placenta to the internal os. This condition is known as low placental attachment if it is less than 5 cm.

A pregnant woman can take a baby, having even a low attachment of placental fabric. In this situation, it is very important for her to monitor her well-being and carefully track all emerging symptoms. The appearance of sudden cramping pains in the lower abdomen and the appearance of bloody discharge should be a reason to immediately contact your obstetrician-gynecologist. Low location of the placental tissue at 20 weeks requires more careful monitoring of the pregnant patient. At this time, the risk of developing intrauterine hypoxia of the fetus increases. This condition can be dangerous due to the development of bleeding, placental abruption, as well as cessation of intrauterine development of the fetus. With a low position of the placental tissue, doctors recommend that patients carefully monitor their well-being. So, a pregnant woman with such a location should not lift weights. This can provoke uterine bleeding.

When a pregnant woman has low placental tissue presentation, she should also keep an eye on her emotional health. Hypertonicity of the uterus is a dangerous condition that can be brought on by stress and anxiety. The likelihood of a spontaneous miscarriage rises in this situation. It is advised that the expectant mother get enough sleep and go for more frequent walks in the fresh air to help normalize the emotional background.

The expectant mother should be admitted to the hospital if she experiences uterine bleeding and has a low placental tissue presentation. In this scenario, if the bleeding started fairly early on, the doctors determine the best course of action for continuing to manage the pregnancy.

The woman may be kept in the hospital for a few weeks "for preservation" if necessary. Following her stay in an inpatient facility, the expectant mother is advised to modify her daily routine and is prescribed medications as needed.

Clinical options

Placental tissue is usually located more often at the level of the anterior and posterior walls of the uterus. Also, in some cases, it reaches the side walls. Much less often, the placenta attaches directly to the bottom of the uterus or in the area of ​​the tubal angles. Doctors believe that not all clinical variants of placental attachment are favorable for the course of pregnancy. Less physiological cases of the location of placental tissue can be dangerous due to the development of complications. The exact location of the placenta can be determined using ultrasound examinations. If the placental tissue covers the internal os, then this is a very dangerous pathology. In this case, the risk of spontaneous labor increases significantly. Also, with this option, the risk of infection from the external genital tract into the uterine cavity, where the fetus is located, is quite high.

Types of pathologies

This clinical condition is referred to as presentation if the placental tissue is found directly at the internal os site. It may be marginal, full, or partial. The placenta’s position in relation to the internal organs determines the type of presentation that occurs.

Finding the placental tissue’s aberrant position is essential. This enables medical professionals to stop the development of several serious diseases that can arise during pregnancy.

1. Central. In this situation, the placental tissue is located in the lower part of the uterus, and also covers the internal os.
2. Lateral. In this situation, the placental tissue is also located in the lower part of the uterus, but the os is not completely covered.
3. Marginal. In this case, the placental tissue and the os are practically touching with their edges.

Because of the potential for extremely dangerous complications during childbirth, previa of the placental tissue can be dangerous. These may show up as weakening of labor, placental tissue ingrowth, atonic uterine bleeding, different infections, and potentially the emergence of septic pathologies.

Obstetricians and gynecologists are compelled to perform a cesarean section in the event of a central placental presentation. Pregnancy is typically 37 weeks along when planned operative obstetric assistance is performed.

There are instances in medical practice where the internal os is covered by the chorion’s presentation along the posterior wall. In these situations, doctors typically monitor the pregnancy’s progress more closely. The chorion finds it challenging to "rise" along the posterior wall.

Sometimes it doesn’t rise from this position and stays there. In this kind of situation, it’s critical to keep an eye on the pregnancy’s progress and make the best decisions regarding future obstetric support. It’s also possible that giving birth will necessitate a cesarean section.

A healthy pregnancy depends on the placenta’s understanding of its relationship to the internal os. The location of the placenta can affect delivery strategies and possible complications. Placenta previa, which may necessitate a cesarean section, can be caused by the placenta being too near to or covering the internal os.

Any placental positioning-related issues can be managed and addressed with the assistance of monitoring and routine check-ups with your healthcare practitioner. They will walk you through the actions you need to take to protect your health and the health of your unborn child.

You can overcome any difficulties relating to placental positioning and concentrate on having a great pregnancy experience by remaining informed and collaborating closely with your medical team.

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