The placenta is an important organ, on the condition of which the course and outcome of pregnancy depends. Of great importance is the attachment of the placenta: the higher it is, the more favorable the pregnancy will be and the probability of premature termination of pregnancy will be lower. Most often, the placenta is formed on the back of the uterus, and this is considered the most favorable option.
Why is the location of the placenta on the back of the uterus more favorable?
Consider why the location of the placenta on the posterior wall of the uterus is preferable to that of the anterior one. In the absence of pregnancy, the bladder is in front of the uterus. During pregnancy, there is a greater extensibility of the anterior wall of the uterus than the posterior one. The growth of the front wall of the pregnant uterus is faster than the growth of the placenta and bleeding may occur due to premature detachment. Since the stretching of the posterior wall of the uterus does not outstrip the growth of the placenta, the attachment of the placenta to the posterior wall is more favorable. It can also happen that a woman will have an indication for a planned or emergency cesarean section, and if the placenta is located on the back of the uterus, it facilitates the technical performance of the operation. If the placenta is located on the front wall of the uterus , then it is possible to injure it during the dissection of the uterus.
Low placenta on the posterior wall of the uterus
The diagnosis of low placentation in pregnancy is set in cases where the edge of the placenta is not less than 6 cm from the inner throat. Frequent pregnancies, abortions in the history, inflammatory diseases of the endometrium (more often of infectious origin) can cause low placentation. A dangerous diagnosis is the placenta previa on the back wall of the uterus. It is exposed in case the lower edge of the placenta is less than 6 cm from the internal pharynx. It is dangerous that during pregnancy the lower segment of the uterus stretches more than the rest of it and there is a threat of premature detachment of the placenta, which will cause heavy bleeding. Such women should undergo ultrasound on time, and, if necessary, additionally. If in 36 weeks of pregnancy this diagnosis persists, then such a woman is hospitalized in the department of pregnancy pathology and performs operative delivery.
Thus, we considered the most favorable options for attaching the placenta during pregnancy, and also considered the features of management of pregnant women with low placenta and placenta previa.