Why does chorionic detachment occur in early pregnancy, and how to treat it?

During pregnancy, many things frighten the expectant mother. The words about the attachment and presentation of the chorion at the first ultrasound sound especially scary. In most cases there is nothing to fear. But some situations require careful follow-up and treatment.

The fertilized egg with the embryo developing in it consists of two membranes. The chorion is the external one, which at 12-14 weeks turns into the placenta.

A feature of the structure of this structure is the abundant amount of villi on the surface. With their help, the fetus is attached to the wall of the uterus. This is an important stage affecting a normal pregnancy.

Types of chorion attachment, some features

The uterus is conventionally divided into three parts: the lower segment, the anterior and posterior walls. When the chorionic villi attach to one of them, the full development of the embryo and placenta begins. There are the following types:

1. Along the front wall.
2. On the back wall.
3. Bottom view.

If the chorion is on the back wall of the uterus, then this is not a pathology, but the most favorable development option. This is related to:

• good blood supply to the area;
• low stretchability;
• the absence of mechanical impact on the fetus when it moves its legs.

Doctors also regard the localization of the chorion along the anterior wall as a variant of the norm. Pregnant women with this diagnosis are included in the high-risk group for bleeding. They are given general recommendations and are not prescribed medication.

Be sure to visit a specialist on an individual schedule!

When treating pregnant women with chorion located on the anterior wall of the uterus, doctors may encounter some difficulties:

Such problems can be easily solved through in-depth monitoring, including more frequent ultrasound and tocography (the baby’s heartbeat is assessed).

Attachment of the chorion in the lower segment of the uterus is a prognostically unfavorable sign. If it is located more than 3 cm above the cervix, then the pregnant woman is treated on an outpatient basis with more careful dynamic monitoring. It is worth considering that such terminology is appropriate only for very short periods. After 12 weeks they talk about placenta previa.

Localization of the chorion

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

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

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

With anterior localization, there is a risk of detachment of the fetal membranes. If you follow all the doctor’s instructions, you will most likely be able to avoid such complications. There is no need to panic when receiving such information. The chorion is capable of moving and migrating.

The chorion may be on the side during pregnancy. This position is always reduced to anterior or posterior. In this case, it is indicated that the chorion is located, for example, in the front and to the right.

Chorionic presentation: what is the danger?

Attachment of the chorion is a natural process necessary for the further good development of the embryo. Against this background, a situation may arise when the fertilized egg is located very low (close to the internal os, less than 3 cm), covering the natural birth canal. This condition is called chorion presentation. The following types are distinguished:

• marginal;
• central;
• incomplete (partial).

Regional presentation is considered more successful. In this case, the chorion touches the area of ​​the internal os and the cervix. As the fetus grows and the uterus enlarges, the placenta may migrate. At an ultrasound scan at 18 weeks, this situation usually changes to a normal location.

With central presentation, the chorion completely blocks the cervical canal. This is the most dangerous type, in which massive bleeding often develops and fetal death occurs.

Partial presentation is characterized by the fact that the chorion covers the lumen of the cervical canal by 2/3 or less. The advantage of this type is that when the placenta migrates, it moves to the marginal localization, and then to the normal position.

The danger of any kind lies in the possible occurrence of complications. These include bleeding of varying degrees of intensity and antenatal fetal death. If medical care is not provided in a timely manner, a woman’s life is at risk. Such complications are due to the development of a good blood supply system when the fertilized egg is attached to the uterine wall.

As a result of certain factors (intense physical activity, high blood pressure, uterine hypertonicity), a slight detachment of the chorionic villi occurs, which is accompanied by the development of bleeding. Depending on the area of ​​the damaged area, it will vary in intensity.

What is chorionic presentation

In some women, the chorion is attached to the lower part of the uterus. In this case, they talk about presentation. Based on the nature of its localization, they are distinguished:

1 Low position

– the chorion is attached to the lower segment of the uterus, but does not block the cervical canal (that is, it does not block the path along which the baby will move during childbirth).

In this case, severe bleeding may occur, feeding and breathing of the fetus becomes impossible. Recommended.

3

Constant disruption of the connection between the placenta and the maternal body can cause fetal hypoxia (oxygen starvation), delayed growth and development, and in severe cases, death.

4

Although a low-lying placenta is considered the least dangerous for mother and baby among all presentation options, it can cause complications during labor.

5

With complete placenta previa, natural childbirth provokes heavy bleeding, which can lead to death of the mother and fetus.

Therefore, a caesarean section would be the only reasonable solution.

6

In case of complete and partial presentation, vaginal examination is not recommended during a gynecological examination, as it can cause bleeding.

Thus, placenta previa, especially complete one, is a truly dangerous phenomenon that causes a lot of difficulties.

But if this problem is detected on time, in the early stages of pregnancy, a woman has a high chance of having a healthy baby. However, control over the condition of the expectant mother and her child should be more careful.

Interesting! Fourth month of pregnancy: development continues

Causes of presentation, diagnosis and treatment

The true reason for the development of such situations has not yet been found. Background factors for the occurrence of presentation are:

The only method for diagnosing chorionic attachment and presentation is ultrasound! It is carried out in the early stages, when it is already possible to diagnose abnormalities and prevent the development of complications.

Pregnant women with central chorionic presentation must be hospitalized in a specialized hospital. It is impossible to cure this condition! The actions of doctors are aimed at preventing the development of complications. Therapy for all patients is comprehensive. It includes general recommendations and prescription of medications. A positive result largely depends on the pregnant woman herself.

Drug therapy is aimed at reducing uterine tone, pressure, and treating stress. Antispasmodics include No-shpa in tablets, Papaverine in rectal suppositories, Magne B6, and ginipral. The dose, duration of use and specific medicine are selected by the doctor!

It is possible to carry and give birth to a child with different localizations of the chorion. Many girls give birth naturally without any complications. If placenta previa persists, delivery is carried out by planned cesarean section. This is done to prevent complications during childbirth and preserve the life of the mother and baby.

In order to fully develop intrauterine development, the fetus needs nutrition and oxygen. The chorion during pregnancy, and later the placenta, performs precisely this function, supplying all the necessary substances through the blood to the embryo.

What is chorion during pregnancy?

After fertilization and implantation of the fertilized egg, the fertilized egg requires nutrition and respiration.
All necessary substances enter through the mother’s blood, initially through the chorion, and later through the placental membrane. Thus, the chorion during pregnancy is, first of all, a temporary organ that guarantees the normal development of the embryo. The appearance of the chorion is the membrane of the embryo with a large number of elongated villi that penetrate the wall of the uterus. Due to the growth of the fetus, the temporary organ also thickens, gradually transforming into the placenta, with the final changes occurring at 12-13 weeks.

In addition to its main function (nutrition and respiration), the chorion during pregnancy produces female hormones and protects the fetus. This means that the temporary body is designed to fully ensure the viability of the child.

Chorionic thickness by week of pregnancy: table

The first ultrasound examination is carried out at approximately 12 weeks.
During the examination, the attachment of the organ is assessed, which may differ and is not pathological. In this case, presentation is diagnosed along the posterior or anterior wall of the uterus, less often a low chorion is recorded, and subsequently migration of the organ to the side walls often occurs. Additionally, the chorion structure and thickness are assessed. Initially, the most thickened section of the chorion, which is approximately equal to the number of weeks of gestation in millimeters, is subject to measurement by ultrasound. The table shows the normal limits for membrane thickness in early pregnancy:

Significant thickening of the chorion is observed in diabetes mellitus or with the development of hemolytic disease, while thinning indicates placental insufficiency and premature aging, which leads to spontaneous miscarriage.

Types of detachment

If the connection between the fertilized egg and the body of the uterus is lost, this is always accompanied by the threat of termination of pregnancy. The detachment can be partial, with only some part of the chorion (central or lateral) leaving its place. This condition is amenable to therapeutic correction; doctors have learned to maintain pregnancy in this case. If total detachment occurs in the early stages, it is most often impossible to save the fetus. Sometimes this becomes dangerous for a woman due to the threat of internal bleeding.

Ultrasound helps to clarify the size of the detachment; only this study provides accurate information about the size and location of the chorion.

Structural parameters of the chorion by ultrasound

During an ultrasound examination, the doctor can record some parameters in the formation of the chorion, among which are:

• a ring-shaped chorion up to 9 weeks indicates the normal development of a temporary organ, which subsequently transforms into a smoother and more branched surface - the placenta;
• A chorionic cyst is the result of an inflammatory process, as a result of which there is no blood supply in one of the areas of the membrane. Such inflammation has little effect on the course of pregnancy;
• edema is diagnosed when the size of the membrane is increased and occurs due to fluid accumulation. This is often considered a variant of the norm if there are no other pathological processes. In other cases, additional studies are prescribed to determine the causes of the edematous reaction.
• hypoplasia or loose, heterogeneous chorion is associated with the fact that the villous structure of the organ is detached from the walls of the uterine cavity, and there is a risk of miscarriage.

After the transformation of the chorion into the placenta, medical specialists use terms such as maturation and aging of the child’s place according to the degree of maturity, in order to describe premature changes at the stage of gestation.

Causes of chorionic detachment in early pregnancy

Throughout the entire 9 months of gestation, the chorion must be hermetically attached to the wall of the uterine cavity; in the case of premature partial discharge, chorion detachment is diagnosed in the early stages of pregnancy.
Complete detachment always leads to spontaneous abortion due to lack of nutritional supply to the fetus. The causes of chorion discharge are often associated with a woman’s older or younger age, with an antisocial lifestyle (smoking, alcoholism), also observed with infectious lesions, during the development of more than one fetus in the womb, in the presence of abdominal injuries and blood clotting diseases.

Treatment for chorionic detachment consists only of reducing the tone of the uterus through special medications and complete rest for the woman. If placental abruption occurs in the later stages, when the child is able to live outside the mother’s womb, then a decision is made to use cesarean section for delivery, otherwise the consequences threaten the lives of both mother and child.

The chorion is a structure that includes the outer membrane of the embryo called the serosa. It is the precursor of the placenta, which is formed by 12-14 weeks of pregnancy. The chorion consists of many villi that perform nutritional, respiratory, excretory and protective functions.

Initially, the villi completely cover the chorion, but from the 5th week of gestation they begin to grow on the side of the fetus and die off on the opposite side. Normally, the outer membrane of the fetus develops at the bottom of the uterus and extends onto its anterior, posterior and side walls. Chorionic presentation is a pathology in which this structure is not located in a physiological place.

Causes of chorionic presentation

The doctor may not be able to determine the factor that played a decisive role in the incorrect location of the placenta. The most common causes of presentation are:

1

Congenital anomalies of the structure of the uterus, scars and defects in its wall, which arise due to previous surgical operations, cesarean section or frequent inflammatory processes.

2

Presentation occurs more often in women who have a large number of children, or in those who encountered this problem during a previous pregnancy.

3

A woman's age over 35 years is also a risk factor; the likelihood of placenta previa increases if the woman has bad habits (smoking is especially dangerous).

What awaits a pregnant woman if she is diagnosed with chorionic presentation

The expectant mother should be aware that in the case of placenta previa, she must be more careful and attentive. Most likely, you will have to spend some time in the hospital.

Some women with this diagnosis are forced to spend quite a long time in the hospital, but the health of the child is more important, so you will have to be patient.

This diagnosis cannot be eliminated by treatment. If the placenta itself does not change its location during pregnancy, then no external factors will be able to influence it.

All medications that are prescribed to a woman for breech presentation are designed to eliminate complications (for example, stop bleeding) or support the condition of the mother and her baby (multivitamins are often recommended, which can reduce the risk of decreased development).

Throughout pregnancy, a woman should follow a more gentle daily routine, rest more, and avoid physical and mental stress that can cause bleeding. Sexual contacts are often prohibited. If bleeding occurs, bed rest is recommended.

During pregnancy, many things frighten the expectant mother. The words about the attachment and presentation of the chorion at the first ultrasound sound especially scary. In most cases there is nothing to fear. But some situations require careful follow-up and treatment.

The fertilized egg with the embryo developing in it consists of two membranes. The chorion is the external one, which at 12-14 weeks turns into the placenta.

A feature of the structure of this structure is the abundant amount of villi on the surface. With their help, the fetus is attached to the wall of the uterus. This is an important stage affecting a normal pregnancy.

Diagnosis

The first screening during pregnancy, carried out at 11-14 weeks of gestation, includes an ultrasound examination.
During an ultrasound, the doctor measures the length of the embryo, studies its structure, and checks for the presence of markers of chromosomal abnormalities. One of the stages of this examination is examination of the chorion. The most appropriate time for an ultrasound examination of the chorionic villus is the 13th week of pregnancy. At this stage, the formed villi are clearly visible; the doctor can accurately determine the position of the future placenta - the connecting link between the mother and the fetus.

According to statistics, in 90% of cases the chorion is visualized in a physiological place - at the bottom of the uterus. But sometimes this structure is located lower, which is a deviation and causes complications. However, when diagnosing chorionic presentation, the expectant mother should not worry too much, since the placenta can change its position after the 1st trimester of pregnancy. This phenomenon is due to the fact that over time the uterus increases in size and pulls up the fetal membrane.

Usually, the incorrect position of the placenta does not show itself in any way; the expectant mother does not have any symptoms. But sometimes, in the presence of chorionic previa, a woman may experience brown discharge on her underwear or sanitary pad. In very rare cases, the abnormal location of the membranes manifests itself as uterine bleeding. The listed symptoms occur against the background of irritants - fitness classes, during stress, etc.

Types of presentation

To assess the position of the chorion, doctors focus on its position relative to the os (the place where the uterus meets the cervix).
If it is more than 3 centimeters away from this anatomical landmark, then the placenta develops normally. In other cases, the following classification is used: 1. Central complete chorion presentation.

It is characterized by the fact that the fetal membrane completely covers the internal os of the uterus. This type of presentation is the most unfavorable.

2. Central incomplete chorion presentation.

Sometimes it is called partial. This presentation is characterized by the fact that the chorion touches up to two-thirds of the uterine pharynx. Has a better prognosis.

3. Regional presentation of the chorion.

It is a variation of the previous one, but some doctors distinguish it into a separate category. With this type of pathology, the placenta develops, affecting less than one third of the uterine os. Regional presentation of the chorion at 12 weeks is a relatively favorable option for the fetus, since in half of the cases the membrane will take a physiological position after a certain period of time.

4. Low chorion presentation.

With this type of abnormal position, the placenta is formed outside the uterine os, but it is located at a distance of 3 or less centimeters from it. Low presentation is a fairly favorable diagnosis; in 90% of cases, by the end of pregnancy, the membrane occupies a normal place in the organ cavity.

Some experts distinguish anterior and posterior chorionic presentation, when the structure is formed on the anterior or posterior wall of the uterus, respectively, but is located at a distance of more than 3 centimeters from the pharynx. These conditions of the membrane are absolutely normal; over time, the placenta will move to the bottom of the organ.

An accessible explanation about “Placenta Previa” by obstetrician-gynecologist S.M. Dyakova:

Causes

It is not always possible for a doctor to determine the cause of abnormal development of the chorion in the uterine cavity in a particular patient.
The main cause of the pathology is a violation of the structure of the walls of the organ, due to which the embryo cannot attach to a physiological place. Damage to the uterine mucosa is a consequence of curettage, abortion, replacement with connective tissue due to infection. Sometimes congenital anomalies of the organ structure occur. Predisposing factors for chorionic presentation also include:

• chronic diseases of the heart, liver, kidneys in the stage of decompensation;
• age more than 36 years and less than 18 years;
• chromosomal abnormalities of the embryo;
• history of difficult childbirth;
• history of caesarean section;
• uterine fibroids;
• polyps of the cervical canal;
• bearing twins;
• endometriosis;
• repeat pregnancy;
• menstrual irregularities due to hormonal pathology.

What can be the danger of chorion presentation?

This condition goes away on its own in most cases. However, there is a category of women in whom the chorion and placenta remain in place and do not move anywhere. What does this mean?

With this outcome, doctors may choose a non-standard delivery. If the placenta completely blocks the entrance to the uterus, then a planned caesarean section is performed. In the case when the chorion (placenta) is located low, the 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 several days before birth and, if necessary, a caesarean section is prescribed.

Consequences

The most common complication of the anomaly is uterine bleeding.
Its type depends on the type of pathology. With central placenta previa, blood may appear in the early stages of pregnancy, starting from 8-. With more favorable positions of the chorion, red discharge is observed later, sometimes it does not occur at all. Uterine bleeding during chorionic presentation is provoked by physical exertion, emotional stress and other irritants. Their peculiarity is the fact that they are not accompanied by other symptoms - abdominal pain, nausea, etc. Thanks to this, bleeding due to the abnormal location of the placenta can be distinguished from spontaneous abortion.

Red discharge does not have any pattern; it can appear at any time of the day, at different intervals. Sometimes they are very scanty in the form of a “daub”; with a central position of the placenta, a woman may observe profuse scarlet bleeding.

Attention! Chorionic presentation is not always a sign of severe pathology; in many cases, over time, the placenta takes a physiological position in the uterine cavity on its own.

The main negative consequence of bleeding, in addition to discomfort, is the development of anemia - a reduction in the amount of hemoglobin and red blood cells per unit volume of blood. Because of this complication, the expectant mother suffers; she is worried about shortness of breath, dizziness, weakness, confusion, and fainting. Anemia also affects the child; he receives less oxygen, which can lead to intrauterine growth retardation and development.

The most dangerous complication of placenta previa is.

Miscarriage and premature birth occur due to increased uterine tone, when the organ begins to spontaneously contract. During a spontaneous abortion, a woman notices red or brown discharge from the vagina, which is accompanied by cramping pain in the lower abdomen.

Abnormal location of the placenta often leads to malpresentation of the fetus - the position in which the unborn baby finds itself in the last weeks of pregnancy. This phenomenon is observed in 50-70% of pregnant women with the above diagnosis. The most unfavorable options are the transverse and oblique position of the baby, in which case a caesarean section is necessary. In case of breech presentation of the fetus, delivery tactics depend on the qualifications of the doctor and the type of pathology.

Possible consequences of retrochorial hematoma during pregnancy

If the pathology is diagnosed in time, the pregnancy can be saved, but if a woman ignores the clinical symptoms and does not follow the doctor’s instructions, the detachment will intensify, which can lead to the following consequences:

• spontaneous miscarriage;
• sepsis;
• massive bleeding that threatens the woman’s life;
• freezing of the fetus.

Signs of retrochorial hematoma in a pregnant woman

Retrochorial hematoma occurs in women in position, usually before the beginning of 4 months. At this time, the child's place is fully formed, which will provide the child with the nutrients and oxygen necessary for his development and growth. The main symptoms of chorionic detachment in the initial stages of gestation of the embryo are:

• blood discharge from the vagina (the amount depends on the severity of the detachment);
• nagging pain in the lower abdomen, radiating to the lower back, sacrum, perineum;
• weakness.

If such signs are detected, the expectant mother should consult a specialist, as timely medical intervention will help save the pregnancy and the life of the child.

Discharge from retrochorial hematoma

Usually, when chorionic detachment occurs, a woman releases a small amount of blood. The discharge can be pink, blood-stained, bloody, bright scarlet, abundant or scanty, brownish - it depends on the scale of the detachment.

If there is repeated scarlet bleeding in small quantities, the woman should be under the supervision of doctors, since such symptoms indicate new areas of detachment. In some cases, with a large detachment, doctors are powerless and the pregnancy cannot be maintained.

Diagnosis of retrochorial hematoma

An informative study that helps identify chorionic hematoma at the initial stage of formation is ultrasound. The sooner a pregnant woman consults a doctor, the higher the chances of preserving the life of the fetus and further successful pregnancy.

If this pathology is detected, the patient should visit her doctor more often and periodically undergo blood tests to determine coagulability. This analysis will allow you to keep the size of the hematoma under control and detect its growth in a timely manner.

Treatment of retrochorial hematoma

Treatment of chorionic detachment is aimed at stopping the growth of the hematoma (the progression of the pathology) and providing the unborn child with everything necessary for his growth and development:

• sexual and mental peace;
• hospitalization;
• antispasmodics to eliminate increased tone of the smooth muscles of the uterus - No-shpa, Papaverine;
• drugs that resolve the hematoma and prevent the formation of clots - Tranexam, Vikasol, Dicynon;
• sedatives to calm a woman’s worries - valerian tablets, herbal teas with lemon balm, lemon balm, motherwort;
• drugs that improve blood supply to the uterus - Actovegin, Curantil;
• painkillers according to indications to eliminate pain;
• Duphaston, Utrozhestan - for hormonal imbalances.

As a rule, with a small detachment, pregnancy can be saved, and women give birth to a healthy baby at term.

Irina Levchenko, obstetrician-gynecologist, especially for Mirmam.pro

Placental abruption

The placenta, fully formed after the 1st trimester of pregnancy, is the site of communication between the blood flow of the mother and the fetus.
With its pathologies, the nutrition and protection of the unborn child are disrupted, which can cause deviations in its development, and sometimes lead to death. Sometimes women diagnosed with placenta previa experience abruption. Placental abruption is usually associated with the death of the vessels that feed it. The pathology is accompanied by bleeding, abdominal pain, deterioration of health, increased heart rate, pallor, and dizziness. If a woman felt fetal movements before the complication developed, when placental abruption occurs, the baby’s movements stop or sharply increase in frequency.

Doctors distinguish three degrees of placental abruption. In the first case, the area of ​​organ damage is less than one third, the child experiences oxygen starvation, but his life is not in serious danger. The second degree is characterized by the fact that the placenta is exfoliated by half, the fetus is in a state of severe hypoxia. With more severe lesions, intrauterine death of the child from suffocation is observed.

If you seek medical help in a timely manner for partial placental abruption, doctors are able to prolong pregnancy. If treatment measures do not end in success, and the child’s age exceeds 22 weeks and he is alive, specialists can perform an emergency caesarean section.

Treatment

With placenta previa, only symptomatic treatment is possible; at the moment, doctors cannot change the abnormal position of the fetal membranes.
Low and marginal presentation of the chorion at week 13 does not require any measures; in most cases, the organ will independently take the correct position. If after a few weeks the position of the placenta does not change, but the woman does not have bleeding, she is advised to avoid physical and emotional stress, refuse intimacy, sleep more than 8 hours a day, and get plenty of rest. Also, the expectant mother should follow a diet rich in vitamins and microelements, especially iron. It is recommended to include more fresh vegetables and fruits, lean meat, fish, and cereals in your diet.

In case of central placenta previa, as well as in the presence of bleeding, hospital treatment is recommended for the woman. In addition to bed rest and a balanced diet, the expectant mother is prescribed medications to support pregnancy.

To prevent placental abruption, progestin drugs are used - Duphaston, Utrozhestan. Their therapeutic effect is based on reducing the tone of the uterus. The woman is prescribed iron supplements that reduce the loss of hemoglobin - Ferrum-Lek. If bleeding develops, the expectant mother is given hemostatic agents - sodium etamsylate.

Also, the expectant mother is prescribed multivitamin complexes aimed at improving metabolism. If there are mental disorders, doctors recommend taking sedatives - Valerian, Motherwort. In case of persistent bleeding that is not amenable to drug treatment, the question of emergency delivery is raised.

Often, diagnosing chorionic breech presentation terrifies expectant mothers for obvious reasons. Having heard a doctor’s comment about the location of the chorion along the anterior, posterior wall or presentation, many begin to wonder what it is. In order not to be afraid, it is important to familiarize yourself with this concept in a timely manner.

What is chorion during pregnancy?

Chorion

- This is the outer shell of the fetus formed in the early stages.

Important!
Second-parous women over 35 years of age are diagnosed with chorionic presentation more often and pose a greater threat to the fetus than young primiparous women.
The outer part of the membrane borders the uterus and is the connecting link between the body and the fetus.

As a connecting link, the chorion performs the following functions:

• protective function ensures protection of the fetus from infections and external influences;
• the excretory function ensures the supply of all necessary substances;
• the gas exchange function ensures the fetus receives oxygen and removes carbon dioxide;
• The excretory function ensures the removal of metabolic products.

These functions are ensured by the outer villous part of the chorion, the blood vessels of which are intertwined with the blood vessels (of the inner layer of the reproductive organ). The exchange occurs through plexus, but not complete fusion, and in some cases it is perceived by the pregnant woman’s immune system as a foreign body. The reason for this condition is that the fetus carries the genetic information of both the mother and the father.

Did you know?
While in the womb, babies are already mastering their native speech.
Researchers claim that the crying of newborn babies carries the melodic structure and tonality typical of their national language. Increasing as the fetus develops, the chorion, gradually merging with the interlacing of blood vessels, is transformed from pregnancy into an embryonic organ of communication between the pregnant woman and the fetus.

Types of presentation

A special role is played by the correct location (attachment) of the chorion to the inner layer of the uterus (). The physiological location of the chorion is along the posterior wall, which means that pregnancy proceeds normally and does not have any problems.

The norm is considered to be attachment on the side walls or its bottom (upper part). But in some cases, incorrect attachment is diagnosed, which indicates its presentation.

Chorionic presentation

- this is a conditional pathology in the development of the fetus, when its location partially or completely blocks the pharynx of the cervical canal, which passes into the uterus. Depending on the type of presentation, doctors assess the future ability of the pregnant woman to give birth: naturally and independently or by method.

This decision is made by the gynecologists leading the pregnancy, depending on the type of presentation:

• full (central) - location that completely covers the pharynx of the cervical canal;

Important!
In 95% of cases when central presentation is diagnosed, urgent hospitalization is indicated.

• incomplete (marginal) - an arrangement in which the pharynx of the cervical canal overlaps by 1/3;
• incomplete (partial) - location in which the cervical canal os overlaps by 2/3;
• low - the location of the chorion is at a distance of 3 cm from the pharynx of the cervical canal and does not overlap it.

Diagnosing presentation in many cases (especially in the early stages) does not indicate a developing pathology. As pregnancy progresses, it constantly increases, and the place of “attachment” can shift throughout the entire period.

Chorion and its presentation

The chorion is the outer membrane of the embryo that connects two organisms - the mother and her baby. As pregnancy progresses, this temporary organ transforms into the placenta. It is vital for the child and performs a number of necessary functions:

• ensures implantation of the fertilized egg into the uterine cavity;
• transfers necessary substances and oxygen between mother and child;
• protects the embryo from negative factors and the mother’s immune response;
• produces human chorionic gonadotropin, a pregnancy hormone.

The chorion begins to form from the first fragmentation of the fertilized egg from the trophoblast, a temporary organ that provides nutrition to the child and implantation of the fertilized egg into the endometrial tissue. Already at 3–4 weeks of pregnancy, part of the chorionic villi is transformed into vessels entering the umbilical cord. This ensures the movement of oxygen, nutrients and metabolic products between mother and child. Until the 8th week of pregnancy, the chorion has a ring-shaped shape, which is the norm - its membranes surround the embryo in the form of a ring. The chorion is then divided into smooth and villous. By the 8–9th week after conception, which corresponds to the 12–13th week of the obstetric period, it becomes the placenta .

Normally, the chorion is located in the fundus of the uterus, along the anterior or posterior wall. These are its best positions, ensuring good functioning of the organ. Most often, the chorion is located along the posterior wall of the uterus. Attachment of the temporary organ to the anterior wall is normal, but the risk of detachment is higher in this case. Chorionic presentation is its incorrect location in the uterine cavity.

Table: types of chorion presentation

When presenting, the chorion can completely block the cervix of the uterus

Main reasons

There are no established reasons contributing to the development of such presentation today, but indirect factors influencing its development have been established:

• numerous
• previous operations;
• anomalies in the structure of the organ;
• chronic inflammatory processes;
• pathologies in fetal development;
• repeat pregnancy with previously diagnosed breech presentation;
• multiple pregnancy.

Did you know?
Starting from the 32-33rd week, babies in the womb, with a sufficient amount of light, can see their surroundings: their arms, legs, and the walls of the uterus.
“Migration” of the chorion depends on the location of the attachment:

when located on the posterior wall of the uterus, movement occurs more slowly than when located on the anterior wall. All the main factors are based on a violation of the structure of the endometrium, as a result of which the embryo does not have the opportunity to attach to a physiological place.

Symptoms and diagnosis

There are no tests to diagnose breech presentation. The only diagnostic method today is ultrasound examination () after (second trimester of pregnancy) gestation.

There are few symptoms indicating presentation, all of them are indirect and indicate only the presence of pregnancy pathology. These include:

• short-term spotting bloody.

Along with these symptoms, the following are considered life-threatening for the baby:

• weakness, dizziness, fainting;
• the appearance of pulling or cramping in the lower abdomen.

During the gestation period, timely contact with a leading specialist if “abnormal” signs appear will help save the baby’s life.

Important!
A final diagnosis of chorionic presentation can only be made by the end of the third trimester of pregnancy.

Chorion is. Localization of the chorion. Chorionic presentation

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. In this article we will talk about the term “chorion”. You will learn about what it is and where this formation is located. You will also be able to get acquainted with the problems that may arise with the chorion.

Treatment Basics

There is no specific treatment for previa. For a normal pregnancy, following the doctor’s recommendations is considered an important condition:

• absence - heavy lifting, sudden movements, sports. When performing such actions, a sharp contraction of the organ can lead to miscarriage;
• complete absence

During fetal development, a woman's body experiences many changes. First of all, the amount of hormones released changes. At the same time, some changes occur in the pregnant woman’s uterus. Most women don't even know about them. During development, the fetus receives all the elements necessary for development through the mother’s blood. This happens due to the activity of temporary internal organs that appear during pregnancy. One of these organs is the chorion, which appears almost immediately after conception. The chorion is a set of outgrowths located around the fetus. These growths constantly increase in size and begin to penetrate the lining of the uterus. And after a while it turns into a child's placenta. It is the chorion that allows blood to circulate through the placenta and can penetrate the walls of the uterus. The chorion is an organ that allows the embryo to develop normally. After all, only with its help can the fetus exist and not die. The chorion is formed approximately seven days after the conception process. The presence of this membrane is detected only through an ultrasound examination, since this is simply impossible to do during a routine examination. Several types of Chorion can be distinguished, changing during different periods of pregnancy. If the period is short (up to forty-five days), then this shell will have a circular shape. In this case, it is still impossible to see the embryo itself, but only its shell. In later stages of pregnancy, it may have a circular or villous form.

Particularly important for the normal development of the fetus is the place of attachment of the chorion to the uterus, or its localization. In medicine, the term chorionic presentation is used. In this case, the chorion is located in the lower part of the uterus, near the transition of the uterus to the cervix. This attachment of the chorion is very dangerous, as it can lead to severe bleeding during childbirth. And during pregnancy it can even lead to miscarriage. Most doctors perform a caesarean section in this situation. Because natural degeneration may be completely impossible. Chorionic presentation is a pathology, but there are no ways to eliminate it yet. But it can disappear on its own. After all, the chorion, like the placenta itself, migrates very often. This is what happens in most pregnant women. However, in some women the chorion remains in one place all the time, which leads to difficulties during childbirth. If it completely covers the cervix, then a caesarean section is mandatory. But if it is located more than five centimeters above the cervical canal, then perhaps the doctor will allow the woman to give birth independently. Bleeding can often occur in this position. But to prevent this from happening, you should completely abandon physical exercise, sudden movements and lifting heavy objects. You should also completely avoid sexual intercourse. Anterior localization of the chorion One of the types of chorion presentation is its localization on the anterior wall of the uterus. In this case, it passes from the anterior wall into the cervix. This localization is not dangerous, because in this case the uterus remains almost completely open. There is no need to worry too much when making this diagnosis. But it is very important that the chorion is localized several centimeters above the internal pharynx. Also, in this position of the chorion, its growth occurs much faster. But even with this arrangement of the chorion, some complications can occur. Indeed, in this case, the placenta grows and develops on the wall of the uterus that is located closer to the mother’s abdomen. Then the fetus can be located behind the placenta, through which the baby’s heartbeat and movements can be heard very faintly. Also, a caesarean section with this diagnosis is much more difficult. Well, besides, after preliminary birth, the placenta can adhere to the muscular layer of the uterus. Posterior localization of the chorion Very often, when undergoing an ultrasound scan, pregnant women learn that their chorion is located on the posterior wall of the uterus. This situation can be called classic. After all, the attachment of the chorion to the posterior wall of the uterus with simultaneous capture of the side walls is natural. This position, unlike the anterior localization of the chorion, is not pathological. Posterior localization of the chorion is normal and is not a deviation from the norm. But it has its effect on a woman’s body. After all, the growth rate of a pregnant woman’s belly depends on this. In the case of a posterior attachment, the abdomen is usually small. Whereas with anterior localization, the abdomen becomes quite enlarged, already in the first stages of pregnancy. In the future, the chorion can move upward. And this is a common occurrence, because this is how it should happen. So, a pregnant woman does not have to worry about anything. You just have to stick to the regime and constantly be under the supervision of a doctor, following all his instructions. And the chorion itself will rise up, and thus the problem of complicating pregnancy will disappear by itself. And the pregnancy itself in this case will end with a successful birth. But there is still a danger that with posterior localization of the chorion, the placenta can completely block the entrance to the uterus. In this case, constant monitoring of the pregnant woman is needed. And it is best for her to be in the hospital, even if she has no complaints and feels quite normal. If the uterus is blocked by the placenta, there is always a risk of bleeding, and this can be very severe and repeated frequently. In addition, it can begin without any preliminary symptoms. During pregnancy, women are subject to many tests. One of them is ultrasound. During such an examination, the doctor must examine both the chorion itself and its location. In this case, the presence of detachments in the membrane and its size are always taken into account, and all possible problems are diagnosed. Therefore, any problems associated with this organ are detected in the very early stages of pregnancy and can be treated immediately. So you should always follow all the doctor’s instructions, and your pregnancy will end successfully.

Chorionic detachment

I’m writing and roaring. I’m 7 weeks pregnant. On April 5, bruising began, I went to the doctor and was diagnosed with chorionic detachment, there is a palpitation. They prescribed Dicenon, Utrozhestan, Folka, Kartan and rest. I complied. the discharge disappeared. And suddenly 13 - again already a pink daub - I haven’t gotten to the doctor yet - he told me to lie down, increased the dose of morning-gestan, dicenone in the morning and evening, papaverine suppositories for 2 rubles. I had a cough, probably because of this? What are the chances that after repeated smearing the child survived?