胎盘成熟度

2017-02-17 14:09 阅读: 编辑:pang 来源:家有宝宝
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内容简介:随着孕周的增加,胎盘也会出现由新到老的变化,称之为胎盘成熟度。医学上通常用4种分级来判断胎盘成熟级别。
       胎盘成熟度共分四级:0级,1级,2级和3级。1级标志胎盘基本成熟;2级标志胎盘已经成熟;3级标志胎盘已衰老,由于钙化和纤维素沉着,使胎盘输送氧气及营养物质的能力降低,胎儿随时有危险。

每个人的情况都不同的:

  • 妊娠中期(12—28周)—胎盘0级;
  • 妊娠晚期(30—32周)—胎盘Ⅰ;
  • 36周以后—胎盘Ⅱ级(比较成熟)。


胎盘成熟度
 

       如果37周以前发现胎盘Ⅲ级并结合双顶径的值及对胎儿体重估计在2500克者应考虑胎盘早熟,警惕发生胎儿宫内生长发育迟缓的可能。38周胎盘进入Ⅲ级,标志胎盘成熟。
 

       胎盘不是越成熟越好的,根据你所在的孕期有相应的胎盘成熟度就好,因为胎盘是供应胎宝宝营养的关键。过早成熟的胎盘意味着胎盘老化得快,容易导致胎宝宝供氧不足,甚至会导致胎宝宝的生长发育迟缓。到了怀孕晚期,胎盘基本趋于成熟。如果怀孕37周以前发现了胎盘已经进入3级,并结合双顶径的值及对胎宝宝体重估计在2500克的准妈,应警惕胎盘早熟。

 

成熟度等级高低会给胎儿带来什么影响?


       1、胎盘是供应胎儿营养的关键,胎盘过早成熟就说明胎盘老化得快,功能就会不足了,会导致胎儿供氧不足,引起胎儿发育不良。不过你的胎盘成熟情况应该不会这么严重,否则医生就要建议你做胎儿监护了,再严重的话就需要吸氧、输液补充营养了。(在家定时测胎动,胎动过频、过慢都可反应出胎儿缺氧的可能。及时去医生检查吧。有情况要及时向医生咨询。)

       2、并不是说胎盘越成熟越好,而是根据你所处的孕期有相应的成熟度就好,反而胎盘早熟,就需要警惕发生胎儿宫内生长发育迟缓的可能。胎盘成熟度是指胎盘的老化程度,成熟程度越低说明胎盘的功能越好,能为宝宝提供的营养也越多(0级为未成熟,多见中孕期;I级为开始趋向成熟,多见于孕29-36周;II级为成熟期,多见孕36周以后;),反而越到后期,胎盘老化到了3级(III级为胎盘已成熟并趋向老化,多见于孕38周以后。)甚至钙化了,给宝宝提供的能量和氧气就会越来越少,会引起宫内窘迫等状况。如果37周以前发现胎盘Ⅲ级并结合双顶径的值及对胎儿体重估计在2500克者应考虑胎盘早熟,警惕发生胎儿宫内生长发育迟缓的可能。38周胎盘进入Ⅲ级,标志胎盘成熟。警惕发生胎儿宫内生长发育迟缓的可能。(需要检查的人群妊娠中、晚期妇女)

       而在检测胎盘成熟度时一般采用b超检查,检测钙化点能否确诊胎盘一定老化:

       “即使b超显示胎盘的发育成熟度超过了妊娠月份,也不一定就是胎盘老化。”医生通过b超判断胎盘成熟度,主要通过胎盘上的钙化点。比如,钙化点散在就诊断为ⅱ级,钙化点连成片就诊断为ⅲ级,这多少会受主观因素影响,也许有的医生看是ⅲ级,在有的医生那儿就只能达到ⅱ级。

 

怎样才能确诊胎盘老化?


      除了做b超检查看胎盘钙化点(选有经验的医生看,还要认真仔细地看)以外,还要看羊水多少,彩超看脐动脉血流速度是否正常,胎心监测,尿检查雌三醇和肌酐比值,查阴道壁上脱落细胞等等,都能反应胎盘状况,必须综合考量后确诊。

       如果胎盘功能确实老化了,就可能造成胎儿宫内缺氧,对于妊娠28周以上的孕妈妈,必要时可提前分娩。

       看了以上内容你有没有想过胎盘成熟等级是否跟胎儿的发育成熟情况成正比?事实是胎盘已经成熟,但是不能只从胎盘分级来判断胎儿是否发育成熟,尚需结合其他临床指标及资料综合进行分析。

       胎儿是否能够分娩,主要决定于子宫内的环境是否有利于继续生长发育,娩出后能否存活下来,这两大关键问题必须由医生根据多项监测指标的综合分析才能确定。
预产期是根据末次月经第一天算起的,推算的预产期和实际的分娩日期可相差1-2周,若现在胎心和胎动都正常,建议你继续观察,不能自然分娩时可考虑剖腹产。

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