Placental Grading What It Means For Your Pregnancy
Apart from the fact that your placenta secures and provides nourishment to your unborn baby during the course of your pregnancy, little is spoken or discussed of this organ. Now, this looks like your liver and is full of blood vessels to transport nutrients to the fetus. It attaches itself to the uterine lining and is connected to the baby through the umbilical cord which would be its source of food for the next nine months.
After you deliver the baby, this placenta automatically detaches from the uterus lining and comes out. As your baby grows inside the womb, your placenta would also undergo changes and gradually calcifies. It is important to track these changes through placental grading to ensure that it doesn’t age prematurely.
Placental Grading During the Course of your Pregnancy
Placental calcification is a normal process when it happens slowly during the course of your pregnancy. It is measured in four stages or placental grades:
• Grade 0:
The beginning stage when the placenta has just attached and is still pretty immature. The chorionic plates or the fetal side of the placenta would be smooth without any indentations or marks.
• Grade I:
Your placenta would advance to the next grade only towards the 31st week of your pregnancy. The ultrasound would show slight calcifications randomly dispersed in the placenta.
• Grade II:
This would happen anytime between the 36thand 37th week of your pregnancy. The calcification would become more pronounced.
• Grade III:
This is the last phase of calcification and would happen during or after the 38th week of your pregnancy. At this stage, your placenta would be too calcified with many grooves or ring-like formation inside it.
How is it Measured and What does it Mean?
Your doctor would be able to analyze the placental grading of your placenta with regular ultrasounds during the course of your pregnancy. It is done by observing the amount of calcification seen in your placenta. Premature calcification would hamper the growth of your fetus and might lead to pregnancy complications like early labour, stunted growth, low amniotic level, etc.
Here is how premature calcification will impact your baby:
Advanced Placental Grading Before 34 weeks
If your ultrasound shows a placental grading III or II before 32 weeks of your pregnancy, you may be at a higher risk of preterm labour and birth complications like postpartum haemorrhage, heavy bleeding, or stillbirth. Your baby might also have low APGAR score (a measure of baby health) due to the availability of lesser nutrients.
This would mean that you and your fetus require additional monitoring and constant observation. You might be advised ultrasounds at more regular intervals.
Advanced Placental Grading at 36 weeks
Grade III placenta should be ideally observed post the 38th week of pregnancy. This condition is more of a concern in high-risk pregnancy and pregnancies with complications like High BP, diabetes, placenta praevia, or anaemia; in which case, the baby might be born with a low birth weight. For an otherwise healthy pregnancy, this would just mean constant monitoring from your doctor.
Calcification after the 37th week
Calcification observed after the 37th week of your pregnancy would have very little impact on your pregnancy.
There is very little research on why some placentas age prematurely and hence, very little is known about how to prevent it. The placental calcification can only be analyzed on a case-to-case basis and the observation would depend on the severity of calcification, how early in the pregnancy the calcification starts, whether the pregnancy is healthy or a high-risk one, and your gynaecologist’s opinion.