Postmaturity placental deterioration- evidence? X-posted

[PreggieUBA2C]

Anyone?

I see and hear the fear related to the thinning or deteriorating placenta frequently and have yet to find a conclusive study that shows a direct correlation or causation relating to post-dates. Does anyone here know where such evidence exists? In everything I've read, it is simply assumed that it is possible and even likely, without any references or citations.

I am unwilling to accept this as a conclusion when it seems that it is simply an opinion based on an unfounded premise (that babies can be 'late').

Thanks!

[NatureMama3]

When I was PG and overdue I never found the evidence you are looking for either. I even found examples of those placental problems in earlier than EDD placentas.

I *personally* believe there are other things involved in those placental deteriorations. blood pressue, diabetes, pre-e, medications being taken by mother.. there must be something that causes it and I worry it is not being looked for. I don't believe it is JUST being late, especially since it also happens early. Maybe it is clotting disorders? sadly, we'll never know unless some researcher takes up the cause.

[KariM]

I wonder about this too!

My midwife insisted that there was placental deterioration with my last pregnancy. She even interrupted my bonding time with my baby to show me the calcification on the placenta that *proved* that I was truly post-term and had endangered my child by not agreeing to natural induction earlier. :

I've gone 41+ weeks with both my kids.

[NatureMama3]

how much calcification? a small spot here or there is NOT dangerous.

[KariM]

Originally Posted by NatureMama3

how much calcification? a small spot here or there is NOT dangerous.

I remember seeing a few spots, but honestly I was so angry with her for choosing that time to say "I told you so," and I didn't have my glasses on, that I really didn't pay much attention to it.

My baby was healthy (apgars of 8 and 9) and didn't show any ill effects at having been allowed to choose her birthdate that I just shrugged it off.

I am interested, like the OP, in reading about evidence based information, though.

[NatureMama3]

my son's placenta had 3 small (ie eraser sized) spots of calcification and he was a 10/10 apgar.

[Juvysen]

My daughter was 9 days late (induction) and had a very healthy (and ENORMOUS) placenta. My son was 40wks 2 days and had some calcification spots. Both were very healthy (well, my son landed in a puddle of amniotic fluid and semi inhaled it, so he had a bit of trouble w/breathing for a couple minutes - nothing that a bit of rubbing and a couple sneezes couldn't take care of - but beyond that we were good.)

[desertgirl351]

My DD was born at 39 weeks and there were a few small spots of deteriorating on the placenta. She was a 10/10 and was screaming before she was all the way out! I am sure of my dates so I guess she was just ready. My MW didn't seem worried by it at all. I had asked to see it when they were looking it over.

[PreggieUBA2C]

So I'm not the only curious one !

Just to add my experience, ds3 was 44+2 weeks and had a very healthy placenta with absolutely no spots at all. He had no vernix or lanugo either; he looked two months old when he was born, but all pink, chubby and strong. I don't understand the ipso facto assumption that calcification is directly correlated with age or that calcification is inherently dangerous either. Is calcification of the placenta the primary issue with regards to postmature babies?

Fwiw, ds3 was also born with light green amniotic fluid (gasp- emergency!) that had been that way long enough to completely stain the placenta a nice earthy green colour, although his skin was not stained and he had only one small meconium poop following birth.

He also screamed before his body was born and then was quiet, content, and calm for days before we discovered that he's really not all that quiet at all . Funny .

Every sign (except calcification) was there to indicate that ds3 was 'postmature' according to medical literature and had he not been born at home, I know he would have been harmed as a result of what is clearly the most healthy time for him to have been born.

I'd still like to see an actual study. I x-posted on Birth Professionals.

Oh, ds3 was 10lbs3oz.

[pamamidwife]

I think there is a huge misunderstanding for care providers.

Placentas age and definitely by 43 weeks or so can look different than a 36 week placenta.

BUT that does NOT mean that the placenta does not continue to function or sustain a baby well.

In fact, even if half your placenta was old and not functioning, your baby would still do well going past the due date.

Calcifications are minor - the amount of calcifications seen on a placenta do not prove that a placenta was nonfunctioning.

This whole idea that the placenta expires at term is weird. Because we know that the placenta is an ever-changing organ. For women that smoke, the placenta is growing out and out looking for fresh places for implantation.

There is so much we don't trust and don't know about the placenta. It's an amazing organ -

[JanetF]

Slightly OT but what bemuses me is that babies are induced so that they don't grow "too big" and yet their placentas are supposedly failing at the same time as they're having this terrific growth rate at the end of pregnancy. Strikes me that surgeons can't have it both ways... But of course logic is not the mainstay of obstetrics or we'd all be hiring mws...


I agree with Pam. There's some interesting research from 1991 (I think) that says pretty much the same thing.

[angelpie545]

I think it *can* happen to some people-it happened to me, sort of. My second daughter was nearly two weeks late, and her heart rate had always been slow (only 120 bts per min.) throughout the pregnancy. Midwives in this state cannot deliver after two weeks past your due date, so my midwife went ahead and stripped my membranes, which sent me into labor. My daughter was born with apgars of 10 and 10 but when the placenta came out, it was very white and not red and healthy looking like my first daughter's had. Also, the NST that I had a few days before I had my second looked less then reassuring, and she wasn't moving much. So...I'm not sure how much longer she could have sat in there without it severly affecting her, but I'm glad she came out when she did.

Another bit of info here-I was hit in the stomach (long story, I'd rather not go into the details on here) early in my pregnancy, and bled quite a lot for a couple of weeks. It wasn't bright red blood, just old brown stuff, but I wondered if perhaps my placenta had been injured during that and my daughter perhaps wasn't getting all the nutrients she needed during her time in the womb. Her heartbeat was always very low, and she never moved around that much. As a baby she slept quite a lot, and was a slow talker, and is very impusive. She's four now, and is catching up, but I kind of wonder if that hit to the stomach somehow affected her.

On the flipside, my older daughter was almost two weeks late and her placenta and heart rate were very healthy. It depends on the individual situation.

[PreggieUBA2C]

Originally Posted by JanetF

Slightly OT but what bemuses me is that babies are induced so that they don't grow "too big" and yet their placentas are supposedly failing at the same time as they're having this terrific growth rate at the end of pregnancy. Strikes me that surgeons can't have it both ways... But of course logic is not the mainstay of obstetrics or we'd all be hiring mws...

Good point! I hadn't though of that before.

[MamaWindmill]

I went 43 1/2 weeks with my daughter. The placenta came out in pieces.

ETA: oh, and she was born very healthy, and is a healthy, happy kid today.