Can you check placental age/viability with a Level 2 U/S?

[anthasam]

I am curious to know what type of information can be gathered about the placenta during a Level 2 Ultrasound. I'm scheduled for one at the end of my 40th week.

One of my midwives is concerned about placental age past 40 weeks -- I have gestational diabetes, but it is well controlled with diet.

DD1 was born naturally at 40 weeks 4 days. I will certainly decline any inductions now, but I'm wondering what perinatology could find during the U/S. I would like to prepare myself for the "induce now" arguments.

Thanks in advance!

[MsBlack]

There may well be more to it than this, but my understanding is that U/S can look at cord blood flow--the state of circulation between placenta and baby, which presumably can tell you something about placental function. I'd be glad to hear more from those who know more.

However, requesting this at end of 40wks seems excessively cautious to me. You mean, just before start of wk 41, right?

If you have 'GD that is well controlled w/diet', then I also question the diagnosis of GD in the first place. But that is another matter....

[anthasam]

Originally Posted by MsBlack

There may well be more to it than this, but my understanding is that U/S can look at cord blood flow--the state of circulation between placenta and baby, which presumably can tell you something about placental function. I'd be glad to hear more from those who know more.

However, requesting this at end of 40wks seems excessively cautious to me. You mean, just before start of wk 41, right?

If you have 'GD that is well controlled w/diet', then I also question the diagnosis of GD in the first place. But that is another matter....

Thanks for the reply -- I assume they are checking the blood flow, I was curious to see if they could actually check the placenta itself.

It is cautious, in my opinion, but I would rather just go for the U/S and have my midwife feel better about the situation. This should calm the "induction push". I went through the same thing with DD1.

Regarding the GD diagnosis: I've been testing my fasting and PP blood sugar since about 20 weeks. I clearly have some trouble with carbs/sugar and I've made my diet fairly strict. I also exercise (walk) quite often.

Thanks again for your reply!!

[kate3]

Yes, you can "grade" the placenta by sono, but it's usefulness depends on gestational age.

For example, by 42 weeks you would expect to see a grade III placenta with some signs of deterioration, but you definitely don't want a grade III placenta at 35-36 weeks. Does that make sense?

And you need to consider the whole picture. A severely post mature placenta with calcifications, decreased placental blood flow, low amniotic fluid, decreased movement and non reactive NST is far worse than just a post mature placenta alone.

[anthasam]

Originally Posted by kate3

Yes, you can "grade" the placenta by sono, but it's usefulness depends on gestational age.

For example, by 42 weeks you would expect to see a grade III placenta with some signs of deterioration, but you definitely don't want a grade III placenta at 35-36 weeks. Does that make sense?

And you need to consider the whole picture. A severely post mature placenta with calcifications, decreased placental blood flow, low amniotic fluid, decreased movement and non reactive NST is far worse than just a post mature placenta alone.

Yes, your post makes lots of sense Thanks so much! Good to know they can spot calcifications. I am a fan of the big picture Sometimes my care providers get stuck on the details, so to speak.