Placental Thickening: Is This Cause For Concern And Can It Harm My Baby?

I am in my 25th week. Although blood flow to the baby is perfect, and the baby appears to be in good health, my first sonogram showed low amniotic fluid and I was just diagnosed by a perinatologist with a "thick placenta." My OB/GYN is performing a whole battery of blood tests, and I return for another level two sonogram in three weeks. Will you give me a short explanation of thick placentas?


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

"In the old days" before ultrasound, we occasionally delivered a baby and then commented on the size of the placenta as being "heavy or large" for the weight of the baby. A placenta should be about one-sixth of the baby's weight. Sometimes the placenta would appear thin or we would see calcifications (white spots) on the surface, especially if the mother was a smoker or the baby was well past the due date.

Now, we have the ?advantage of seeing some of these changes before the baby arrives. We don't always know what these changes or irregularities mean because we don't have the years of experience in collecting such data. Sometimes, these "problems" don't mean anything, and we put the parents though needless worry and grief. Other times, we are able to more closely monitor babies with such irregularities and we save some babies from being born too early, or from an environment which is poor in the perfusion of oxygen and nutrients.

Placental depth can be measured on ultrasound and, generally, the depth in millimeters corresponds to the gestational age. So at 25 weeks, the placenta should roughly measure 25 mm in depth. "Placentomegaly," a placenta of greater than normal thickness, has been associated with certain maternal conditions such as diabetes, placental hemorrhage, some kinds of infections, occasionally chromosomal abnormalities or, uncommonly, a rare form of malignancy. Or it may have no significance at all.

It is good that your provider is following up with blood work, and he or she will undoubtedly perform other tests of fetal well-being such as non-stress testing, contraction stress testing or biophysical profile.

You can maximize baby's growth by continuing to get an excellent diet with plenty of fluids. Rest can increase placental perfusion -- preferably a couple of hours in increments throughout the day on your left side. The kidneys work better in that position.

I hope this all resolves or you can be reassured that all is well for your baby. I know that you will worry until your baby is safe in your arms; this is natural. But try to rest and think positive thoughts. Your best indicator of baby's well being is his or her continued growth, which will probably be followed with serial ultrasounds. I hope you are getting the necessary support for this loss of the "normal" or ideal pregnancy that we always wish for.

I'll be thinking of you. Let us know how you are doing.

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