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The placenta is your baby’s lifeline, delivering oxygen and nutrients to your fetus while removing waste. It’s the only organ in the body that serves two masters independently, and the only organ that is transient. So it stands to reason that anything that compromises its function can adversely affect your pregnancy.

There are many disorders of the placenta that we have discussed in detail, including placenta previa, placenta accreta, placental insufficiency, and placental abruption.

Here, we look at placental calcification – what characterizes it, how it is diagnosed, what causes it, and at what point in your pregnancy it can become a danger to you and your baby.

What Is a Calcified Placenta?

A calcified placenta is characterized by a buildup of calcium deposits. How it affects you and your baby depends on when it occurs in your pregnancy and how severe the calcification is.

When extensive placental calcification occurs late in pregnancy, after 36 weeks gestation, it is generally considered a normal part of the aging process for this transient organ. But when it occurs in its most severe form at 28-36 weeks gestation, it can compromise the functioning of the placenta, leading to poor health outcomes or even stillbirth, even among women with no other risk factors. This is referred to as Preterm Placental Calcification or PPC.

The prevalence of PPC varies widely across research studies, ranging from 3.8% (at 36 weeks), 9% (before 28 weeks), 15% (at 34-36 weeks), 23.7% (at 31-34 weeks), and 39.4% of pregnant women at term [*]. Not all studies filtered out women at elevated risk.

How Is a Calcified Placenta Diagnosed?

A calcified placenta can be seen on an ultrasound scan. Your radiologist will use a rating scale called the Grannum classification to characterize the extent of the calcification and where the calcium deposits appear on the placenta (the basal and chorionic plates as well as within the organ).

The Grannum scale, which goes from Grade 0 to Grade 3, also describes at what point in gestation the calcification is considered a normal part of the aging process and when the calcification process may be progressing too quickly [*][*].

  • Grade 0 occurs before week 18; No calcium deposits.
  • Grade 1 occurs between weeks 18-29; Some calcium deposits.
  • Grade 2 occurs between weeks 30-38; More deposits with slight indentations in the layer of the placenta attached to the uterus.
  • Grade 3 occurs around week 39; Lots of deposits, with deep indentations and ring-like structures.

The Grannum scale does not distinguish cell type-specific calcification patterns, and this limits its usefulness in determining whether the calcification is normal or an indication of an underlying condition that is more sinister. It cannot determine if the calcification is a part of the physiological aging process of the organ (some have likened it to wrinkles) or pathological.

What Does a Calcified Placenta Look Like?

In Grade 3 placental calcification, the most severe form, your ultrasound scan will reveal significant calcium-phosphate mineral deposits in the placental tissue on the basal plate and a number of indentations in the chorionic plate or ring-like formations within the placenta. These will appear as white spots spreading from the base of the placenta to the surface [*].

What Causes Placenta Calcification?

We don’t know exactly what causes placental calcification, but we do know that factors such as exposure to radiation, reaction to certain medications including calcium supplements, and genetic factors can add to the risk of having it [*].

Doctors generally think of placental calcification just before the baby is due to be a normal part of the aging process of the placenta but it can also be a symptom of a bacterial infection in the placenta.

Other risk factors for placental calcification include [*]:

  • Diabetes
  • Anemia

What Are Placental Calcification Symptoms?

Women with placental calcification usually don’t experience any symptoms, but there are some warning signs that may indicate your placenta is not working as it should:

  • The pattern or frequency of your baby’s movements has changed.
  • The growth of your womb has slowed.
  • Sharp pain in your lower back or abdomen.
  • Spotting, bleeding, or contractions.

Call your doctor to discuss your concerns and seek prompt medical care for any severe symptoms.

Is Placental Calcification Dangerous?

This is a surprisingly hard question to answer directly. Calcification of the placenta can block the supply of blood and nutrients to your baby but at the same time, a Grade 3 placental calcification seen only at full term may be considered normal and not raise alarm bells.

Much depends on the timing. Mothers with a Grade 3 placenta at 36 weeks were nearly five times more likely to develop preeclampsia later in pregnancy in one recent study, even though none had protein in their urine or hypertension at the time of their scan. These women were also three times more likely to deliver a baby less than the 10% for weight at birth [*].

Earlier studies on this subject vary widely in their cohorts and methods, and some were based on earlier sonography equipment, leading to some confusion as to outcomes [*]. However, there is a large body of more recent research indicating that Grade 3 preterm placental calcification (at or before 36 weeks) is associated with a number of poor outcomes for baby and mother — independent of any other risk factors [*].

Your baby may experience [*]:

  • Fetal growth restriction / low birth weight
  • Preterm birth
  • Low Apgar scores
  • Stillbirth
  • NICU admission

A mother may experience:

  • Postpartum hemorrhage
  • Placental abruption
  • Increased likelihood of developing preeclampsia [*]

How Long Can a Fetus Survive in Placenta With Calcification?

It depends on the extent of the calcification and when in the gestation a Grade 3 diagnosis occurs. In cases where PPC is diagnosed, your care team will monitor you closely for fetal growth restriction and the overall health of the fetus. In some cases, your doctor may recommend inducing labor or having a cesarean to deliver early.

How Is Placenta Calcification Treated?

There is currently no treatment for placental calcification. Doctors don’t know the exact reason placental calcification occurs – it can happen for different reasons and in different ways, biologically speaking. In many cases, it is considered a natural part of the aging process of the placenta.

Can Placental Calcification Be Prevented?

Given there is no clear cause for placental calcification it cannot be prevented, but you can definitely minimize your risk [*].

  • Don’t smoke cigarettes and avoid exposure to secondhand smoke. Maintain your regular neonatal scans and doctor appointments.
  • If you have any of the known risk factors for PPC, like diabetes, anemia, or high blood pressure, follow your doctor’s advice to manage these conditions during your pregnancy.
  • Maintain a healthy diet rich in antioxidants (e.g. pomegranate, berries, walnuts, cooked spinach, and dark chocolate) and low in salt, which can aggravate high blood pressure.

The Bottom Line

In most cases, when it is part of the normal aging process of the placenta and occurs just before delivery, placental calcification is not a cause for concern. That said, the earlier it occurs in your pregnancy, the more cause there is for concern.

Placental calcification is an issue that needs more research to determine what causes it, but what is most promising here is how a diagnosis of PPC at 36 weeks or before can be used to identify a high-risk infant in an otherwise low-risk mother — to anticipate and remediate adverse health outcomes for the baby and its mother [*].

About MiracleCord

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DISCLAIMER: THE INFORMATION ON THIS WEBSITE IS NOT INTENDED TO BE USED AS MEDICAL ADVICE.The materials and information contained on the MiracleCord website is provided for educational and informational purposes only, and is not intended to, and does not constitute, medical or other health advice or diagnosis, and should not be used as such. You should not use this information to diagnose or treat a health problem or disease. If you are seeking personal medical advice, you should consult with a licensed physician. Always consult with a qualified health care provider regarding a medical condition.

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