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The placenta is an organ that grows in the womb during pregnancy. Placental insufficiency (also called placental dysfunction or uteroplacental vascular insufficiency) is an uncommon but serious complication of pregnancy. It occurs when the placenta does not develop properly, or is damaged. It is a blood flow disorder marked by a reduction in the mother’s blood supply. This complication can also occur when blood supply doesn’t adequately increase by mid-pregnancy.
When the placenta malfunctions, it is unable to supply adequate oxygen and nutrients to the baby from the mother’s bloodstream. Without this vital support, the baby cannot grow and thrive. This can lead to low birth weight, premature birth, and birth defects. It also carries increased risks of complications for the mother. Diagnosing this problem early is crucial to the health of both mother and baby.
The placenta is a highly complex biological organ. It forms and grows where the fertilized egg attaches to the wall of the uterus.
The umbilical cord grows from the placenta to the baby’s navel. It allows blood to flow from mother to baby, and back again. The mother’s blood and the baby’s blood are filtered through the placenta, but they never actually mix.
The placenta’s primary jobs are to:
The placenta has an important role in hormone production as well. It also protects the fetus from harmful bacteria and infections.
A healthy placenta continues to grow throughout the pregnancy. The American Pregnancy Association estimates that the placenta weighs 1 to 2 pounds at the time of birth.
The placenta is removed during labor. According to the Mayo Clinic, it’s delivered between five and 30 minutes after the baby.
Placental insufficiency is linked to blood flow problems. While maternal blood and vascular disorders can trigger it, medications and lifestyle habits are also possible triggers.
The most common conditions linked to placental insufficiency are:
Placental insufficiency may also occur if the placenta doesn’t attach properly to the uterine wall, or if the placenta breaks away from it (placental abruption).
There are no maternal symptoms associated with placental insufficiency. However, certain clues can lead to early diagnosis. The mother may notice that the size of her uterus is smaller than in previous pregnancies. The fetus may also be moving less than expected.
If the baby isn’t growing properly, the mother’s abdomen will be small, and the baby’s movements will not be felt much.
Vaginal bleeding or pre-term labor contractions may occur with placental abruption.
Placental insufficiency is not usually considered life-threatening to the mother. However, the risk is greater if the mother has hypertension or diabetes.
During pregnancy, the mother is more likely to experience:
The symptoms of preeclampsia are excess weight gain, leg and hand swelling (edema), headaches, and high blood pressure.
The earlier in the pregnancy that placental insufficiency occurs, the more severe the problems can be for the baby. The baby’s risks include:
Getting proper prenatal care can lead to an early diagnosis. This can improve outcomes for the mother and the baby.
Tests that can detect placental insufficiency include:
Treating maternal high blood pressure or diabetes can help improve the baby’s growth.
The plan of maternity care may recommend:
You may need to keep a daily record of when the baby moves or kicks.
If there is concern about premature birth (32 weeks or earlier), the mother may receive steroid injections. Steroids dissolve through the placenta and strengthen the baby’s lungs.
You may need intensive outpatient or inpatient care if preeclampsia or IUGR become severe.
Placental insufficiency can’t be cured, but it can be managed. It’s extremely important to receive an early diagnosis and adequate prenatal care. These can improve the baby’s chances of normal growth and decrease the risks of birth complications. According to Mount Sinai Hospital, the best outlook occurs when the condition is caught between 12 and 20 weeks.
Written by: Sandy Calhoun Rice and Kristeen Cherney
Medically reviewed on: Jun 30, 2015: Steven Kim, MD
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