• Clinical science

Placental insufficiency

Abstract

Placental insufficiency is a disorder of the fetomaternal circulation that results in inadequate blood flow to the placenta and impairment in substance exchange (e.g., oxygen) between the mother and fetus, resulting in a metabolical compromise of the fetus. The condition may be either chronic or acute. Acute placental insufficiency occurs due to a sudden disruption in blood flow from the placenta or umbilical cord and results in fetal hypoxia, which, without treatment, may rapidly lead to intrauterine death. Chronic placental insufficiency is usually caused by pregnancy-related or general maternal disorders, which lead to the gradual deterioration of blood flow in fetomaternal circulation. A potential complication is severely impaired fetal growth, which may result in intrauterine fetal death. Fetal heart monitoring and sonography are used to diagnose placental insufficiency. Treatment should address the underlying cause. Caesarean section is performed in acute cases if there are signs of fetal hypoxia or an increased maternal risk of death.

Overview

Time point Causes Consequences Treatment
Acute placental insufficiency Particularly in the 3rd trimester

Within minutes or hours:

  • Fetal hypoxia
  • Intrauterine fetal death
  • Left lateral positioning of the mother
  • Avoid lying in the supine position
Particularly in the 3rd trimester or intrapartum

Chronic placental insufficiency

Chronic

Within days or weeks:

  • Timely diagnosis
  • Causal treatment and close monitoring
  • Signs of fetal hypoxia: caesarean section

References:[1][2]

Diagnostics

Intrauterine Growth Restriction

References:[3]