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
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.
Vital Functions of the Placenta
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:
- move oxygen into the baby’s bloodstream
- carry carbon dioxide away
- pass nutrients to the baby
- transfer waste for disposal by the mother’s body
The placenta has an important role in
hormone production as well. It also protects the fetus from harmful bacteria
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.
Causes of Insufficiency
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:
- chronic high blood pressure (hypertension)
- blood clotting disorders
- certain medications (particularly blood thinners)
- drug abuse (especially cocaine, heroin, and
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
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:
- preeclampsia (elevated blood pressure and protein in
- placental abruption (placenta pulls away from the
- preterm labor and delivery
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:
- greater risk of oxygen deprivation at birth (can cause
cerebral palsy and other complications)
- learning disabilities
- low body temperature (hypothermia)
- low blood sugar (hypoglycemia)
- too little blood calcium (hypocalcemia)
- excess red blood cells (polycythemia)
- premature labor
- cesarean delivery
Diagnosis and Management
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
- pregnancy ultrasound to measure the size of the
- ultrasound to monitor the size of the fetus
- alpha-fetoprotein levels in the mother’s blood (a
protein made in the baby’s liver)
- fetal non-stress test (involves the wearing of two
belts on the mother’s abdomen and sometimes a gentle buzzer to wake the
baby) to measure the baby’s heart rate and contractions
Treating maternal high blood pressure
or diabetes can help improve the baby’s growth.
The plan of maternity care may
- education on preeclampsia, as well as self-monitoring
for the disease
- more frequent doctor visits
- bed rest to conserve fuel and energy for the baby
- consultation with a high-risk maternal fetal specialist
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
You may need intensive outpatient or
inpatient care if preeclampsia or IUGR become severe.
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.