If the blood supply to the placenta is impaired or the placenta is not functioning properly, there is insufficiency (inadequacy, weakness).
In this case, the unborn child does not have an adequate supply of oxygen and nutrients. The unrecognized and untreated inadequate supply and the resulting lack of oxygen can have serious health consequences for your baby.
Healthy placenta @ Artemida-psy /AdobeStock
There are three types of placental insufficiency, which have different causes:
- Acute form (develops within minutes or a few hours)
- Subacute form (develops within a few days)
- Chronic form (develops over the course of several weeks or months)
In most cases, your doctor will discover that you have placental insufficiency during your regular check-ups. The symptoms will show up in your unborn child.
If the placenta is not functioning properly, the foetus is often too small or more inactive than normal. The amount of amniotic fluid is also often less than in a healthy placenta.
Many pregnant women do not notice any symptoms themselves. As a result, there is a risk of not noticing placental insufficiency.
Common symptoms are
- High blood pressure
- High blood pressure in conjunction with increased protein excretion in the urine(pre-eclampsia)
If you have a chronic course of the disease, this may be indicated by low weight gain and a comparatively small abdominal circumference.
Acute placental insufficiency is a medical emergency and is life-threatening for your baby. It is possible that the placenta suddenly detaches from the uterine wall (premature placental abruption).
Symptoms include severe abdominal pain or spontaneous bleeding. A quick visit to the doctor is crucial to save the fetus.
Depending on the cause of the acute placental insufficiency, an emergency delivery by caesarean section (emergency caesarean section) may be unavoidable.
If left untreated, the baby's life is at considerable risk. The long-term consequences for the child include developmental delays and severe mental and physical disabilities.
In most cases of acute placental insufficiency, doctors have to terminate the pregnancy immediately by emergency caesarean section @ samrith /AdobeStock
The reasons for the development of placental insufficiency vary considerably and are often based on risk factors.
Causes in an acute course are
- Premature placental abruption
- Circulatory disorders of the umbilical cord or
- Maternal eclampsia (seizure)
Another possibility is vena cava compression syndrome, in which the child exerts pressure on the inferior vena cava. This disrupts the blood flow to the expectant mother's heart.
In subacute placental insufficiency and chronic placental insufficiency, the damage progresses more slowly but still requires medical treatment.
There are several possible underlying diseases that can cause this, such as
The consumption of nicotine, alcohol and drugs is also a relevant risk factor.
It is essential to attend regular check-ups during pregnancy. Here, it is possible to recognize promptly whether there is insufficient placental function.
Your gynecologist will first ask you about your condition and any previous illnesses. He will then carry out an ultrasound examination. Here, he will determine the developmental progress based on the size of the baby in relation to the week of pregnancy.
A baby that is clearly too small is a first indication of an insufficient supply of nutrients. A small size or unusual shape of the placenta are also indications of placental insufficiency.
In addition to the diagnosis, your doctor will carry out a CTG (cardiotocography). This is an examination in which your gynecologist records the contractions and heart rate of the fetus.
If necessary, further imaging procedures may be considered.
By measuring the heartbeat, the CTGenables an assessment of the baby's oxygen supply @ Kzenon /AdobeStock
In acute cases, the doctor will carry out emergency measures, usually in the form of early induction of labor, often by caesarean section.
In less acute cases, hospitalization is possible for monitoring and regular check-ups. In addition, the pregnant woman should take it easy physically.
In chronic cases, your doctor, a specialist in gynecology and obstetrics, will draw up a birth plan with you. This will contain the measures to be taken if there are specific signs of deterioration.
In principle, placental insufficiency as such cannot be treated. Therapeutic measures relate to the causative diseases. Your doctor will treat these in order to minimize risks. Physical rest and a healthy lifestyle are also advisable.
The course of the disease is not uniform, but depends on the severity of the placental insufficiency. Compared to a pregnancy without complications, there is an increased risk of stillbirth.
The limit of viability for premature babies is 25 weeks of pregnancy. In this case, we therefore speak of extreme prematurity with very high risks for the child.
Premature babies have a good chance of normal development after the 35th week of pregnancy.
Due to the insufficient supply of nutrients to the child in the event of placental insufficiency, there is a significant risk of various diseases in later life.
These include, for example
The earlier placental insufficiency is diagnosed and treated, the better complications can be prevented. Unfortunately, a cure is not always possible.
In the worst case, the child may even die in the womb. Very often, however, a caesarean section or early induction of labor is possible to protect the child.
