Placental insufficiency is a defective function of the placenta, which is important for the nutrition of the unborn child. The placenta is not supplied with sufficient blood, so that the exchange of substances between the fetus and placenta does not work properly.
What is placental insufficiency?
The placenta is very important for the unborn child because it allows nutrients and oxygen to pass from the mother’s system to the child’s. In addition, hormones are formed in the placenta, including progestins, estrogens and human chorionic gonadotropin (hCG). See polyhobbies for Meanings of Diabetic Retinopathy.
In addition, the placenta ensures the removal of waste products and keeps toxins away from the unborn child. So the placental barrier is a kind of filter that can be used to protect the fetus. If the placenta cannot fulfill these functions, it is referred to as placental insufficiency.
Causes
Acute placental insufficiency occurs when blood flow is reduced in the fetal or maternal part of the placenta. Possible causes for this can be a drop in blood pressure or a storm of labor during childbirth. The so-called vena cava compression syndrome (a circulatory disorder in the mother because the child is lying down exerts pressure on the inferior vena cava) or premature detachment of the placenta can also cause placental insufficiency. In some cases, umbilical cord problems such as knotting, prolapse or entanglement are also the cause.
In the case of acute placental insufficiency, the child is not supplied with sufficient oxygen, so that there is a risk of death. Slowed growth in the unborn child is the cause of chronic placental insufficiency, with the mother usually having an underlying disease such as high blood pressure, renal insufficiency, diabetes mellitus or anemia. However, circumstances that are specific to pregnancy can also cause acute placental insufficiency.
These include, for example, preeclampsia (pregnancy intoxication) or Rhesus incompatibility. Nicotine or alcohol during pregnancy can also lead to acute placental insufficiency. Other factors that can promote chronic placental insufficiency are also a low weight gain in the mother during pregnancy, especially if she already had a low body mass index before pregnancy. A short mother’s height, drug abuse during pregnancy and other genetic factors also play a decisive role.
Symptoms, Ailments & Signs
In the case of acute placental insufficiency, there are actually no direct symptoms to be identified. It occurs suddenly during the birth process. As a result, the child is undersupplied and the heartbeat slows down. The mother may experience cramps and bleeding. Another warning sign can be very rare movements of the child. In this case, it is best to consult a doctor.
With chronic placental insufficiency, the child grows very slowly and the amount of amniotic fluid is reduced. The unborn child reacts to the lack of care in many different ways. These include the following changes:
- Metabolic: insulin secretion, gluconeogenesis and lactate increase and the ability to transport amino acids decreases.
- endocrine: increase in glucagon and decrease in cholesterol
- vascular: Fetal blood flow is redistributed, leading to an increase in blood flow in the adrenal gland, coronary arteries, and liver.
- biophysical: Maturation is delayed and heart rate changes. Physical activity decreases.
- Haematological: Changes in the immune system occur, above all the number of B lymphocytes and T helper cells decreases.
Diagnosis & course of disease
If, for example, the mother has diabetes mellitus, the reduced height growth of the child can be determined with the help of an ultrasound examination. In addition, the doctor can measure the blood flow velocity using Doppler sonography and thus receive an indication of a possible placental insufficiency. Sometimes the mother is also admitted to the hospital with chronic placental insufficiency so that the baby can be monitored and treated immediately if there are any problems.
The following criteria are also used for the diagnosis of chronic placental insufficiency, such as fetal movement activity and fetal heart rate, oxytocin load text (OBT) and amnioscopy. Also the color of the amniotic fluid, Clifford rating and imaging methods (sonography, MRT) in order to be able to prove a brain lesion postportal.
Complications
Placental insufficiency can cause serious discomfort and complications during pregnancy or childbirth. As a rule, however, this disease is only discovered by chance, so that early diagnosis and therapy is usually not possible. In most cases, the mother suffers from heavy bleeding and cramps due to placental insufficiency.
These lead to severe pain and not infrequently to irritability of those affected. Inner restlessness or feelings of anxiety can also occur due to placental insufficiency and thus significantly reduce the quality of life. The amount of amniotic fluid is reduced, so that the child suffers from a significant undersupply. In the worst case, this can lead to the development of various deformities or malformations.
In the worst case, the affected person suffers a stillbirth or the child dies shortly after birth. For this reason, patients and their relatives are often dependent on psychological treatment. In the case of placental insufficiency, labor must be induced early. This can lead to various complications. The mother’s life may also be endangered due to the premature birth.
When should you go to the doctor?
Acute placental insufficiency is manifested by bleeding and cramps. If these and other unusual symptoms appear, a gynecologist should be consulted. The gynecologist can determine the condition using an ultrasound scan and initiate further measures. If there is a risk of premature birth, the patient must be taken to a hospital immediately. Close medical supervision is required until the premature baby is born, so that any complications can be addressed quickly. Mothers who have developed placental insufficiency during pregnancy also need further follow-up examinations.
The child must also be examined in detail by the pediatrician and a neurologist. Chronic placental insufficiency does not produce any clear symptoms. If the condition is detected during maternity care, regular visits to the doctor are recommended. If the treatment measures do not have the desired effect, the doctor must be informed. Depending on the suspected cause, a cardiologist or a nutritionist may be involved in treatment. Many patients also require therapeutic support.
Treatment & Therapy
If acute placental insufficiency occurs, immediate emergency measures are required. These include, for example, a forceps or ventouse birth or a caesarean birth. If the placenta detaches prematurely, labor is also induced prematurely. In the case of chronic placental insufficiency, strict bed rest is required and the condition of the unborn child is regularly checked by CTG (cardiotocography) or ultrasound examinations. However, a direct treatment of the restricted function of the placenta is not possible.
However, the causes such as diabetes mellitus or high blood pressure are treated. However, the child can suffer severe damage due to a lack of oxygen supply. In the event of an extreme undersupply, it is therefore necessary to initiate the birth before the due date. If the unborn child is not yet ready for birth, lung maturity can be accelerated with appropriate medication. If the baby is small, but still developing, then the causes of chronic placental insufficiency should be addressed, but otherwise there is no urgent need for action.
Prevention
If the mother suffers from diabetes or high blood pressure, a restricted function of the placenta can be recognized and treated with the help of intensive examinations. In addition, pregnant women should also refrain from cigarettes, as this can significantly reduce placenta failure.
Aftercare
In most cases, those affected with placental insufficiency have no special and direct follow-up measures available. First and foremost, a quick and, above all, very early diagnosis and subsequent treatment of the disease is necessary in order to prevent further complications and symptoms. However, in many cases placental insufficiency cannot be completely cured, so that the child sometimes dies.
An early diagnosis therefore usually has a very positive effect on the further course of this disease. In many cases, the child is delivered by caesarean section. The mother should definitely rest and take care of herself after the procedure. Efforts or physical and stressful activities should be avoided.
In many cases of placental insufficiency, the support and care of one’s family and friends is very important. This can prevent the development of depression and other mental health problems. An intervention is not always necessary, so that placental insufficiency does not always have to be treated if the child develops normally.
You can do that yourself
Placental insufficiency means that the child in the womb can no longer be adequately cared for. Mothers who use nicotine during pregnancy risk the placenta becoming so calcified early in the 40 weeks of pregnancy that the baby is no longer getting enough nutrients. Accordingly, in the area of self-help, it is urgently advisable to give up smoking during pregnancy immediately. Mothers who smoke despite known risks should by no means hide this from the doctor, but address their vice openly.
With the help of special ultrasound examinations, the doctor can determine how the child is being cared for. It is therefore important in everyday life that mothers attend all check-up appointments and also address known risks such as nicotine, so that the gynecologist can pay particular attention to care via the placenta.
Aside from risks such as smoking, placental insufficiency is often a surprising finding unrelated to maternal lifestyle or other known medical conditions. Accordingly, those affected cannot treat placental insufficiency themselves. Once the insufficiency of the placenta has been determined with certainty, it is important to carry out close checks. If it is found that the baby is undersupplied in the womb, therapy can only consist of ending the pregnancy and initiating the birth.
