Placental insufficiency

Placental insufficiency is a term given to a situation where the placenta cannot bring enough oxygen and nutrients to the growing fetus.

Clinical presentation

Fetuses may present with intra-uterine growth restriction (IUGR) (especially asymmetrical IUGR).


It can be primarily caused by three main mechanisms 4

  • impairment in maternal circulation
    • maternal hypertension
    • maternal thrombophilic disorders
  • impairment in fetal circulation
    • placental implantation over a fibroid
  • vascular thrombosis, e.g placental infarction
Risk factors
  • maternal narcotic (cocaine/heroin) use

Radiographic assessment

Doppler ultrasound

In chronic placental insufficiency there is often abnormal umbilical arterial Dopplers.

Fetal MRI

Not part of routine investigation. There are some reports suggesting the presence of restricted diffusion and reduced ADC values on MRI 2

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