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Placental insufficiency

Last revised by Joshua Yap on 21 Aug 2022

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

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)
  • maternal narcotic (cocaine/heroin) use

In chronic placental insufficiency, there is often abnormal umbilical arterial Doppler with traces showing a reduction, absence, or reversal, of end-diastolic flow. 

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

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