Placental insufficiency

Last revised by Subhan Iqbal on 27 Aug 2023

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 and globular placenta on MRI 2,7

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