Placental Insufficiency

What is placental insufficiency?

Placental insufficiency (or placental dysfunction) is a condition that means your placenta isn’t working properly during pregnancy. A placenta is the organ that supplies oxygen and nutrients to a fetus during pregnancy. With placental insufficiency, your placenta isn’t transferring blood, oxygen or nutrients efficiently. This can happen because your placenta doesn’t develop correctly or is damaged. This can lead to the fetus being small for its age because it isn’t getting what it needs to grow. A fetus being too small can lead to premature birth and other pregnancy complications.

There isn’t a treatment for placental insufficiency. A pregnancy care provider will monitor the fetus closely for the remainder of your pregnancy. In some cases, early delivery is the safest route.

How common is placental insufficiency?

Placental insufficiency affects 1 in 10 pregnancies.

What are signs of placental insufficiency?

There are often no noticeable signs of placental insufficiency. But symptoms like vaginal bleeding in early pregnancy and feeling the fetus move less may be an indication that there’s an issue with your placenta. You may also notice you’re not gaining as much weight as you have in prior pregnancies.

What can cause placental insufficiency?

Placental insufficiently happens when your placenta doesn’t transfer enough blood (containing oxygen and nutrients) between you and the fetus. This means the fetus may not be getting what it needs to grow. Issues with how your placenta attaches to your uterine lining can cause placental insufficiency.

Other causes include:

• Your placenta breaking away from your uterine lining.
• Damage or injury to your placenta.
• Your placenta being an irregular shape.
• Your placenta not growing large enough or being too small.

Medical conditions or lifestyle factors can also cause your placenta not to work as well. Sometimes, placental insufficiency happens without a known cause (idiopathically).

What are the risk factors for placental insufficiency?

Healthcare providers know that certain medical conditions can affect how a placenta develops and grows in pregnancy. Having these conditions increases your risk for placental disorders. These conditions include:

• Diabetes.
• High blood pressure.
• Heart disease.
• Blood clotting conditions.
• Going beyond 40 weeks of pregnancy.
• Preeclampsia.
• Untreated uterine infections.
• Heavy bleeding or other complications early in your pregnancy.
• Being older than 35.
• Certain medications.

Using cigarettes, drinking alcoholic beverages and misusing drugs during pregnancy can also cause the placenta to not work as well.

What are complications of placental insufficiency?

Placental insufficiency can cause complications for both the parent and the fetus. It’s more life-threatening for the fetus.

Complications to the fetus from placental insufficiency can cause the following:

• Premature birth. Premature birth can cause low body temperature and low birth weight.
• IUGR (intrauterine growth restriction).
• Fetal hypoxia or lack of oxygen to the brain, which can lead to other complications.
• Anemia.
• Low blood sugar.
• Low calcium levels (hypocalcemia).
• Too much bilirubin in their blood.
• Stillbirth.

In the birth parent, complications from placental insufficiency include:

• Placental abruption.
• Preterm labor.
• Preterm delivery.

How is placental insufficiency diagnosed?

Your pregnancy care provider will diagnose placental insufficiency during a prenatal exam or through an ultrasound. An ultrasound can detect blood flow between the placenta and the fetus, as well as determine the size and position of the placenta and the fetus.

Your provider may suspect an issue with the placenta if the fetus seems smaller than average on the ultrasound or when your fundal height measurement is smaller than expected.

You should also discuss how much you feel the fetus move, as well as other concerns you may have. These could provide clues to your provider about how your pregnancy is developing.

How is placental insufficiency managed?

There usually isn’t any treatment for placental insufficiency. There isn’t a cure or direct treatment to fix a placenta. Your pregnancy care provider will suggest ways to manage it and reduce its impact on your pregnancy. The care you’ll need is unique to your pregnancy, and often depends on:

• What trimester of pregnancy you’re in.
• Your test results.
• Other complications or symptoms you have.

Monitoring your pregnancy is an important part of treatment. Your pregnancy care provider may want to see you more frequently and perform ultrasounds and fetal heart monitoring regularly to check on the growth and health of the fetus. Managing other conditions you may have (like diabetes or hypertension) is also a key part of treatment.

Often, if the pregnancy is at term (37 weeks), your provider may recommend delivery if it’s safest for you and the fetus.

If you haven’t made it to term, your provider may monitor you more closely and look for signs that the fetus isn’t tolerating pregnancy well. In this case, they may recommend an early delivery because it’s safest. If you need an early delivery, they may prescribe steroids to help the fetus’s lungs develop.

Can placental insufficiency improve?

Once you have placental insufficiency, your placenta won’t become fully functional. Your pregnancy care provider will manage the condition and monitor the fetus closely for signs of problems.

But an early diagnosis, managing underlying conditions and attending all of your prenatal care appointments can keep your placenta from breaking down further.

Can you prevent placental insufficiency?

Most times, you can’t prevent placental insufficiency. Getting early prenatal care is often the best thing you can do because it can allow a provider to detect it sooner. Early detection and management will reduce the chances of you experiencing complications during your pregnancy.

Managing any preexisting or new health conditions can also go a long way in preventing additional complications.

What is the survival rate for fetuses with placental insufficiency?

Most pregnant people with placental insufficiency make it to delivery. But it depends largely on what types of underlying conditions are present, how severe the placental dysfunction is and how many weeks pregnant you are at diagnosis.

How do I take care of myself if I have placental insufficiency?

Follow your pregnancy care provider’s instructions on how to take care of yourself. How they manage the condition varies and depends on how far you are in pregnancy and the seriousness of your condition.

Babies born prematurely or with a health condition may need special care at birth in a neonatal intensive care unit (NICU). It may help to prepare yourself for this happening. Don’t be afraid to share your concerns with your provider. Ask them any questions you have on what you can do to increase your chances of delivering a healthy baby.

When should I see my healthcare provider?

As placental insufficiency doesn’t always cause symptoms, the best thing you can do is attend all of your prenatal care appointments and discuss any symptoms you do have with your provider. This can help them better detect pregnancy complications. During pregnancy, you should always contact your provider if you experience vaginal bleeding or pelvic cramps.

A note from Cleveland Clinic

There isn’t a cure for placental insufficiency, but there are ways to manage it and increase your chances of having a healthy pregnancy and delivery. Follow your pregnancy care provider’s advice on how to best care for yourself, including managing health conditions and attending all of your prenatal care appointments. Avoid drinking alcoholic beverages, using recreational drugs and smoking cigarettes during pregnancy. Your provider will monitor you closely for the rest of your pregnancy to look for signs of complications, and may even recommend an early delivery.