Placental insufficiency: causes and treatment

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

While carrying a long-awaited baby, women are often forced to face various kinds of problems. In some situations, there is no danger either for the mother herself or for her baby. However, if you have any ailments, you should consult a doctor.

If a woman is diagnosed with placental insufficiency during pregnancy, then this is not yet a sentence. This disease is a whole complex of changes in the area where the growing fetus is located. In some cases, such a pathology can lead to impaired functioning of the baby’s organs that are just beginning to develop. Therefore, it is worth considering in more detail what constitutes uteroplacental insufficiency. If you clarify the symptoms of the disease, you can avoid serious complications.

General information

Placental insufficiency is a special syndrome that leads to disturbances during the functioning of this important component. This happens against the background of the fact that the fetus begins to react to the ailments from which the woman herself suffers.

If we talk about the manifestation of this disease, then usually it is expressed in the fact that the placentaat some point it stops responding to the needs of the baby. In this case, quite serious molecular changes occur that affect cells and neighboring tissues. This affects the speed and quality of development of the internal organs of the fetus.

If we talk about statistics, placental insufficiency during pregnancy occurs in 30% of cases. Most often, this is caused by diseases of the cardiovascular system, disruptions in the hormonal composition, and inflammatory processes occurring in the genitourinary system of a woman. In some situations, with a complex degree of pathology, it can lead to the death of the fetus.

Women most affected by placental insufficiency are women who have previously experienced a miscarriage or suffered from a number of complications, including the so-called miscarriage. In the process of this disease, the fetus may begin to retard in development. This phenomenon is commonly called feto-placental insufficiency.

Varieties

In medical practice, primary placental insufficiency is distinguished. It develops during the first 16 weeks of gestation. During this period of time, the necessary nutrient medium for the fetus is formed and the fetal egg is directly fixed on one of the walls of the uterus. At the secondary stage of the development of the disease, blood flow is disturbed.

Also exists:

• Acute placental insufficiency. In this case, there is a sharp violation of blood flow in the uterus. This is due to the detachment of the placenta itself and the appearance of hematomas. This stage is very dangerous because itmay develop within a few hours. During this time, the fetus becomes hypoxic and dies.
• Chronic placental insufficiency. In this case, the violation of blood flow occurs gradually. When the nutrient medium loses its ability to adapt to changed conditions, it undergoes dystrophy. In addition, other changes may be caused.

Chronic placental insufficiency is less dangerous than an acute attack. However, this kind of illness requires immediate medical intervention.

Severity of disease

Based on this indicator, allocate:

• Compensated placental insufficiency. In this case, minor violations of biochemical processes occur in the body of the expectant mother. For example, too much protein is produced. In this case, the placenta maintains a normal level of blood flow, but there is still a possibility of fetal hypoxia.
• Decompensated insufficiency. In this case, during the formation of the placenta, quite serious violations occur that adversely affect the functions of the nutrient material necessary for the baby. In addition, at this stage, there is a deterioration in blood flow in the uterus, which leads to serious oxygen starvation of the fetus.

Three phases of disease development

This pathology develops according to a certain pattern. In the first phase, the placenta begins to react sharply to any changes that occur in the woman's body. She works with highby force if the fair sex is diagnosed with prolonged pregnancy. Also, a similar ailment develops against the background of preeclampsia in a mild form and with an increase in the cholesterol content in the body of the future mother.

During the second phase, the placenta loses its former activity. At the same time, her indicators go beyond the norm. During this period, there is an increase in lipids, and the activity of hormones, on the contrary, decreases. Mild preeclampsia, hypertension, heart defects and other diseases lead to such changes.

In the third phase comes a complete failure of the placenta. As a result, the blood circulation in the fetus is seriously disturbed. This phase of placental insufficiency leads to serious delays in the process of intrauterine development of the fetus. This can lead to hypoxia and death.

It is also worth considering why this ailment often occurs in women bearing a baby.

Placental insufficiency of the 1st degree: causes of occurrence

This type of pathology is manifested primarily due to genetic disorders associated with the fetus itself. This happens in rare cases when the genetic material of the parents contains certain errors. Trisomy may be found in the fetus. This means that it has three identical types of chromosomes at once. A deletion and so on can also be diagnosed.

Another reason for the development of uteroplacental insufficiency of the 1st degree is that the mother could suffer from serious infectious diseases forthe first 16 weeks of gestation. In this case, viruses or bacteria in her body could have caused these fetal anomalies.

Also, insufficient activity of the ovaries often leads to this stage of the development of the disease. For example, if the female body produces an insufficient amount of progesterone, which is necessary for a full pregnancy.

Placental insufficiency of the 2nd degree: why it develops

In this case, the most common reason is that the woman has certain biological features that lead to such troubles. It is also worth considering the age of the expectant mother. If she is not yet 18 years old or more than 30, then in this case the body may not be able to fully cope with the bearing of the baby. In the first case, he is not yet fully prepared for such shocks, and in the second case, he may be too “worn out” for such events.

Also, the lifestyle of the future mother can become the cause of placental insufficiency during pregnancy. If a woman eats poorly, continues to smoke, drink or use drugs, then all this will adversely affect the developing fetus.

Especial care should be taken by those who, due to their work, are forced to come into contact with aggressive chemicals or poisons. Also, fetal anomalies and a violation of the formation of the placenta can be caused by the fact that a woman, by virtue of her profession, is forced to constantly work with X-ray equipment or in conditions of extremely high or low temperatures. Negatively canaffect and excessive physical activity, which is categorically contraindicated for ladies in position.

Also, speaking about the causes of placental insufficiency, it is worth paying attention to whether a woman suffers from chronic ailments. For example, if she was previously diagnosed with kidney disease, cardiovascular disease, high blood sugar or hormonal disorders, then all this can lead to unpleasant consequences for the fetus, in particular in the process of proper formation of the placenta. Those who suffer from thyroid pathologies and blood diseases should also be careful.

It is also worth carefully studying the medical history of the expectant mother. Very often, placental insufficiency is experienced by women who have undergone treatment for infertility, have experienced a miscarriage. Any complications that were recorded during a previous pregnancy can result in consequences that affect the proper functioning of the internal organs and the formation of the placenta necessary for the development of the baby.

If a woman had an abortion or had a uterine malformation, this can also affect the process of bearing a fetus.

Risk factors

The most careful should be those women who lead an unhe althy lifestyle, suffer from obesity and constant stress and depression.

Gynecological ailments in the past can also lead to serious problems in the present. For example, if a woman suffered from endometrial lesions. As a rule, this happenscaused by an incorrectly performed abortion procedure. Also, women who have previously been diagnosed with uterine fibroids are more likely to undergo a doctor's examination and take tests. The same goes for those who have been treated for infections such as chlamydia and other pelvic gynecological diseases.

However, if there were no problems earlier, this does not mean that you can relax. During the current pregnancy, a wide variety of complications can also develop that can provoke placental insufficiency. For example, if a woman suffers from bleeding during the second trimester of bearing a baby. The same goes for those diagnosed with oligohydramnios or polyhydramnios.

Women with a negative Rh factor need to be doubly careful. This indicator is very dangerous. In some situations, pregnancy is completely contraindicated for women.

Symptoms

If we talk about the manifestations of placental insufficiency, then its presence is almost impossible to determine independently. As a rule, when the first serious symptoms appear, the fetus already receives quite serious damage that is incompatible with life. To diagnose the first manifestations of this disease, a comprehensive examination is necessary. Based on the data obtained, the specialist will be able to see the main manifestations of placental insufficiency. These include:

• Partial restructuring of arterial vessels. However, in 56% of cases thisthe clinical picture is typical for the normal bearing of the baby. Therefore, the doctor also pays attention to the size of fibroids, if they are found. If the nodes are quite large, then there is a possibility that the uteroplacental arteries have been deformed.
• Also, with the development of placental insufficiency, you can see dead areas.
• To signal a possible problem, too thinned muscle membrane, which is located between the fibroids and the fetal egg itself.

Treatment

If we talk about therapeutic measures, then first of all, doctors try to establish blood flow in the uterus. Also, in the process of treating placental insufficiency, preventive measures are taken to eliminate the possibility of fetal growth retardation. This takes into account the size and condition of the baby.

Also at this stage, doctors try to choose the best time for childbirth and its type. In some situations, the birth of a baby in a natural way becomes impossible, then a caesarean section is performed.

One of the main stages of treatment is careful observation of any changes in the condition of the fetus. For this, a weekly ultrasound is mandatory. It is also required to measure the speed of blood flow in the uterus and its main vessels. A similar check is performed at intervals of 3-5 days.

Cardiotocography is also performed. This procedure is a record of how synchronously the contractions of the fetal heart muscle are produced. This event is necessaryperform daily.

Also, treatment includes medication. First of all, the doctor prescribes drugs that can significantly improve blood flow. Angioprotectors are also used, the activity of which is aimed at protecting the vessels from possible damage. In some situations, it is required to reduce muscle tension directly in the uterus itself. To do this, the doctor prescribes tocolytics.

Since a woman is already experiencing tremendous stress during this period, additional stress can only aggravate the situation. Therefore, the fair sex is recommended to take light sedatives. The doctor also prescribes a course of general strengthening agents that can stabilize the condition of the woman in labor and improve the functioning of the immune system.

If a woman was diagnosed with decompensated insufficiency, then in this case there is a serious delay in the development of the fetal egg. In such situations, urgent hospitalization is required.

Possible Complications

As mentioned earlier, such a pathology can lead to hypoxia and delayed fetal development. All these negative phenomena can lead to his intrauterine death.

If the baby is still born and born, then pneumonia, pathological jaundice and other skin ailments may develop.

Placental insufficiency of the fetus can lead to prematurity, even if the birth took place at the prescribed time. At the same time, the mass of the baby can hardlyreach 2000, provided that the baby was born at 38-40 weeks.

Also, a similar ailment can provoke quite serious perinatal lesions of the fetal nervous system. In this case, the functioning of the child's brain will be impaired.

Prevention

In order to avoid such problems, it is necessary to responsibly approach pregnancy planning and preparation for it. If a woman has certain chronic diseases, then it is necessary to cure them in a timely manner and only after that start thinking about conceiving a baby.

A mother-to-be should definitely get enough sleep and spend as much time outdoors as possible. In this case, it is necessary to register in the antenatal clinic. The doctor must conduct a comprehensive examination and monitor the he alth of the expectant mother at all stages of bearing the baby.

You also need to watch your diet and without fail give up all bad habits. The diet should include as many fruits, vegetables and greens as possible.