To prevent placental insufficiency (placental insufficiency), attention must be paid to reducing individual risk factors.
Behavioral risk factors
- Diet
- Malnutrition
- Micronutrient deficiency (vital substances) – see micronutrient therapy.
- Pleasure food consumption
- Alcohol
- Tobacco (smoking)
- Drug use
- Drugs, unspecified
- Overweight (BMI ≥ 25; obesity).
Disease-related risk factors (detected by intensified prenatal care).
- Anemia (anemia)
- Diabetes mellitus
- Heart disease
- Hypertension (high blood pressure), preeclampsia (disease occurring during pregnancy and characterized by increased blood pressure (hypertension), increased protein excretion in the urine (proteinuria) and water retention (edema)), eclampsia (sudden onset, severe disease, especially in the last third of pregnancy, accompanied by seizures), HELLP syndrome (H = hemolysis / dissolution of erythrocytes (red blood cells) in the blood), EL = elevated liver enzymes (increase in liver enzymes), LP = low platelets (thrombocytopenia / reduction in platelets).
- Kidney disease
- Systemic lupus erythematosus (SLE) – group of autoimmune diseases in which the formation of autoantibodies occurs. It belongs to the collagenoses.
X-rays
- Radiation exposure
Other risk factors
- Risk factors for acute placental insufficiency:
- Umbilical cord complications (umbilical cord nodules, umbilical cord entanglement, umbilical cord too short, umbilical cord compression).
- Placenta praevia hemorrhage (placenta praevia: malposition of the placenta (placenta); it is nested near the cervix and covers all or part of the birth canal)
- Uterine rupture
- Vena cava compression syndrome (synonym: hypotensive syndrome) – pregnancy complication caused by circulatory disturbance of the mother due to pressure of the child in the uterus on the inferior vena cava (vena cava inferior) with obstruction of blood flow to the heart).
- Premature placental abruption
- Labor abnormalities (hypertonic, uncoordinated, prolonged uterine contractions/labor)
- Risk factors for chronic placental insufficiency.
- Exceeding the term of delivery (e.g., diabetes mellitus).
- Transfer
Pharmacotherapeutic prevention
In the setting of hypertension-induced placental insufficiency, administration of acetylsalicylic acid (ASA) at low doses (low-dose therapy) or low-molecular-weight heparin are the only preventive measures with an established benefit. Application must begin early, before 16 weeks of gestation, to be effective and is stopped at 34-36 weeks of gestation. Dosage of acetylsalicylic acid: 75-150 mg/die. In Germany, therapy is usually given at 100 mg/die. Administration of low molecular weight heparin in prophylactic dosage.
