Definition – What is placental insufficiency?
Placental insufficiency is a disorder of the so-called fetomaternal circulation. During pregnancy there is a constant exchange of metabolic products between mother and child, which is maintained by the placenta and the umbilical cord. A functioning placenta is essential for this.
For various reasons, the blood flow in the placenta is disturbed in placental insufficiency and the exchange of substances can no longer take place properly. By definition, a distinction is made between acute and chronic placental insufficiency. While in acute placental insufficiency a sudden event, such as a prolapsed umbilical cord, leads to an interruption of the metabolism, chronic placental insufficiency develops insidiously on the basis of general maternal diseases. Placental insufficiency is a threatening condition for both mother and child and must therefore be treated.
What accompanying symptoms indicate placental insufficiency?
Placental insufficiency often lacks complaints and symptoms, so that it is usually detected in the preventive examinations. The pregnant woman usually notices nothing of the placental insufficiency. There, characteristic changes in ultrasound and CTG show up, which indicate placental insufficiency.
However, acute placental insufficiency, or its cause, can be characterized by the appearance of various symptoms. Premature placental abruption can be manifested by sudden onset of severe lower abdominal pain, anxiety, excessive contractions (labor pains), and possibly dark, vaginal bleeding. The massive loss of blood can lead to shock.
A so-called placenta praevia, which can also be accompanied by acute placental insufficiency, is usually manifested by painless, bright red, vaginal bleeding, with other signs of well-being for the pregnant woman. A compression syndrome of the inferior vena cava often leads to dizziness or even fainting. A placental insufficiency is usually a painless event.
In particular, chronic placental insufficiency does not cause any clinical symptoms such as pain, and is therefore only noticeable during regular examinations by the gynecologist. Acute placental insufficiency can cause symptoms, but pain is also rather rare. A strong contraction (storm in labour), during which placental insufficiency can occur, is accompanied by pain.
Premature placental abruption can also be accompanied by severe lower abdominal pain. However, pain is not necessarily present at the beginning of bleeding. Other conditions in which acute placental insufficiency occurs, such as vena cava compression syndrome or placental preevia bleeding, do not cause pain.
Pre-eclampsia is a pregnancy-associated disease that is associated with an increased risk of chronic placental insufficiency. The disease, which belongs to the hypertensive pregnancy diseases, is associated with high blood pressure and a so-called proteinuria. The high blood pressure values first appear from the 20th week of pregnancy in women who do not have high blood pressure outside of pregnancy.
Proteinuria is the occurrence of large amounts of protein in the urine. Pre-eclampsia is a serious disease, the origin of which is not yet fully understood. It has a negative effect on placental function and can result in placental insufficiency.
