Medical conditions that increase the mother's chances of blood clots
Taking cocaine or other drugs
Certain medications can also increase the risk of placenta insufficiency.
In some cases, the placenta:
May have an abnormal shape
May not grow big enough (more likely if you are carrying twins or other multiples)
Does not attach correctly to the surface of the womb
Breaks away from the surface of the womb or bleeds
A woman with placental insufficiency usually does not have any symptoms.
Signs and tests
The health care provider will measure the size of your growing womb (uterus) at each visit, starting about halfway through your pregnancy.
If your uterus is not growing as expected, a pregnancy ultrasound will be done. This test will measure your baby's size and growth, and assess the size and placement of the placenta.
Other times, problems with the placenta or your baby's growth may be found on a routine ultrasound that is done during your pregnancy.
Either way, your doctor will order tests to check how your baby is doing. The tests may show that your baby is active and healthy, and the amount of amniotic fluid is normal. Or, these tests can show that the baby is having problems.
If there is a problem with the placenta, you and your doctor must decide whether to induce labor.
You may be asked to keep a daily record of how often the baby moves or kicks.
The next steps your doctor will take depend on:
The results of tests
Your due date
Other problems that may be present, such as high blood pressure or diabetes
If your pregnancy is less than 37 weeks and the tests show that your baby is not under too much stress, your doctor may decide to wait longer. Sometimes you may need to get increased rest on your side. You will have tests often to make sure your baby is doing well. Treating high blood pressure or diabetes may also help improve the baby's growth.
If your pregnancy is over 37 weeks or tests show your baby is not doing well, your doctor may want to deliver your baby. He or she may induce labor, or you may need a c-section.
Problems with the placenta can affect the developing baby's growth. The baby cannot grow and develop normally in the womb if it does not get enough oxygen and nutrients.
Getting prenatal care early in pregnancy will help make sure that the mother is as healthy as possible during the pregnancy.
Smoking, alcohol, and other illicit drugs can interfere with the baby's growth. Avoiding these substances may help prevent placental insufficiency and other pregnancy complications.
Baschat AA, Galan HL, Ross MG, Gabbe SG. Intrauterine growth restriction. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap.31.
Grivell RM, Wong L, Bhatia V. Regimens of fetal surveillance for impaired fetal growth. Cochrane Database Syst Rev. 2009;(1):CD007113.
Farinelli CK, Wing DA. Abnormal labor and induction of labor. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap.14.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.