Placenta not feeding baby enough

Placental Insufficiency: Causes, Symptoms, and Diagnosis

Placental Insufficiency: Causes, Symptoms, and Diagnosis
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Medically reviewed by Debra Rose Wilson, Ph. D., MSN, R.N., IBCLC, AHN-BC, CHT — By Sandy Calhoun Rice on January 8, 2018


The placenta is an organ that grows in the womb during pregnancy. Placental insufficiency (also called placental dysfunction or uteroplacental vascular insufficiency) is an uncommon but serious complication of pregnancy. It occurs when the placenta does not develop properly, or is damaged. This blood flow disorder is marked by a reduction in the mother’s blood supply. The complication can also occur when the mother’s blood supply doesn’t adequately increase by mid-pregnancy.

When the placenta malfunctions, it’s unable to supply adequate oxygen and nutrients to the baby from the mother’s bloodstream. Without this vital support, the baby cannot grow and thrive. This can lead to low birth weight, premature birth, and birth defects. It also carries increased risks of complications for the mother. Diagnosing this problem early is crucial to the health of both mother and baby.

Vital functions of the placenta

The placenta is a highly complex biological organ. It forms and grows where the fertilized egg attaches to the wall of the uterus.

The umbilical cord grows from the placenta to the baby’s navel. It allows blood to flow from mother to baby, and back again. The mother’s blood and the baby’s blood are filtered through the placenta, but they never actually mix.

The placenta’s primary jobs are to:

  • move oxygen into the baby’s bloodstream
  • carry carbon dioxide away
  • pass nutrients to the baby
  • transfer waste for disposal by the mother’s body

The placenta has an important role in hormone production as well. It also protects the fetus from harmful bacteria and infections.

A healthy placenta continues to grow throughout the pregnancy. The American Pregnancy Association estimates that the placenta weighs 1 to 2 pounds at the time of birth.

The placenta is removed during labor. According to the Mayo Clinic, it’s delivered between 5 and 30 minutes after the baby.

Causes of insufficiency

Placental insufficiency is linked to blood flow problems. While maternal blood and vascular disorders can trigger it, medications and lifestyle habits are also possible triggers.

The most common conditions linked to placental insufficiency are:

  • diabetes
  • chronic high blood pressure (hypertension)
  • blood clotting disorders
  • anemia
  • certain medications (particularly blood thinners)
  • smoking
  • drug abuse (especially cocaine, heroin, and methamphetamine)

Placental insufficiency may also occur if the placenta doesn’t attach properly to the uterine wall, or if the placenta breaks away from it (placental abruption).


There are no maternal symptoms associated with placental insufficiency. However, certain clues can lead to early diagnosis. The mother may notice that the size of her uterus is smaller than in previous pregnancies. The fetus may also be moving less than expected.

If the baby isn’t growing properly, the mother’s abdomen will be small, and the baby’s movements will not be felt much.

Vaginal bleeding or preterm labor contractions may occur with placental abruption.



Placental insufficiency is not usually considered life-threatening to the mother. However, the risk is greater if the mother has hypertension or diabetes.

During pregnancy, the mother is more likely to experience:

  • preeclampsia (elevated blood pressure and end-organ dysfunction)
  • placental abruption (placenta pulls away from the uterine wall)
  • preterm labor and delivery

The symptoms of preeclampsia are excess weight gain, leg and hand swelling (edema), headaches, and high blood pressure.


The earlier in the pregnancy that placental insufficiency occurs, the more severe the problems can be for the baby. The baby’s risks include:

  • greater risk of oxygen deprivation at birth (can cause cerebral palsy and other complications)
  • learning disabilities
  • low body temperature (hypothermia)
  • low blood sugar (hypoglycemia)
  • too little blood calcium (hypocalcemia)
  • excess red blood cells (polycythemia)
  • premature labor
  • cesarean delivery
  • stillbirth
  • death

Diagnosis and management

Getting proper prenatal care can lead to an early diagnosis. This can improve outcomes for the mother and the baby.

Tests that can detect placental insufficiency include:

  • pregnancy ultrasound to measure the size of the placenta
  • ultrasound to monitor the size of the fetus
  • alpha-fetoprotein levels in the mother’s blood (a protein made in the baby’s liver)
  • fetal nonstress test (involves the wearing of two belts on the mother’s abdomen and sometimes a gentle buzzer to wake the baby) to measure the baby’s heart rate and contractions

Treating maternal high blood pressure or diabetes can help improve the baby’s growth.

A maternity care plan may recommend:

  • education on preeclampsia, as well as self-monitoring for the disease
  • more frequent doctor visits
  • bed rest to conserve fuel and energy for the baby
  • consultation with a high-risk maternal fetal specialist

You may need to keep a daily record of when the baby moves or kicks.

If there is concern about premature birth (32 weeks or earlier), the mother may receive steroid injections. Steroids dissolve through the placenta and strengthen the baby’s lungs.

You may need intensive outpatient or inpatient care if preeclampsia or intrauterine growth restriction (IUGR) become severe.


Placental insufficiency can’t be cured, but it can be managed. It’s extremely important to receive an early diagnosis and adequate prenatal care. These can improve the baby’s chances of normal growth and decrease the risk of birth complications. According to Mount Sinai Hospital, the best outlook occurs when the condition is caught between 12 and 20 weeks.

Last medically reviewed on January 9, 2018

  • Parenthood
  • Pregnancy
  • Pregnancy Complications

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

  • Eating for two when over or under weight. (2015).
  • Mayo Clinic Staff. (2015). Pregnancy week by week.
  • Placental insufficiency. (n.d.).

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jan 9, 2018

Written By

Sandy Calhoun Rice

Edited By

Nizam Khan (TechSpace)

Medically Reviewed By

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT

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Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — By Sandy Calhoun Rice on January 8, 2018

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Placental insufficiency – what it is and how it can affect a pregnancy

Placental insufficiency – what it is and how it can affect a pregnancy | Pregnancy Birth and Baby beginning of content

6-minute read


It’s important to see your doctor or medical team as soon as possible if you have any concerns when you are pregnant. If you have bleeding and/or significant pain, call triple zero (000) for an ambulance or go to your nearest hospital emergency department.

What is placental insufficiency?

The placenta delivers oxygen and nutrients to your baby. Placental insufficiency is when the placenta does not work properly. It’s not very common but it is serious, and can affect the growth and wellbeing of your baby.

If you have placental insufficiency, your baby may not grow as expected, leading to complications during pregnancy or birth.

What causes placental insufficiency?

Placental insufficiency occurs because the placenta doesn’t implant and grow properly in your uterus, or because it’s damaged. Sometimes there is no obvious cause.

The risk of placental insufficiency can be increased if you have medical conditions or other risk factors, such as:

  • diabetes
  • pre-eclampsia
  • blood clotting conditions
  • certain infections
  • if you smoke drink alcohol or use illegal or recreational drugs
  • high blood pressure, kidney problems or heart disease
  • if you have had complications earlier in this pregnancy, particularly heavy bleeding
  • older age during pregnancy (older than 40 years)
  • if you have previously had a small baby, pre-eclampsia or stillbirth

How is placental insufficiency diagnosed?

Placental insufficiency may be picked up during your routine antenatal visits and tests.

Your doctor or midwife will measure and track the growth of your uterus and the baby. Placental insufficiency may be diagnosed during a routine ultrasound if your baby isn’t growing as expected.

Sometimes pregnant women may notice that their tummy isn’t growing, is smaller than in previous pregnancies or their baby isn’t moving as much. If you have any concerns during your pregnancy, contact your midwife or doctor immediately.

Diagnosing placental insufficiency early is important for the health of the mother and baby.

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What are the risks to you and your baby?

Placental insufficiency can lead to problems both for mother and baby.

For the mother, it can be linked to conditions such as:

  • pre-eclampsia
  • other problems with the placenta, including placental abruption (when the placenta comes away from the wall of the uterus)
  • preterm labour and delivery

If the placenta does not develop properly, it can also lead to problems for your baby. When the baby doesn’t get enough oxygen and nutrients, it can prevent normal growth and development. This is known as fetal growth restriction (FGR).

Some of the challenges that babies with FGR can have include:

  • breathing or heart problems
  • low oxygen levels at birth
  • difficulty maintaining body temperature
  • trouble feeding and gaining weight
  • infection
  • bleeding on the brain (called ‘intraventricular haemorrhage’)
  • problems with their eyes and vision
  • problems with their bowel

These conditions are more likely in premature babies.

How is placental insufficiency managed?

If your doctor suspects placental insufficiency, they will keep a close eye on how your baby is growing and developing. They will monitor you and your baby regularly and may arrange for you to give birth in a major hospital with appropriate medical support.

You will be asked to keep a record of your baby's movements and let your medical team know if you notice any changes.

At any stage of your pregnancy, if you are concerned about your baby's movements, contact your midwife or doctor immediately. Do not wait until the next day. A slowing down of movement may be a sign that your baby is unwell.

You will likely need more frequent ultrasounds and have regular monitoring of your baby’s heart rate to assess their growth and wellbeing.

Treatment will depend on the stage of the pregnancy. If you’re under 37 weeks, your doctor may recommend waiting for as long as possible and keeping a close eye on the baby. But if there are signs that your baby is not well, it may be safest to induce labour or deliver your baby with a caesarean.

If your baby hasn’t been growing as expected, they may require additional support from the medical team at birth. The team will care for your baby, keep them warm and may help them to breathe with an oxygen mask or breathing tube.

Your baby may need to be transferred to the neonatal intensive care unit (NICU) or special care nursery for extra care.

It’s important to see your doctor or medical team as soon as possible if you have any concerns when you are pregnant. If you have bleeding and/or significant pain, call triple zero (000) for an ambulance or go to your nearest hospital emergency department.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Department of Health and Aged Care (Fetal growth restriction and well-being), Clinical Medicine Insights: Pediatrics (Intrauterine Growth Restriction: Antenatal and Postnatal Aspects), Elsevier, ScienceDirect (Placental Insufficiency), Perinatal Society of Australia and New Zealand/Stillbirth Centre of Research Excellence (Position Statement: Detection and Management of Fetal Growth Restriction in Singleton Pregnanciex)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2022

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