Facts on Placental Immaturity

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Placental villous immaturity, also known as villous immaturity, is villous development that is inappropriate for gestational age. This condition can be associated with gestational diabetes mellitus, and is associated with fetal death close to term. Over 60% of fetal deaths are connected with some form of placental abnormality including placental villous immaturity. The immature chorionic villi in this condition are larger than usual, and have more central blood vessels. This causes the diffusion distance for oxygen and nutrients to be greater than in the normal placenta, thus causing a malfunctioning placenta.

Interestingly, placental immaturity is also associated with anencephalic infants. This observation was published in the 1985 publication of Obstetrics and Gynecology by Batson, JL, et al.

Genetic abnormalities and fetal infections can account for some cases of intrauterine growth retardation (IUGR), but most cases of IUGR are associated with placental pathology. What has become more evident over the years is that the IUGR complications produced by the abnormally functioning placenta does not stop at birth. Type II diabetes mellitus, cardiovascular disease, and obesity seem to be associated with the placental changes that existed in utero.

Thousands of placentas are submitted to pathologists across the country every year. Many pathologists do not have an interest in studying the placenta. There are a few pathologists who are the exception to the rule. Most often, the pathologist sees the placenta as tissue to be identified as such on the final pathology report.

Examining the placenta can have important consequences. The findings could determine if the condition is likely to recur in future pregnancies, and it could also explain an adverse pregnancy outcome. The examination could also have medicolegal implications.

Up until recently, examination of the placenta was almost nonexistent. As we have learned more about placental physiology, we have become more aware that the placenta is much more complex than we thought initially.

Unfortunately, not much is known about placental villous immaturity so a treatment to prevent this condition does not currently exist. My advice to any woman who is pregnant is to alert your provider of any changes that you are worried about. This concern can range from “I don’t know what’s wrong, but I feel that there’s something wrong,” to “I’ve noticed that my baby is not moving as much as he was previously.” Your provider will appreciate any information that you can give him. The most often used excuse as to why I wasn’t called about a concern that a patient had, when I was practicing, was “I didn’t want to bother you.” I would always answer with “I’d rather you call me twenty times, and twenty times it be nothing than you not call me the one time that it would have made a difference.” I encourage you to communicate with your provider. If your provider is not receptive to your concerns, then I would recommend you find a new provider.

Wishing you a happy and uncomplicated delivery, Pablo.

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