Hello XXXXXXX

Thanks for writing to us. I am trying to solve your problem as per your concern.

First of all, placental infarction develops from obstruction of blood supply to a part of the placenta and resulting its cells to die. They may be small or large in size.

Generally small infarcts which are present at the edge of the placental disc, are regarded as normal at term. They are found in 25 - 30% women with normal term pregnancy and do not cause any problems or complication in such cases.

Large ones are mostly associated with vascular abnormalities or pregnancy induced hypertension (PIH). Very large infarct may cause placental insufficiency and leads to intra uterine growth retardation (IUGR) of the developing baby and in extreme cases, intra uterine fetal death (IUFD) may occur. These type of infarcts only cause problems during pregnancy and may give adverse effect on growth and development of the newborns in later life.

As per expected date of delivery (19th March), I can assume that your wife is in term ( between 37th-40th weeks). Here, you need to consult with your obstetrician regarding this for complete assessment of the pregnancy profile including fetal maturity, size of the infarcts, any other associated factors etc. Depending on this findings, your obstetrician can make a decision for the delivery of the baby.

In such cases, planned caesarean section is ideal choice for safe delivery whether amniotic fluid or liquor is still sufficient (good sign) and 2 weeks early delivery from expected date does not cause any ill health effect on the baby rather than it saves baby from major complication.

Following measures are helpful:

1) Take Healthy protein XXXXXXX diet and eat more vegetables & fresh fruits.
2) Drink plenty of water/ juice to stay hydrated & for better feto-placental circulation.
3) Take adequate bed rest and preferably 10-12 hrs daily in divided schedule.
4) Try to avoid stress/tension/emotional upset by regular XXXXXXX breathing.
5) Maintain personal hygiene including breast & genital care with proper washing.
6) Continue Iron/ calcium supplements till delivery of the baby and up to 6 months after birth of the baby.
7) Measure weight gain and control blood pressure. 10-12 kg weight gain is normal in pregnancy period.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish her for good health and successful motherhood.

Regards,
Dr Soumen

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Hello XXXXXXX

Thanks for follow up query.

According to your information, weight of the baby (2.8 kg) is quite good in this stage of pregnancy. But size of the infarct is needed to be assessed whether it is small or large and risk of the baby depends on it. Possible risks during pregnancy include placental insufficiency, further growth restriction or in extreme cases, fetal death. In later life or after birth, new born baby may face delayed development or growth retardation if there is very large placental infarct. Otherwise all things will be normal.

Therefore, it is advisable to undergo elective caesarean section 1-2 weeks early from expected date for such cases to avoid possible risks and conduct safe delivery of the baby. Your obstetrician can only take that decision.

Follow all suggestive measures (that I describes in my earlier reply) and take care of her.

If you do not have any clarifications, you can close the discussion and rate the answer.

Regards,
Dr Soumen

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Hello XXXXXXX

Thanks again for follow up query. I am trying to give answer as per your concern.

Yes, only large placental infarction can cause poor feto-placental perfusion and leads to decrease amniotic fluid volume or oligohydramnios by interfering fetal glomerular filtration rate (GFR). It is more commonly associated with PIH (pregnancy induced hypertension) or preeclampsia.

On the other hand, small infarcts usually do not create any complication but we have to stay in safe place in conducting safe delivery of the baby so that possible risks can be avoided. Only your obstetrician can take the right decision in such cases.

If you do not have any clarifications, you can close the discussion and rate the answer.

Regards,
Dr Soumen

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