Fetal Brain Insults of Placental Origin
- The placenta plays critical roles in fetal brain development including endocrine support, growth factor provision, respiratory function, and nutrient supply.
- Placental failure predominantly impacts respiratory and nutrient functions, significantly affecting fetal neurodevelopment.
Placental Respiratory Failure
- Occurs when placental gas exchange is compromised, leading to fetal hypoxemia and acidosis.
- Potential mechanisms include decreased uteroplacental perfusion, increased villous membrane diffusion distance, decreased maternofetal circulatory interface, fetal anemia, and fetal circulatory anomalies.
- Fetal compensatory mechanisms (e.g., peripheral vasoconstriction) may become overwhelmed, leading to fetal acidemia and hemodynamic compromise.
- Severe lactacidosis disrupts peripheral vasoconstriction, myocardial function, and cerebral autoregulation, precipitating fetal brain injury.
Placental Ischaemic Disease
- Includes fetal growth restriction (FGR), placental abruption, and pre-eclampsia.
- Commonly arises from impaired trophoblast invasion and abnormal placentation.
- These conditions significantly elevate fetal and neonatal mortality and risk of long-term neurodevelopmental impairment.
- These diseases are major contributors to preterm birth and subsequent brain injury.
Login to Read More
