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Geburtshilfe und Frauenheilkunde 1987-Sep

[What is the placental insufficiency syndrome?].

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E Kuss

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The concept of "placental insufficiency" appears to offer a plausible explanation for foetal emergency situations; in reality, however, it leads to unproven and possibly wrong ideas on the genesis of these phenomena. It is applied in a semantically inconsistent manner, and that is one of the reasons why it is unsuitable as a term that can be used in scientific language. It is nevertheless being continually used in present-day "medicalese" and even in recent textbooks of obstetrics as a definition of nosological entities. The claim that the term "placental insufficiency" is necessary for mutual communication in obstetrics, is not substantiated or, if at all, with the self-confirming claim that it cannot be eliminated because it is already firmly rooted in clinical thinking. The conditions in the foetus and the newborn labelled "placental insufficiency syndrome" could be defined without additional linguistic effort by means of a number of sufficiently precise and far more important terms, namely "underweight", "dystrophy", "asphyxia/hypoxia". These terms stand for results of direct observation without hypothetical connotations. The conditions they describe are--at least in principle--objectifiable and measurable. The expressions allow and induce further deliberations and studies on actual causes of chronic or acute deficient supply of the foetus, the nascent and newborn infant, and how to avoid these causes. The criticism of the concept "placental insufficiency" presented and reviewed here, is not new.(ABSTRACT TRUNCATED AT 250 WORDS)

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