Placental Pathophysiology Underlying Fetal Growth Restriction

Abstract

Fetal growth restriction (FGR) is a major pregnancy issue that affects 5–10% of pregnancies worldwide. When the fetus fails not fulfill its genetic growth potential, it raises the risk of newborn morbidity, death, and long-term neurodevelopmental problems. Placental dysfunction, which hinders the flow of nutrients and oxygen from the mother to the fetus, is the main cause of FGR. Placental abnormalities such as maternal and fetal vascular malperfusion, villitis, abnormal trophoblast invasion, and inadequate spiral artery remodeling contribute to reduced blood flow and chronic fetal hypoxia. Oxidative stress further damages placental vessels, leading to symmetric or asymmetric growth restriction depending on the timing and severity of the insult. Early diagnosis is essential and relies on Doppler ultrasound, fetal and maternal biometry, and placental biomarkers such as PlGF and sFlt-1. Understanding placental pathology is crucial for timely intervention and improved pregnancy outcomes.