Placental insufficiency: a case report

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A complication-free pregnancy is a beautiful thing. Waiting to welcome a healthy new life into the world is a time of happy anticipation, aches, pains, morning sickness and a whole lot of love. However, the moment a medical complication enters the equation, it can become quite stressful.
Among the many complications that can occur during pregnancy is that of placental insufficiency. It is an uncommon but serious condition that occurs when the placenta doesn’t develop properly, thus limiting fetal access to oxygen and nutrients. It can be triggered by a variety of conditions including hypertension, diabetes and blood clotting disorders [1]. Carrying risks for mother and infant alike, the condition can lead to low birth weight, premature birth, birth defects and tragically in some cases, stillbirth. There is no known cure, and current management techniques have reaped varying levels of success [1].

When a case-report detailing resolution of placental insufficiency hit the journals, it was noteworthy for a couple of reasons. One of them is that there is no other published literature on placental insufficiency and chiropractic care. This case report is the first.

The other reason was the seriousness of the condition. Fetal growth had begun to slow at 28 weeks gestation, and a reduction in head circumference was noted in between weeks 30 and 32. The consulting obstetrician was “very concerned” about the health of the fetus and had suggested an emergency caesarian section if growth didn’t improve by 32 weeks.

No underlying pathology was noted, and no other interventions utilized (other than the consulting obstetricians suggestion of an early delivery via caesarian section).

The patient presented for chiropractic care and was managed using Thompson Terminal Point Technique. This allowed for full-spine adjusting using low force. Additionally, the TTPT protocol “allows to distinguish between primarily cervical or pelvic subluxation involvement [3].”

This, clearly, was a case in which any delay in results could be detrimental to fetal health. That’s what makes the results so encouraging. “One day following the initial chiropractic care session the patient returned to the hospital for a scheduled Doppler ultrasound, the placental resistance was now shown to be within normal limits [3].” Over the four weeks to follow, “Doppler measurements indicated an increase and normalization in fetal growth [3].”

This enabled another 4 weeks in utero (before the patient opted to give birth via caesarian section at 37 weeks gestation). This advancement in gestational age at birth is significant given the potential differences in lung function, brain development, immunity, feeding issues and weight.

The study was one of a number of papers recently published that carry the Foundation’s definition of vertebral subluxation, which is an exciting development indeed. Being that it is a case-report though, there are inherent limitations.

That being said, this article serves a distinct purpose. Being the first of its kind, it should serve as a flag to anyone else who is considering writing a case study on the matter. This would add valuable first-indicators to a topic that would benefit from further investigation. In recent history, we have seen studies on chiropractic care and pregnancy (including the ground-breaking study showing its impact on the pelvic floor [5]), but there is still more to be done.

Once again, further research not only into chiropractic care and pregnancy but also the impact of the vertebral subluxation is very much warranted.

At this point, we can’t confidently point to why the patient saw such a quick improvement following chiropractic care. All we know is that the situation was serious, warranting an emergency caesarian section if the situation did not improve, and that improvement was concomitant with chiropractic care.

Only time and further research will enable us to have a clearer picture of the impact of the vertebral subluxation on pregnancy. This case report provides us with an indicator that there is, indeed, more to see here.

Published by Australian Spinal Research Foundation at June 5, 2018
[1] Rice S, Cherney K and Wilson D, (2018), “Placental Insufficiency,” Healthline, https://www.healthline.com/health/placental-insufficiency retrieved 19 April 2018

[2] Staff Writer, (2018), “Chiropractic for the pregnant mother,” Australian Spinal Research Foundation, https://spinalresearch.com.au/chiropractic-pregnant-mother/ retrieved 26 April 2018

[3] Rashid M, Findlay M, Russell D (2017), “Reduction in Placental Insufficiency and Normalized Fetal Growth Rate in a Pregnant Patient Following Chiropractic Care for Vertebral Subluxation: A Case Report,” Journal Pediatric Maternal and Family Health, November 2017

[4] McKenzie D (2017), “Dangers of Delivery a baby at 32-34 weeks,” Livestrong, https://www.livestrong.com/article/238691-dangers-of-delivering-a-baby-at-32-34-weeks/ retrieved 26th April

[5] Staff Writer (2016), “Just published, ground-breaking results: chiropractic and pelvic floor control,” Australian Spinal Research Foundation, https://spinalresearch.com.au/just-published-ground-breaking-results-chiropractic-pelvic-floor-control/ retrieved 26 April 2018

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