By Lindsey Wimmer, MSN, CPNP
Stillbirth Mom and Founder Star Legacy Foundation
Harvey Kliman, MD, PhD of Yale University School of Medicine was the first researcher to present his work at the Stillbirth Summit 2011 in October. He is doing extensive research at Yale to investigate the role of the placenta in pregnancy health and outcomes.
Alterations in the formation and development of the placenta can be indicators of similar alterations in the baby. Additionally, his work has identified several components of placental structure that are consistent with abnormal outcomes. These may range from minor aesthetic changes to miscarriage or stillbirth. He is also evaluating how the placenta may be used to identify children who will be at higher risk of health conditions as they grow and develop. His work is incredibly exciting and provides great hope for the future health of our children!
Another aspect of his research involves evaluating the size of the placenta. He and his team have developed a simple calculation to determine the placental volume during pregnancy from measurements obtained during an ultrasound. He believes that this measurement should become a standard component of any obstetrical ultrasound. The size of the placenta is important as it can provide early warning signals for babies who will be compromised at some point in the pregnancy.
Obstetricians currently measure fetal growth externally. However, this measurement can be skewed by an abnormally large or small placenta, volume of amniotic fluid present, size of the infant, and size of the mother. A baby who is not growing appropriately in utero is at a much higher risk of premature birth, birth injury, stillbirth, and neonatal complications. Accurate measurement of the size of the baby and the placenta can help predict at-risk mothers and babies.
Measurement of the baby and placenta is becoming easier for physicians and midwives to determine. Ultrasound technology is advancing every day in quality and accessibility. New ultrasound machines are available in hand-held devices that could be portable and used in any setting. In addition, the calculations recommended by Dr. Kliman are now available as a smart phone application!
Dr. Kliman has proposed that the placenta can only be effective in sustaining the baby when the baby and placenta are in proper proportions to each other. In particular, if the baby is more than six times the size of the placenta, the baby will begin to suffer. Knowing the size of both could be a major indicator for pregnant mothers and their health care team. His continuing research is aimed at refining his findings to provide better techniques and knowledge for obstetricians to use.
We would like to extend a huge thank you to Dr. Kliman for presenting his work and continuing to press forward in stillbirth prevention efforts!
Lindsey Wimmer, a Pediatric Nurse Practitioner, is Mom to four children; Garrett who was stillborn in 2004, Grant, Bennett and Austyn. Lindsey and her husband Trent founded the Star Legacy Foundation shortly after Garrett’s birth when realizing that the numbers of stillbirths in the US were staggering and that very little was being done to determine the causes or find prevention initiatives. Visit the Star Legacy Foundation to learn more.