[The placental insufficiency syndrome (a clinical concept) (author's transl)].

Placental insufficiency means insufficient exchange or metabolic efficiency of this organ for the growing foetus. The placenta should not be considered as an isolated, autonomically functioning organ but rather as an integral part of a maternofoetal or foetoplacental functional unit. The extension of the concept "placental insufficiency syndrome" is in line with such a concept. Pathophysiologically we can differentiate between three main froms of insufficiency: 1. haemodynamic placental insufficiency, 2. insufficiency of the placental membrane, 3. cellular parenchymatous insufficiency. The haemodynamic placental insufficiency must be considered as an overriding principle of the insufficiency of all partial functions of the placenta. It is probable that the intrauterine growth of the foetus depends mainly on the placental blood flow factors, the oxygen uptake appearing to be the actually limiting factor. For clinical purposes it is advisable to follow the well-tried principle of dividing the placental insufficiency syndrome into three parts, namely, a chronic, a subchronic and an acute form. The possibilities of early detection, of clinical diagnosis, prevention and treatment of placental insufficiency are discussed.