Question about placental gestational age vs baby gestational age (death mentioned)

[Momof2plus1]

I have no idea where to post this. I'm sorry if this is the wrong place. I thought maybe it should go in the loss section, but I'm looking more for answers for future pregnancies or for other people that have heard of or experienced this particular issue.

Let me start with my background. In 2008 I was pregnant with my second child. An u/s around 12 weeks changed my due date from December 4th to December 18th (I had the u/s because they couldn't find the heartbeat and feared I had miscarried). On November 11th, 2008 my son was born still. At the time they believed I was 34w6d (I still believed my due date to be the 4th tho, so I felt I was 36w6d). Benjamin was born 6 pounds, 3 ounces and seemed perfect. Based on his weight and length they decided that he was, in fact, 36w6d.

I recently requested all my medical records, including the autopsy report for Benjamin. I already knew the cause of death was blood clots in the umbilical cord and his lung. I had gotten pregnant again 2 months after he was born so we had all the blood clotting testing done to make sure what happened to Benjamin wouldn't happen to the new bean I was carrying. That pregnancy went off without a hitch (well, except our anxiety levels!!). Even though we had no reason to think that what happened to Benjamin wouldn't happen to this baby we still also believed we had no reason to believe it wouldn't happen (since there was no reason to think it would happen to Benjamin either). At 38 weeks I was induced and gave birth to a healthy screaming baby. The best sound in the world.

Now, on to my question... The autopsy report states that "there is a discrepancy between body measurements which correspond to a later gestation of 38-39 weeks gestation, and the placental weight, which corresponds to 33-34 weeks gestation." His weight and lengths (bone length, crown to rump and crown to heel lengths), head circumference and foot length all indicated a gestational age of 36-40 weeks (the foot length was 36 weeks, all the rest were 38-40). How can the placenta have only been 33-34 weeks gestation? How do they even know this? I've never read of a placenta being 'younger' than the baby.

Could this have somehow contributed to his death? Could the fact that he was so much 'older' than the placenta have caused things to not work properly and caused the blood clots? The report gives no answers at all, just has left me more confused. I know it really doesn't matter, that it won't change anything. But it's frustrating. It's mostly frustrating because I wonder if they had known that he was older than they thought then maybe something could have been done. IDK. It's just frustrating.

So my main questions are these: What would cause a placenta to be that much 'younger' than the baby? Does this have health concerns to the baby? Could something have been done (I am not looking to place any blame, I'm just wondering for any future pregnancies). My daughter that was born after Benjamin was always on the small side and I had more monitoring with her (since we were so anxious). I would like to have one more baby and thought I would be fine with less monitoring, but now this has me all freaked out. I'm worried that something that we could have caught caused his blood to clot.

TIA for any insight.

-Rae

[mommato5]

 I am so sorry for your loss!!

I would contact a perinatologist and see if they can answer your questions.

[liz-hippymom]

i m so sorry for your loss mama. i wish i knew the answers to your questions. i second the suggestion of going to a perinatologist. they can be so informative. i pray you get your answers!!

[Serenity Now]

I'm not an expert, but to me it sounds like a placental insufficiency. The placenta wasn't as large and healthy as it should be, and that was probably the reason for your baby's death. It may be a fluke. But it may not, and I don't really know.

I'm so sorry for your loss. I cannot imagine what you have gone through.

[Lisoula]

Not an expert either but I would guess that the clots are what caused the size difference.  I sounds to me that the placental wasn't growing appropriately (placenta insufficiency like a pp has said).  If the blood flow is reduced, say due to clotting, the placenta will not grow as it should.

I agree that contacting a perinatologist or maternal-fetal medicine specialist will probably give you the best answers.

Hugs, mama.

[L J]

This sounds a lot like what our pathology report said. I am out of town so I don't have it right here in front of me, but it said things about "large retroplacental hematoma" and then talks about large hematomas in the placenta itself. The retroplacenta hematoma is, from what I understand, a large blood clot between the placenta and the uterus.

My son was IUGR and was born at 35w5d. It stated that the placenta has an age of 32w and some odd days.

We did not have an autopsy done, so the official cause of death was "placental insufficiency".

I am seeing a regular OB this time around, and I took the pathology report to her and she was able to explain a lot of it to me, too. I tried calling the pathologist at the large teaching hospital who's parking lot I delivered in, and he wouldn't give me any answers. They wouldn't even give me the report, they wanted to fax it to an OB. I didn't have one at the time, so they just picked one and of course, he was willing to turn over the report to me but wouldn't explain any of it.

I hope you get some answers mama. I was insane and obsessed for months, it was all I could do - try and decode that report. Even though I now understand everything on it, I still don't really have any answers or peace. Good luck to you.

I am so sorry about the loss of your Benjamin.