What is the placental infarction that caused the loss of Lulu Ty's baby?

The recent and tragic loss of baby Léo, son of digital influencer Lulu Ty in the 38th week of pregnancy, sparked a warning about serious complications in the final stretch of pregnancy.

The main medical hypothesis for the death of the fetus, which was born lifeless in the maternity ward, is an extensive placental infarction associated with thrombophilia. The case reignited the debate about monitoring fetal vitality during pregnancy and the importance of specific tests after pregnancy losses.

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According to doctor Itaércio Fernandes, specialist in Placental Accreta, the problem occurs when the placenta suffers a drastic reduction in blood circulation.

In serious and acute cases, the only way to try to save the baby is to perform an emergency delivery. However, when the condition evolves silently, postpartum anatomopathological examination becomes the main tool to protect future pregnancies.

What is placental infarction and how does it work?
Placental infarction is characterized by the death of placental tissues due to a lack of oxygenation and nutrients caused by obstruction of blood vessels. Although small foci are common and asymptomatic, large areas directly compromise the life of the fetus.

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"Placental infarction corresponds to areas of the placenta that have suffered a significant reduction in blood circulation, and appear as hyperechoic ('white') areas on ultrasound, signaling a reduction in the function of that placental territory. Small foci can occur without major clinical repercussions, but extensive infarctions are associated with placental insufficiency, fetal growth restriction, pre-eclampsia and fetal distress", explains Dr. Itaércio Fernandes

When is emergency delivery indicated?
In cases where fetal distress due to acute placental insufficiency is detected in time during hospital or routine examinations, immediate termination of the pregnancy becomes the standard protocol to avoid hypoxia (lack of oxygen in the baby's brain) and death.

According to the specialist, the decision is based on strict medical criteria. "The indication for emergency delivery depends on gestational age, fetal viability and mainly on the presence of signs of acute fetal distress, including: important changes in cardiotocography; persistent fetal bradycardia; repetitive late decelerations; severely altered fetal Doppler. (...) In many cases, especially when there is an imminent risk of fetal hypoxia, emergency cesarean delivery becomes the safest way to preserve maternal and fetal life."

Placenta examination is key to the reproductive future
When pregnancy loss occurs without a prior diagnosis, as in the report of influencer Lulu Ty - who underwent prenatal examinations a week before giving birth and had a healthy baby -, clinical analysis of the placenta after birth becomes essential. It works like a biological tracker of what went wrong.

"The anatomopathological examination of the placenta is an extremely important tool after pregnancy losses, severe prematurity or relevant obstetric complications. The placenta functions as a true 'biological record' of the pregnancy, and can reveal changes that help to understand the cause of the obstetric outcome.

Microscopic analysis can identify: extensive placental infarcts; thrombosis; inflammations and infections; genetic changes", says Fernandes.

According to the specialist, it is the data obtained from the exam that can completely change the management of a future pregnancy, allowing doctors to introduce preventive therapies (such as the use of anticoagulants in the case of thrombophilia) from the first weeks.

"In many situations, the diagnosis makes it possible to classify the next pregnancy as higher risk and establish early preventive measures, directly contributing to reducing risks and consequently providing better outcomes for future pregnancies", he concludes.

*Published by André Nicolau, from CNN Brasil

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Source: CNN