North American Registry of Midwives (NARM) Practice Exam

What is a likely cause of a smaller and lighter than normal placenta?

1. Maternal obesity

2. General systemic diseases affecting uterine nourishment

3. Presence of multiple fetuses

4. Maternal use of certain medications

The correct answer is: General systemic diseases affecting uterine nourishment

A smaller and lighter than normal placenta is often associated with general systemic diseases that affect the uterine environment and its ability to nourish the placenta effectively. Conditions that fall into this category include maternal hypertension, diabetes, or infections. These systemic diseases can lead to inadequate blood flow, nutrient transport, and hormonal signaling, which are essential for healthy placental development and function. When the placenta cannot receive appropriate nourishment and support, it may fail to grow to a normal size, thereby presenting as smaller and lighter than expected. Other factors, such as maternal obesity, the presence of multiple fetuses, or the use of certain medications, influence placental size as well but not in the same direct manner. For instance, while maternal obesity can result in placental overgrowth due to increased maternal blood volume and metabolic demands, the correlation is not as straightforward as in cases of systemic disease where the very ability to nourish the placenta is compromised. Thus, when considering the question within the broader context of maternal health and placental development, systemic diseases indeed represent a more likely cause for a smaller and lighter placenta.