![]() And that's exactly what happens with the placenta,” he says. It’s a cliff, like a rubber band that stretches and then finally breaks. But once it gets too small, every percentage makes a massive difference. In fact, you could then lose most of your remaining kidney before its function is ever majorly impacted. Kliman compares the placenta to the kidneys: You can donate one kidney and still have normal renal function. A placenta that is too small poses a stillbirth risk because, as a baby nears their due date and peaks in size, the placenta can no longer sustain their life. In the realm of placenta research, it’s agreed upon that small placentas correlate with adverse outcomes for babies, and that identifying them would be one of the fastest ways to reduce the stillbirth rate. While the majority of stillbirths go unexplained, Kliman analyzed pathology reports from close to 400 stillbirths and found one-third of the infants had small placentas (defined as being below the 10th percentile). ![]() ![]() This equation launched Kliman into a decades-long quest, first to prove that the estimated placental volume (EPV) measurement is accurate, and second that it should be offered to all pregnant people. Even with a small placenta, a baby will continue to grow normally - until all of a sudden, they can’t. Kliman himself has 10 patents in his field, according to his Yale bio.) The elder Kliman was intrigued by the problem and came back to his son with an equation to calculate a placenta’s size on ultrasound. He told me that his daughter, Laura, worked on the chemistry for the patented Impossible Burger. (Kliman is very proud of his family’s achievements. Kliman, who tends to speak in a professorial tone and quizzed me about my qualifications during our phone calls, took the problem to someone he thought could help: his father, Merwin Kliman, a NASA engineer who built the computers on the Voyager 1 and 2 space probes. It’s a yarmulke-shaped organ, Kliman explains, that is hard to measure on an ultrasound because it doesn’t lie flat in space. But there’s no way the doctors could have known, Kliman’s Yale colleagues told him, because there was no way to calculate the size of the placenta on an ultrasound. In the early 2000s, Kliman had already been working at Yale for a decade, and had established himself as a leading placental researcher, when he investigated three stillbirth cases in a row that all followed a pattern: An OB was being sued after a stillbirth by a patient who argued that their doctors should have done something to prevent it, and the reason for all three tragedies came down to a small placenta. (By comparison, sudden infant death syndrome, or SIDS, takes approximately 1,400 lives per year.) Few parents are counseled about the possibility of a stillbirth during their pregnancy, though many hear a lot about how to prevent SIDS. Each year, there are approximately 21,000 of them in the United States according to the Centers for Disease Control and Prevention (CDC). Kliman, M.D., Ph.D.Īny loss of a baby after 20 weeks gestation is considered a stillbirth. Why had no one checked her placenta size during her pregnancy? O’Neill immediately reached out to the podcast guest, Dr. The pathology report said it was below the 10th percentile. He claimed that about a third of stillbirths could be prevented with a simple new screening tool he had developed through his work as the director of the Reproductive Placental Research Unit at the Yale School of Medicine.Įlijah had had a very, very small placenta, O’Neill remembered. A placental pathologist was explaining that small placentas can cause a stillbirth. Then, in mid-October 2018, just weeks after receiving the fruitless pathology report, O’Neill’s ears perked up while she was listening to a podcast called Stillbirth Matters. Three months and one long, confusing pathology report later, there was still no clear explanation for Elijah’s death. He died and I was the one caring for him, so I thought it must be my fault.” “I thought for sure I had done something wrong, but I didn’t know what. “I was terrified initially to look for answers," O’Neill told me, but she requested an autopsy, genetic testing, and for labs to be run on her placenta. He was born at 8 pounds and 13 ounces, and the OB-GYN could not explain why he had died. O’Neill delivered her son, Elijah, the following day. It was there that a doctor told her her baby no longer had a heartbeat. ![]() She didn’t want to be perceived as the “stereotypical, hysterical pregnant woman,” but she headed to the hospital anyway, just to be safe. On the morning before her due date, she noticed her baby had stopped moving. By all standards, this pregnancy, like her others, was healthy and low risk. It was the summer of 2018, and Ann O’Neill was pregnant with her fourth baby - another boy.
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