Small estimated placental volume (EPV) in the setting of decreased fetal movement.

Although 60.5 % of clinically unexplained stillbirths can be attributed to placental insufficiency and/or fetal growth restriction, clinicians rarely calculate estimated placental volume (EPV). We present a scenario in which EPV was used to inform patient care of a 28-year-old with decreased fetal movement at 32 weeks and 1 day gestation. Although estimated fetal weight (EFW), amniotic fluid index (AFI), and nonstress test (NST) were normal, EPV was low (<0.1st percentile), which prompted more frequent patient follow-up. Oligohydramnios was detected at 38 weeks and 1 day, and labor was induced. An infant with birthweight in the 12th percentile for gestational age was born. We learned that EPV can precede intrauterine growth restriction (IUGR), oligohydramnios, and low birthweight.