An indication of placental insufficiency is:

The indication of placental insufficiency is indeed intrauterine growth restriction (IUGR). Placental insufficiency occurs when the placenta does not deliver an adequate supply of nutrients and oxygen to the fetus, which can lead to poor fetal growth. IUGR is characterized by a fetus that is smaller than expected for the gestational age, often resulting from inadequate placental blood flow and nutrient transfer.

The condition of IUGR can be linked to various factors, including maternal health issues, placental abnormalities, or environmental factors that impede the placenta's functionality. When the placenta fails to function optimally, it directly affects the fetus's growth and development.

Other options, such as macrosomia, are actually indicative of conditions where the fetus is larger than average, often due to factors like gestational diabetes, which can lead to excessive nutrient supply. Placental rupture is a serious complication but is not typically a direct indicator of insufficiency. Gestational diabetes can contribute to placental issues but is not itself a direct manifestation of placental insufficiency. Thus, IUGR is the most definitive indicator in this context.