Intrauterine Growth Restriction (IUGR) is a situation in which the fetus grows abnormally in the womb and, consequently, is smaller than the expected gestational age. What are the causes and symptoms of IUGR? What is the treatment of intrauterine growth restriction?

Intrauterine Growth Restriction(IUGR ) is diagnosed from an ultrasound image. Determining the etiology of the disorder allows for the implementation of appropriate therapeutic procedures, and thus reduces the impact of pathology on the development of the fetus as much as possible. Unfortunately, in many cases it is not easy to assess the factors that disrupt normal fetal growth. Regardless of the mechanism of the disorder, it is extremely important to closely monitor such patients. It is necessary to monitor the well-being of the fetus more often with the use of CTG and ultrasound.

IUGR and hypotrophy

The term IUGR defines a situation in which the fetal body weight differs from the appropriate for the gestational age, and more precisely is less than the 10th percentile of the standard body mass curve. The definition focuses only on body weight and does not take into account the length or other dimensions of the fetus. Unfortunately, there is a common misconception that IUGR is the same as hypotrophy. Nothing could be more wrong. Well, the hypotrophy may result from constitutional factors, i.e. the child is smaller because he has small parents. Apart from the low birth weight, the newborn is completely he althy and does not require specialist care. In the case of IUGR, the cause of the disturbed growth is usually related to some pathology and very often the child should be monitored after birth. Intrauterine growth inhibition affects 3-10% of pregnancies and, due to the forms of pathology, it is distinguished by a symmetrical and asymmetrical form.

IUGR - common causes

Factors having a direct impact on fetal growth failure should be divided into fetal, resulting from abnormalities within the fetus itself, maternal, when the problem concerns the mother, and placental, when growth inhibition is related to placental pathology. The most common factors are:

  • maternal: diseasesinternal medicine, mainly in the field of cardiovascular diseases, i.e. hypertension, anemia, diabetes, kidney diseases. Stimulants also play an important role: cigarettes, because nicotine has a huge impact on the blood vessel wall and can disrupt proper perfusion. According to demographic data, low social status also has a negative impact on the proper growth of the fetus. The structure of the uterus itself is of great importance. Any anatomic difference may increase the risk of IUGR. The presence of uterine fibroids is also important.
  • fetal: genetic disorders, in particular neural tube defects, heart diseases, including congenital heart defects, intrauterine infections.
  • placental: inflammatory changes or placental tumors, placental cysts, premature detachment of the placenta

Intrauterine growth inhibition: diagnosis

The first suspicion of abnormal growth may be made by the doctor during the gynecological examination, when assessing the height of the uterine fundus. In the case of abnormal growth, the height of the bottom does not correspond to the gestational age. The next step is the ultrasound evaluation of the fetus. In the case of the discussed pathology, it is not enough to perform fetal biometry once, but it is particularly important to repeat such measurements on a regular basis and assess the fetal growth trend. Of course, apart from the assessment of dimensions, it is necessary to determine the gestational age, if the menstrual cycles were irregular, the date of delivery is determined on the basis of an ultrasound scan from the first trimester.

As mentioned above, the inhibition of intrauterine growth may be symmetrical, which appears already in the early stages of pregnancy and is even, i.e. the dimensions of long bones, the circumference of the abdomen and the head are symmetrically smaller than appropriate for the gestational age. The cause may be multiple pregnancy or an intrauterine infection. The asymmetric type applies to the second or third trimester of pregnancy and is manifested by a marked reduction in the circumference of the abdomen compared to the fetal head. The cause may be diabetes in pregnancy that does not respond to treatment, arterial hypertension or malnutrition in a pregnant woman.

IUGR - therapeutic management

The management of limited intrauterine growth has not yet been established. The main goal of treatment is to eliminate the causative agent. Women with growth disorders should remain under close supervision: ultrasound and CTG and control of fetal movements. A he althy lifestyle is also recommended, avoiding stress, eating a balanced diet, and resting. Increased monitoring of patients results from more frequent death of the fetus above 36 weeks of gestation. The method of termination of pregnancy should take into accountthe current well-being of the fetus measured on the basis of the pulsation index of the middle cerebral artery and umbilical artery. Incorrect spectra of these flows indicate the centralization of circulation, which is associated with a threat to the child's life.

The delivery of your baby should take place in a specialist center for the best care possible. This is important because patients diagnosed with IUGR are more prone to perinatal hypoxia, acidosis or carbohydrate metabolism disorders in the form of hypoglycemia.

Long-term studies show that the further development of children and its regularity are related to the cause of the pathology in question. Development may be as normal as possible, but may be physically and intellectually retarded.

As in any pathology, also in the case of intrauterine growth inhibition, prophylaxis is extremely important, i.e. elimination at the earliest possible stage of th risk factors. Maternal diseases (hypertension, diabetes, anemia), stimulants: smoking, alcohol or the prevention of intrauterine infections.

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Pregnancy