Overview of Intrauterine Growth Restriction (IUGR)
Intrauterine growth restriction (IUGR), also known as fetal growth restriction (FGR), occurs when the fetus is smaller than expected for its gestational age (the number of weeks in the pregnancy). It signifies that the fetus is not developing at the expected rate while still within your uterus. IUGR is characterized as weighing less than 9 out of 10 babies at the same age (below the 10th percentile).
Fetuses grow at varied rates, thus “measuring small” does not necessarily indicate that the fetus has IUGR. In most cases, tiny fetuses are born healthy. However, some moms have an underlying medical issue that causes the fetus to be underdeveloped for its gestational age.
Types of IUGR Cases
Symmetric (or primary): Each fetal body part is tiny in size. This accounts for up to 30% of all IUGR patients.
Asymmetric (or secondary): Only the fetus’s abdomen measures small. The head and brain have the proper sizes. This represents up to 80% of all IUGR cases.
Symptoms of IUGR
Most people show no symptoms or indicators that the fetus is undersized for its gestational age. You may believe that your belly or fetus isn’t as large as it should be. Even if you suspect this, only your doctor can confirm intrauterine growth restriction.
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Causes of IUGR
There are numerous potential causes of fetal growth restriction. In certain circumstances, it develops due to a problem with the placenta or umbilical cord. Other reasons include:
- Having twins or triplets
- Having had a previous baby with IUGR.
- Having high blood pressure, heart disease, or a low blood count.
- Smoking, consuming alcohol, or engaging in recreational drugs.
- Having an autoimmune condition.
- Having a kidney-related illness.
- Using antiseizure medicine.
- Having diabetes.
- Possessing an infection like rubella, syphilis, cytomegalovirus (CMV), or toxoplasmosis.
Fetal growth restriction can also happen if your baby has a congenital or genetic disease like Down syndrome.
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Diagnosis of IUGR
IUGR (Intrauterine Growth Restriction) is usually diagnosed by the following methods:
Ultrasound: Ultrasound is the principal method for evaluating fetal size and growth. Ultrasound biometry, which involves measurements of the fetus’s head, abdomen, and limbs, is used to estimate the baby’s weight and compare it to growth charts for the gestational age.
Fundal Height: Measuring the distance between the pubic bone and the top of the uterus (the fundus) is a fast approach to determine fetal size. After 20 weeks of pregnancy, this measurement should be nearly equivalent to the number of weeks of gestation. A smaller-than-expected fundal height may indicate IUGR.
Amniotic Fluid Volume: Ultrasound can determine the volume of amniotic fluid surrounding the fetus. Low amniotic fluid (oligohydramnios) may be a sign of IUGR.
Doppler Flow Studies: Ultrasound can detect blood flow in the umbilical cord and fetal vessels, indicating potential placental issues leading to IUGR.
Fetal Monitoring: If IUGR is suspected, fetal monitoring (non-stress testing) may be performed to examine the baby’s heart rate and movements.
Screening for Maternal Infections: Infections in the mother can sometimes impair fetal growth, hence screening for infections may be part of the diagnostic procedure.
Amniocentesis: It is a procedure that collects a sample of amniotic fluid to diagnose IUGR or determine the baby’s lung maturity.
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Complications Associated with IUGR
Certain complications may arise due to IUGR, such as:
- Increased chance of C-section and early birth.
- Breathing and feeding issues during birth.
- Hypoxia (lack of oxygen during birth).
- Low blood sugar levels at birth (hypoglycemia).
- Having trouble regulating body temperature.
- Meconium aspiration (when your infant swallows their first poop).
- Polycythemia (an increased quantity of red blood cells).
- Problems battling infection.
- Some premature or small babies may require additional hospitalization or specialized care in the neonatal intensive care unit.
IUGR can have long-term consequences based on:
- The underlying ailment that triggered it.
- How limited your baby’s development was.
- How many weeks pregnant were they at the time of delivery.
Your baby may be predisposed to cognitive or developmental issues such as hyperactivity, cerebral palsy, and poor academic performance. They may also be more likely to develop obesity and cardiovascular disease later in life.
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Care and Management of IUGR
There is no fixed treatment for intrauterine growth restriction. However these are some ways involved in the management of intrauterine growth restriction:
Increased Monitoring: Your doctor will closely watch you and the fetus, using ultrasounds and other tests to assess fetal growth.
Early Delivery: If the pregnancy is not progressing or the fetus is at risk, labor may be induced before 37 weeks of gestation. Vaginal deliveries can be stressful for growth-restricted babies, so a C-section is often suggested.
Corticosteroid Medicine: If your doctor advises an induction, they may administer medication to assist your baby’s lungs to develop.
In rare or severe circumstances, your doctor may admit you to the hospital for further evaluation and management of intrauterine growth restriction.
Prevention of IUGR
Modifiable variables can increase your risk of IUGR, including:
- Using drugs, alcohol, or smoking cigarettes.
- Consuming an unhealthy diet.
- Not gaining enough weight while pregnant.
Avoiding the above mentioned habits and bringing the required changes can help you prevent IUGR.
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Conclusion
Many factors can contribute to the fetus’s small stature before delivery. Your doctor will assess whether there is an underlying issue keeping the fetus from developing. In rare circumstances, there may be no explanation, and the fetus develops smaller than expected. If the fetus is diagnosed with IUGR, the doctors treating you will closely monitor fetal growth for the rest of your pregnancy. Their top priority is to guarantee that you and the fetus receive the necessary care and treatment. It is also important to remember that the majority of children born with IUGR have no health concerns.
FAQ’s
1. What is intrauterine growth restriction in pregnancy?
Intrauterine growth restriction (IUGR) is a disorder in which a fetus is smaller than normal for its gestational age, indicating that it is not developing at the expected rate during pregnancy. This can be caused by insufficient nutrition or oxygen reaching the fetus via the placenta, or underlying maternal or fetal problems.
2. Can fetal growth restriction improve?
While fetal growth restriction (FGR) cannot be reversed, various interventions may improve fetal health and potentially lessen the risks involved. These include constantly monitoring the fetus, treating any underlying maternal problems, and considering an earlier birth if necessary.
3. Can fetal growth restriction cause birth defects?
Yes, while not necessarily the primary cause, intrauterine growth restriction (IUGR) can raise the risk of birth abnormalities and other complications.
4. Is fetal growth restriction a high-risk pregnancy?
Yes, fetal growth restriction (FGR), also known as intrauterine growth restriction (IUGR), is classified as a high-risk pregnancy since it can lead to difficulties for both the mother and the baby.
