Fetal growth retardation

Fetal Growth Retardation
Synonyms	Intrauterine Growth Restriction (IUGR)
Pronounce	N/A
Specialty	N/A
Symptoms	Small size for gestational age
Complications	Stillbirth, developmental delays
Onset	Prenatal
Duration	Until birth
Types	N/A
Causes	Placental insufficiency, maternal factors, fetal factors
Risks	Maternal smoking, malnutrition, infections
Diagnosis	Ultrasound, Doppler studies
Differential diagnosis	N/A
Prevention	N/A
Treatment	Monitoring, early delivery if necessary
Medication	N/A
Prognosis	Varies depending on cause and severity
Frequency	3-7% of pregnancies
Deaths	N/A

Fetal Growth Retardation (FGR), also known as Intrauterine Growth Restriction (IUGR), is a condition in which a fetus is unable to achieve its genetically determined potential size. It is a significant cause of perinatal morbidity and mortality.

Classification

Fetal growth retardation can be classified into two main types:

Symmetrical FGR

Symmetrical FGR occurs when the fetus is proportionally small. This type is often associated with early pregnancy insults such as chromosomal abnormalities, congenital infections, or severe maternal malnutrition.

Asymmetrical FGR

Asymmetrical FGR is characterized by a normal-sized head and brain but a smaller abdomen. This type is usually due to placental insufficiency and is more common in the third trimester.

Causes

Fetal growth retardation can result from a variety of maternal, fetal, and placental factors.

Maternal Factors

• Hypertension
• Pre-eclampsia
• Chronic kidney disease
• Diabetes mellitus
• Malnutrition
• Substance abuse (e.g., smoking, alcohol, drugs)

Fetal Factors

• Chromosomal abnormalities (e.g., Down syndrome)
• Congenital anomalies
• Multiple gestation

Placental Factors

• Placental insufficiency
• Placental abruption
• Placenta previa

Diagnosis

The diagnosis of fetal growth retardation is primarily made through ultrasound measurements. Key diagnostic criteria include:

• Estimated fetal weight below the 10th percentile for gestational age
• Abnormal Doppler ultrasound studies of the umbilical artery
• Discrepancy between fundal height and gestational age

Management

Management of fetal growth retardation involves close monitoring and timely intervention to prevent adverse outcomes.

Monitoring

• Regular ultrasounds to assess fetal growth and amniotic fluid volume
• Doppler studies to evaluate blood flow in the umbilical artery
• Non-stress tests to monitor fetal well-being

Intervention

• Early delivery may be indicated if there is evidence of fetal distress or severe growth restriction.
• Corticosteroids may be administered to enhance fetal lung maturity if preterm delivery is anticipated.

Prognosis

The prognosis for fetuses with growth retardation varies widely and depends on the underlying cause, the severity of the growth restriction, and the gestational age at delivery. Early detection and appropriate management can improve outcomes.

Prevention

Preventive measures include:

• Adequate maternal nutrition
• Avoidance of smoking and substance abuse
• Management of chronic maternal conditions
• Regular prenatal care to monitor fetal growth

See also

• Fetal development
• Preterm birth
• Neonatal intensive care unit