Intrauterine growth restriction

Intrauterine growth restriction (IUGR), also known as fetal growth restriction (FGR), is a condition where a fetus is unable to achieve its genetically determined potential size. This can be due to a variety of factors, including maternal, placental, or fetal issues.

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Definition

IUGR is typically defined as a fetal weight that is below the 10th percentile for gestational age. This means that the fetus is smaller than 90% of all other fetuses of the same gestational age. It is important to distinguish IUGR from small for gestational age (SGA), which refers to any fetus or newborn that is smaller than 90% of their peers, regardless of the cause.

Causes

The causes of IUGR can be divided into three categories: maternal, placental, and fetal.

Maternal Causes

Maternal causes of IUGR include conditions that affect the mother's health or her ability to provide nutrients to the fetus. These can include malnutrition, anemia, hypertension, and diabetes. Maternal smoking and alcohol use can also contribute to IUGR.

Placental Causes

Placental causes of IUGR involve conditions that affect the placenta's ability to supply nutrients and oxygen to the fetus. These can include placental insufficiency, where the placenta is not functioning properly, and placental abruption, where the placenta detaches from the uterus prematurely.

Fetal Causes

Fetal causes of IUGR involve conditions that affect the fetus directly. These can include genetic disorders, infections, and multiple gestations (such as twins or triplets).

Diagnosis

Diagnosis of IUGR is typically made through ultrasound measurements of the fetus. Other tests may include Doppler ultrasound to assess blood flow in the umbilical artery, and amniocentesis to check for genetic disorders.

Treatment

Treatment for IUGR depends on the cause and severity of the condition. It may involve treating the mother's underlying health condition, such as controlling her diabetes or hypertension. In some cases, early delivery may be necessary.

Prognosis

The prognosis for babies with IUGR depends on the cause and severity of the condition. Some babies may catch up in size after birth, while others may have long-term growth problems. Babies with IUGR are at higher risk for complications such as low birth weight, premature birth, and neonatal intensive care unit (NICU) admission.