Intrauterine growth retardation

Intrauterine Growth Retardation
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Synonyms	Fetal growth restriction
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Intrauterine growth retardation (IUGR), also known as fetal growth restriction (FGR), is a condition in which a fetus is unable to achieve its genetically determined potential size. This condition can result from a variety of factors affecting the fetus or the maternal environment.

Causes

IUGR can be caused by multiple factors, which are generally categorized into three groups: maternal, fetal, and placental causes.

• Maternal Causes: These include conditions that affect the mother's health and, consequently, the nutrient and oxygen supply to the fetus. Common maternal causes include malnutrition, anemia, heart disease, hypertension, and smoking during pregnancy.
• Fetal Causes: These involve genetic disorders or infections that directly affect the fetus. Examples include chromosomal abnormalities, congenital infections like rubella or cytomegalovirus, and multiple gestations.
• Placental Causes: Problems with the placenta such as placental insufficiency or placental abruption can lead to reduced nutrient and oxygen supply to the fetus.

Diagnosis

Diagnosis of IUGR is typically made through prenatal ultrasound, which can measure the size of the fetus and evaluate its growth over time. Additional tests might include:

• Doppler ultrasound to assess blood flow in the umbilical artery
• Amniocentesis to check for genetic conditions
• Maternal blood tests to identify infections or other conditions

Management

Management of IUGR depends on the cause and the gestational age of the fetus. The primary aim is to optimize fetal growth and prevent complications. Strategies may include:

• Managing maternal conditions such as improving nutrition or controlling blood pressure
• Monitoring fetal growth and well-being through regular ultrasounds and testing
• In severe cases, early delivery may be considered if the environment in the uterus is thought to be less favorable than the external environment

Complications

IUGR is associated with an increased risk of both short-term and long-term complications. Short-term complications include:

• Preterm birth
• Low birth weight
• Hypothermia
• Hypoglycemia
• Increased risk of neonatal morbidity and mortality

Long-term complications can include:

• Developmental delays
• Metabolic syndrome
• Cardiovascular diseases

Prevention

Prevention of IUGr involves adequate maternal nutrition, proper management of maternal chronic conditions, avoidance of harmful substances like tobacco and alcohol, and regular prenatal care to monitor fetal growth and maternal health.

See also

• Prenatal nutrition
• Placental insufficiency
• Low birth weight