Intrauterine Growth Restriction

Intrauterine growth restriction (IUGR) means that the baby is smaller than normal at the time of the pregnancy or at birth. This should not be confused with Small for Gestational Age (SGA), which means the baby's weight at birth is at the lower end (less than 10%) of normal birth weights.

CAUSES

Medical problems with the mother:

  • High blood pressure.

  • Kidney, lung or heart disease.

  • Diabetes with arteriosclerosis.

  • Hemoglobinoathies- blood diseases.

  • Antiphospholipid antibody syndrome - a disorder of the immune system.

Other causes:

  • Smoking, drug abuse and excessive alcohol drinking.

  • Diseases of the placenta.

  • Having twins or more.

  • Malnutrition.

  • Infections.

  • Genetic problems.

  • Pregnant women 16 years old or younger and pregnant women 35 years old or older.

  • Exposure to toxic chemicals.

SYMPTOMS

  • Smaller than normal uterus when measuring the uterine size on the abdomen.

  • Ultrasound measurements of the fetuses head circumference, the abdominal circumference, the diameter of the biparietal area (sides) of the head and the length of the femur less than normal indicating IUGR.

RISKS AND COMPLICATIONS

  • Fetal death in the uterus or a stillborn baby.

  • Not having enough fluid in the baby's sac (oligohydramnios).

  • Fetal heart rate problems. This leads to more Cesarean Section deliveries.

  • Low Apgar scores (evaluates the baby's condition at birth).

  • Increase in the acidity of the baby's blood (acidosis).

SGA babies can also have complications such as:

  • Low blood sugar.

  • Increase of bilirubin in the blood.

  • Low body temperature (hypothermia)

  • Low Apgar scores, convulsions, fetal death and stillborn.

TREATMENT

  • Close following and monitoring of the fetus during the pregnancy.

  • Treat infections that may be present.

  • Treat and control the medical disease present.

  • Look at the condition of the fetus with non-tress tests, contraction stress tests and biophysical profile of the fetus.

  • Doppler ultrasound (measure the umbilical artery blood flow) lowers the risk of fetal death and stillborn by delivering the baby early if it is abnormal.

HOME CARE INSTRUCTIONS

  • Follow your caregiver's advice, instructions and keep all of your prenatal appointments.

  • Get plenty of rest and sleep.

  • Eat a balanced diet and take all your vitamin and mineral supplements.

  • Do not over use your energy with hard exercise, work and household activities.

  • Do not exercise unless your caregiver says it is OK to do so.

  • Do not smoke, drink alcohol or take illegal drugs.

  • Avoid chemicals like pesticides.

SEEK MEDICAL CARE IF:

  • You develop a temperature of 100° F (37.8° C) or higher.

  • You do not feel the baby moving as much or not at all.

  • You develop leaking of fluid from the vagina.

  • You develop vaginal bleeding.

  • You develop abdominal pain.

  • You develop uterine contractions.