Intrauterine growth restriction, or IUGR, is a condition in which an unborn child grows at a slower rate than expected.
There are expected ranges of growth for an unborn child at a given gestational age. The growth of an unborn child depends on the health and nutrition of the mother and the health of the baby.
IUGR may occur if the health of the placenta or its blood supply is impaired. IUGR may also occur if the mother's nutrition, health, or lifestyle prevents a healthy pregnancy.
There are often no symptoms of IUGR. Symptoms that do occur may include the following: a uterus that is smaller than in previous pregnanciesfewer fetal movements than expected
Women with certain conditions may be more likely to have a child with IUGR. These conditions include the following: placental insufficiency, which leads to poor nutrition of the fetusmultiple pregnancies, such as twinsIUGR in a previous pregnancyhigh blood pressurediabetessevere kidney diseaseheavy smokingpoor weight gain in pregnancypreeclampsia or eclampsia, which are complications of pregnancy causing high blood pressure in the motherexposure to high altitudesdrug abuseHIV infectionsevere inflammatory bowel disease or ulcerative colitisalcohol dependence or abuseTORCH infections, a set of infectious diseases that can harm the baby if the mother is infected during her pregnancypoor nutrition in the mothercongenital or chromosome abnormalities in the fetusrecurrent bleeding, such as placenta previa, a condition in which the placenta implants over or near the opening of the cervix blood disorders, such as sickle cell anemia or thalassemiasmall stature in the motherplacenta abruptio, which is a premature separation of the placenta from the uterine wall
Most cases of IUGR cannot be prevented, especially if they are due to genetic causes. Some cases can be prevented by taking the following precautions: avoiding risk factors for the TORCH infectionseliminating use of alcohol, tobacco, and illicit drugscareful monitoring and early treatment for high blood pressure and diabeteseating a diet high in folate before and during pregnancy to protect against certain birth defects
The diagnosis can be made with 2 tests: pregnancy ultrasound which uses many measurements to evaluate the unborn child. the nonstress test which measures the heart rate and the movement of the baby.
Other tests can be used to check for other conditions affecting the fetus.
Long-term effects in the baby before or during delivery include the following: premature deliverypoor tolerance of laborincreased chances of a Cesarean birth, or delivery of the baby through an incision in the mother's abdomenincreased risk of birth defectsasphyxia, or too little oxygen, at birth, which may lead to cerebral palsy
Long-term effects in the infant after delivery include the following: temperature instabilityhypoglycemia, or low blood sugardifficulty fighting infectiondeath
Complications later in childhood may include: learning disabilitiesdevelopmental delays
IUGR is not contagious, but it does pose a risk for the fetus. IUGR may also occur in future pregnancies.
Treatment of IUGR depends on the suspected cause and may include the following: stopping smokingstopping all drugs, such as cocaine and alcoholeating a good diet with proper amounts of folic acid and other vitaminsincreasing bed rest, lying on the left side as much as possibleif prescribed, taking low-dose aspirin to prevent tiny clots from forming in the placentamonitoring fetal movements, contractions, or spontaneous rupture of membranesclose monitoring by the healthcare providerusing continuous internal fetal heart monitoring during labor to detect fetal distressusing minimal anesthesia, although epidurals are safehaving a Cesarean birth or forceps delivery if distress of the unborn child is suspected
Treatments are intended to prevent serious complications in infants with IUGR. Side effects of surgery include bleeding, infection, and reaction to anesthesia.
Recovery from surgery may take a few days to several weeks, depending on the procedure used. The baby may be given oxygen, antibiotics, and intravenous fluids after delivery. An infant with cerebral palsy or seizures may need physical therapy. Other disabilities may require other treatments.
The following may be used to monitor the pregnancy: nonstress testing every week or twobiophysical profile every week or two. This test uses ultrasound and a series of measurements to determine the health status of the developing baby.pregnancy ultrasounds every 10 to 14 days
Any new or worsening symptoms should be reported to the healthcare provider.