Intrauterine Growth Retardation
Intrauterine Growth Retardation
- low birth weight
- small for gestational age
- intrauterine growth restriction
Intrauterine growth restriction, or IUGR, is a condition in which an unborn child grows at a slower rate than expected.
What is going on in the body?
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
What are the causes and risks of the disease?
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 fetus
- multiple pregnancies, such as twins
- IUGR in a previous pregnancy
high blood pressure diabetes
- poor weight gain in pregnancy
preeclampsiaor eclampsia, which are complications of pregnancy causing high blood pressurein the mother
- exposure to high altitudes
drug abuse HIVinfection
inflammatory bowel diseaseor ulcerative colitis alcohol dependence or abuse TORCH infections, a set of infectious diseases that can harm the baby if the mother is infected during her pregnancy
- poor nutrition in the mother
- congenital or chromosome abnormalities in the fetus
- recurrent 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 anemiaor thalassemia
- small stature in the mother
placenta abruptio, which is a premature separation of the placenta from the uterine wall
What can be done to prevent the disease?
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
- eliminating use of
alcohol, tobacco, and illicit drugs
- careful monitoring and early treatment for
high blood pressureand diabetes
- eating a diet high in
folatebefore and during pregnancy to protect against certain birth defects
How is the disease diagnosed?
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
What are the long-term effects of the disease?
Long-term effects in the baby before or during delivery include the following:
- poor tolerance of labor
- increased chances of a
Cesarean birth, or delivery of the baby through an incision in the mother's abdomen
- increased risk of birth defects
- asphyxia, or too little oxygen, at birth, which may lead to
Long-term effects in the infant after delivery include the following:
- temperature instability
hypoglycemia, or low blood sugar
- difficulty fighting infection
Complications later in childhood may include:
learning disabilities developmentaldelays
What are the risks to others?
IUGR is not contagious, but it does pose a risk for the fetus. IUGR may also occur in future pregnancies.
What are the treatments for the disease?
Treatment of IUGR depends on the suspected cause and may include the following:
- stopping all drugs, such as cocaine and
- eating a good diet with proper amounts of
folic acidand other vitamins
- increasing bed rest, lying on the left side as much as possible
- if prescribed, taking low-dose aspirin to prevent tiny clots from forming in the placenta
- monitoring fetal movements, contractions, or spontaneous rupture of membranes
- close monitoring by the healthcare provider
- using continuous internal
fetal heart monitoringduring labor to detect fetal distress
- using minimal
anesthesia, although epidurals are safe
- having a
Cesarean birthor forceps delivery if distress of the unborn child is suspected
What are the side effects of the treatments?
Treatments are intended to prevent serious complications in infants with IUGR. Side effects of surgery include bleeding, infection, and
reaction to anesthesia.
What happens after treatment for the disease?
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.
How is the disease monitored?
The following may be used to monitor the pregnancy:
nonstress testingevery week or two biophysical profileevery week or two. This test uses ultrasound and a series of measurements to determine the health status of the developing baby. pregnancy ultrasoundsevery 10 to 14 days
Any new or worsening symptoms should be reported to the healthcare provider.