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Intrauterine Growth Restriction (IUGR)

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Intrauterine Growth Restriction (IUGR), previously known as intrauterine growth retardation, is a way to say that your baby is not as big as a normal sized baby for that portion of pregnancy. It is more common to have this happen towards the end of your pregnancy. IUGR can be caused by many things including:

  • genetic issues or birth defects in baby
  • high blood pressure or pregnancy induced hypertension (PIH)
  • problems with the placenta
  • infection
  • maternal illnesses
  • some prescribed medications
  • smoking in pregnancy
  • drug use

As you can see, the majority of the reasons for IUGR are beyond your control. Getting proper prenatal care, watching your nutritional status and avoiding hazards to your pregnancy and baby will help ensure the healthiest pregnancy you can have, but previous problems with diseases or complications in pregnancy. Factors you can control should be addressed prior to getting pregnant when possible.

While some families believe that a smaller baby is easier to give birth to, there is a large body of evidence that show us that smaller babies are at a great risk for many problems. Some of these problems are life threatening or follow the baby for a long time. Right after birth, an IUGR baby may have trouble breathing or maintaining their own temperature, meaning they will require a stay in the neonatal care nursery (NICU). They may also suffer from problems with blood sugar, immune issues and other issues. But the biggest fear is that an IUGR baby is at a great risk for stillbirth, depending on the degree of IUGR and the reason for the IUGR.

IUGR is found during routine prenatal care typically. This can be found as your doctor or midwife measures your growing uterus (fundal height) at every visit from about 20 weeks of pregnancy. A discrepancy of greater than two weeks would indicate further investigation. This is typically an ultrasound to estimate fetal weight. While these estimates are often inaccurate in predicting fetal weight, a series can be helpful to determine fetal growth. It may also be an opportunity to look for issues with the placenta or the baby. The ultrasound is also a chance to check on the amniotic fluid volume, which can also indicate fetal health.

If your baby is determined to have a growth issue, you may receive more frequent monitoring. This may mean more frequent prenatal visits. It can also include more ultrasounds, bedrest or non-stress tests.

You may or may not need to have other intervention. Sometimes your practitioner might suggest early induction of labor if your baby is still not growing well after additional measures have been added to your care. This is not always the case. In some cases of IUGR, the baby is weak and does not tolerate labor well. In this case, a cesarean section (c-section) will be done as the safest way for your baby to be born. This is hard to predict before labor.

You and your baby will most likely have a normal hospital stay. The exception would be if your baby were extremely premature or if your baby or you had complications after birth. This may be a time when one or both of you needed extra care.

Sometimes babies are simply smaller than average. Sometimes this is related directly to genetics in the case of small family members or of previous children who were born on the smaller side. In fact, only about a third of all small babies actually have IUGR.

The best news is that if your baby has IUGR in this pregnancy, it does not mean that your next pregnancies will suffer from IUGR as well. If the belief is that an illness caused the IUGR in the first place, like high blood pressure, good control before pregnancy is the key to prevention.

Source:

Smith JF Jr. Fetal health assessment using prenatal diagnostic techniques. Curr Opin Obstet Gynecol. 2008 Apr;20(2):152-6.

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