Fetal Intrauterine Growth Retardation (IUGR)

Fetal Intrauterine Growth Retardation (IUGR) During pregnancy, each baby's development progresses at different rates. However, in some cases, the baby may grow slower than expected in the womb. This condition is called fetal intrauterine growth restriction (IUGR). Simply put, IUGR means the baby is smaller than expected for its gestational age.

Doctors typically monitor the baby's weight, length, and organ development through ultrasound measurements. If the baby's measurements are significantly below the average values for the same gestational week, a diagnosis of IUGR may be made. Causes of IUGR There is no single cause of IUGR; it usually occurs when multiple factors come together. The causes can be examined in three main groups: Maternal Causes High blood pressure (preeclampsia) or chronic hypertension Diabetes, kidney or heart disease Malnutrition or low-calorie diet Smoking, alcohol or substance use Severe stress or extreme fatigue Infections (e.g. toxoplasmosis, cytomegalovirus, rubella) Placental causes The placenta is a vital organ that provides the baby's connection to the mother.

If the placenta cannot perform its function properly, the baby will not receive sufficient oxygen and nutrients. Placental insufficiency Umbilical cord problems (entanglement, compression) Premature aging of the placenta Causes Related to the Baby Genetic disorders or chromosomal abnormalities Congenital diseases Twin or multiple pregnancies How to Recognize IUGR? IUGR is usually detected during regular pregnancy check-ups. Your doctor monitors your progress based on fundal height (abdominal size); if it is smaller than expected, an ultrasound is performed. The following findings may be observed on ultrasound: Low birth weight Small measurement of abdominal or head circumference Decreased amniotic fluid Impaired blood flow (detected by Doppler ultrasound) Possible Consequences of IUGR Not every IUGR diagnosis poses a serious problem; however, if precautions are not taken, the risks include the following: Premature birth Low birth weight Oxygen deficiency during birth Hypoglycemia (low blood sugar) Hypothermia (decreased body temperature) Postnatal developmental delays Treatment and Follow-Up Process There is no definitive "cure" for IUGG; the approach varies depending on the underlying cause.

The goal is to ensure the baby grows as healthy as possible in the womb. The primary methods employed are: Regular ultrasound and Doppler monitoring Recommendations for rest and nutrition regimen to the mother Quitting harmful habits Management of maternal diseases Decision for premature birth when necessary Recommendations for Pregnant Women with IUGR Do not neglect your check-ups Eat a balanced and regular diet Drink plenty of water Allocate time for rest Avoid smoking, alcohol and caffeine Monitor your baby's movements

References:

• American College of Obstetricians and Gynecologists (ACOG). Intrauterine Growth Restriction. Practice Bulletin No. 227. Obstet Gynecol. 2021;137:e16–e28.

• Figueras F, Gratacós E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther. 2014;36:86–98.

• Baschat AA. Fetal growth restriction – from observation to intervention. J Perinat Med. 2011;39:213–221.

• Kingdom JC, et al. Fetal growth restriction: pathophysiology and clinical management. Clin Obstet Gynecol. 2018;61:479–494.

• Unterscheider J, et al. Customised versus population-based growth charts to identify neonates at risk. Ultrasound Obstet Gynecol. 2013;41:572–577.