What is intrauterine growth restriction or fetal growth restriction?
Fetal growth restriction means a fetus is smaller than expected for the number of weeks of pregnancy or its gestational age.
It is sometimes defined as a projected weight that is below the 10th percentile. In other words, although being the same gestational age, the infant weighs less than nine out of ten babies their own weight.
For neonates with FGR, the phrase "small for gestational age" may be used.
FGR can begin at any time during pregnancy. When FGR is present, the baby's growth is subpar. The development of the baby's organs, tissues, and cells may all be impacted by FGR in addition to the baby's overall growth. This could lead to a lot of problems. Many little infants, though, might just be that.
Fetal growth restriction outcomes
Mild FGR typically doesn't cause long-term problems. The majority of impacted babies actually catch up in height and weight by age 2.
However, severe FGR can harm a newborn both prenatally and postnatally. How serious the problems are will depend on where the growth limitation originated from and how severe it was. It also depends on the stage of the pregnancy at which it starts.
IUGR could result in:
- birth defects and early delivery
- having trouble handling the stress of vaginal delivery
- decreased oxygen levels
- Hypoglycemia (low blood sugar)
- limited resistance to infection
- low Apgar ratings (a test performed shortly after birth to determine the physical health of the infant and whether it requires any extra medical attention)
- Meconium aspiration, which can affect a baby's breathing (when the infant inhales its own feces passing while in the uterus),
- having trouble controlling body temperature
- abnormally high red blood cell count
- Worse, FGR can result in stillbirth. Additionally, it may hamper long-term growth.
Intrauterine growth restriction causes
The following maternal health conditions could possibly cause intrauterine growth restriction:
- long-term diabetes
- either cardiovascular disease or hypertension
- Syphilis, toxoplasmosis, CMV, and rubella are examples of infections.
- Disease of the lungs or kidneys
- anemia or a lack of nutrition
- Anaemia aplastic
- Immune dysfunction
- using illegal drugs, smoking, or drinking alcohol
Living above 5,000 feet in elevation, having numerous pregnancies (twins, triplets, or more), or the child having chromosomal issues are additional fetal factors that could exist.
Intrauterine growth restriction symptoms
Pregnant ladies do not experience FGR symptoms. However, a newborn with FGR could later display particular symptoms like:
- low birth weight
- low blood sugar levels
- lowering of body temperature
- high number of red blood cells
- having trouble battling illnesses
The primary sign of FGR is an infant that is small for gestational age. Particularly, the estimated weight of the child is less than the 10th percentile, or less than 90% of children of the same gestational age.
The baby may be underweight or appear to be small all over, depending on the cause of the IUGR. They may have loose, flaky skin that is thin and pallid. The umbilical cord is typically thin and dirty rather than thick and lustrous.
Fetal growth restriction and risks to multiple pregnancies
Fetal growth restriction can also happen in as many as 25% of twin pregnancies.
Twins who share a placenta may:
- Have uneven blood and nutrient distributions. Therefore, one twin might be significantly smaller. This is selective intrauterine growth restriction.
- Have shared blood vessels. Twin-twin transfusion syndrome (TTTS), a serious sickness, could strike them. When this happens, there is an imbalance in the twins' blood exchanges, endangering both of them.
- Share an amniotic sac. The umbilical cords may then twist, cutting off the blood supply to one or both twins.
IUGR babies long term effects
Babies with IUGR are more susceptible to certain health problems. Premature births or very small at birth babies are more likely to require a lengthy hospital stay. They can also need specialist treatment in the newborn critical care unit (the NICU).
The following problems may also result from intrauterine growth restriction:
- problems with breathing and eating
- body has trouble staying at a consistent temperature
- abnormal blood cell numbers
- decreased sugar levels (hypoglycemia)
- problems fighting infections
- a neurological disorder
The long-term effects of IUGR on a newborn may depend on the condition that caused the problem.
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Intrauterine growth restriction prognosis
FGR may have a number of serious repercussions. It's possible that you'll have to deliver your child early and stay in the hospital. Your baby could experience problems like infections, breathing difficulties, and other things. Both deaths and stillbirths are possible. As your child gets older, they are more likely to experience problems with their blood vessels and hearts. Intrauterine growth restriction in infants increases the risk of- Hypoxic ischemic encephalopathy (HIE)
- brain damage
- spinal paralysis
- seizures disorders
- defects in intelligence
- developmental delays
Do babies with IUGR move a lot
A study entitled, Fetal movements and intrauterine growth retardation, measured fetal movement (FM) rate in both symmetrical and asymmetrical intrauterine growth retardation (IUGR) cases and compared it to the FM rate in a healthy pregnancy.There was a noticeable decrease in FM rate in both groups of IUGR from the 25th to 36th week of gestation, which was more pronounced in the symmetrical group. A progressive upward trend in the FM rate with growing gestational age was also seen in both groups with IUGR. There have been instances with asymmetrical IUGR that had much reduced FM up until they ended. FM needs rapid hospitalization and fetal heart rate monitoring in this group of IUGR-decreased patients in order to detect any potential respiratory failure and impending fetal death.
When to deliver IUGR baby
The due date may change based on how well your baby is doing. Occasionally, infants with IUGR continue to develop inside the womb. It might not be necessary to deliver early if your baby keeps gaining weight before you are due. However, if your baby is not growing at all or is having other problems, your doctor might decide that an early delivery might be advantageous. In this case, your doctor may decide to induce labor. The heart rate and motion of your infant will be continuously tracked to help you and your doctor make this decision.Fetal growth restriction diagnosis and treatment
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Fundal Height
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Weight Check
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Doppler flow
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Amniocentesis
How to prevent intrauterine growth restriction
Web MD recommends the following ways to prevent fetal growth restriction or intrauterine growth restriction. Although FGR can occur in mothers in good health, there are things they can do to reduce their risk and raise the likelihood of a healthy pregnancy and baby.- Attend all prenatal appointments on time. Early problem identification paves the way for early problem-solving.
- Keep an eye on your baby's movements. A baby that stops or moves slowly might be having problems. If you notice any changes in your baby's movement, contact your doctor right once.
- Check the prescriptions you have. Sometimes a mother's medication for a different medical condition can have a harmful impact on her unborn child.
- Maintain a healthy diet. Your baby will be well-nourished with a balanced diet that contains appropriate calories.
- Get plenty of rest. If you get enough sleep, you'll feel better and it might even help your child grow. Every night, get at least eight hours of sleep. You should also take an hour or two long snoozes in the afternoon.
- Create a wholesome lifestyle. You should give up smoking, consuming alcohol, and doing drugs for the health of your unborn child.
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