Intrauterine growth restriction (IUGR) is a condition where the growth of the foetus is restricted and the foetus is smaller than 90% of foetuses of the same age. Babies in this condition are also known as ‘small for gestational age’ and occur in up to 5% of all pregnancies.
IUGR is a condition where the growth of the baby is slow while in the mother’s womb. It is also known as Intrauterine Growth Retardation or Foetal Growth Restriction.
There are two types of Intrauterine growth restriction – Symmetrical IUGR and Asymmetrical IUGR.
Symmetrical IUGR, also known as Primary IUGR, comprises 20-25% cases of IUGR. In this condition, the baby displays overall restriction in growth and all internal organs are reduced in size.
Asymmetrical IUGR, also known as Secondary IUGR, is when the baby’s head and brain are of normal size while the rest of his body is comparatively small. This condition is more difficult to diagnose and can go unnoticed up until the third trimester.
IUGR may be caused by various factors, ranging from the medical history of the parents to pregnancy complications. The following are some of the causes of IUGR:
While the small size of the baby may be indicative of the condition, it is also important to note that not all babies that are born small have IUGR.
The primary symptom of IUGR is the ‘small for gestational age’ (SGA) trait. A baby is considered an SGA baby when the estimated age of the baby is below the 10th percentile. i.e. if the estimated weight of the baby is less than 90% of the babies of the same gestational age. The baby may also appear thin, pale, have loose, dry skin, or just be small in overall size. Also, the umbilical cord is thin and dull instead of thick and shiny.
There are various methods that doctors have at their disposal to check the estimated size of babies in the womb. One of the commonest test procedure employed is to measure the distance from the top of the mother’s uterus to her pubic bone. 20 weeks into the pregnancy, this measurement in centimetres should roughly correspond with the number of weeks of pregnancy. If the measurement is lower than the expected number, it is a strong indicator that the baby is not growing in the usual way.
There are also other tests that can be conducted to check for IUGR which include:
Ultrasound is an IUGR radiology method that creates an image of the baby in the womb by the use of sound waves. An ultrasound allows the doctor to see the baby in the womb and take the measurement of the baby’s head and abdomen. These measurements are then compared to growth charts for an estimate of the baby’s weight. This method may also be used to detect the amount of amniotic fluid in the uterus. Any volume of amniotic fluid that is lower than necessary may be indicative of IUGR.
This is a method of measuring the flow of blood, its amount, and the speed with which blood is flowing through blood vessels. Doppler in IUGR can measure the flow of blood in the umbilical cord and the blood vessels in the baby’s developing brain.
There are several factors that may cause IUGR. It has been observed that mothers carrying twins and triplets run a risk, as do mothers who have had an IUGR pregnancy previously. It has also been observed that underweight women or women with poor appetites also face the risk. Women with lung disease, heart ailments, and blood and kidney disorders are vulnerable too.
Some complications that can arise because of IUGR include:
Certain effects of an IUGR pregnancy are listed below:
There are certain precautions that can be taken to manage IUGR. Here are some of them:
While there are no specific treatments or medication for women with IUGR pregnancies, there are some treatments that can help:
Certain preventive measures that can be taken are:
IUGR in pregnancy is not the end of the world, as most IUGR babies would catch up with other children after birth. In case of severe IUGR, babies may face complications that preterm babies face but can also live a normal life once they are around the age of three. While IUGR is a risky condition, the advances in modern medicine and improved knowledge of the condition today allow us to address most of the problems associated with it.
Resources and References: WebMD