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Intrauterine Growth Restriction Intrauterine
growth restriction (IUGR) is a term used to describe a condition in
which the fetus is smaller than expected for the number of weeks of
pregnancy. Newborn babies with IUGR are often described as "small
for gestational age" or "SGA". IUGR is the second leading
cause of perinatal morbidity and mortality. IUGR results when a problem or abnormality prevents cells and tissues from growing or causes cells to decrease in size. This may occur if the fetus cannot receive the needed nutrients and oxygen or because of infections. Some babies are genetically small but most IUGR is due to other causes. Some maternal factors include: high blood pressure, kidney disease, advanced diabetes, heart or respiratory disease, malnutrition, anemia, infections, substance abuse (alcohol, drugs) or smoking. Other problems affecting the placenta or uterus such as infections around the fetus, decreased blood flow in the uterus or placenta, placental abruption (detachment from the uterus) or placenta previa (implanted low in the uterus) can lead to IUGR. Nutrient transfer can also be inhibited by abnormalities of the umbilical cord. Babies with IUGR can have many problems at birth including: decreased oxygen levels, low Apgar scores, meconium aspiration, hypoglycemia (low blood sugars), problems with maintaining body temperature or polycythemia (too many red blood cells). IUGR fetuses often require a premature delivery and often do not tolerate the stress of labor. In pregnancies complicated by IUGR, fetal size is best estimated by using ultrasound measurements to estimate fetal weight. Usually the fetus' head, abdomen and upper leg bone measurement are used to estimate the weight and charts are available to assess the fetus' growth at a particular gestational age. Doppler flow studies are used to measure blood flow to the placenta and in the umbilical cord connecting the placenta and the fetus. These can be helpful indicators of fetal well-being in pregnancies complicated by IUGR. Although it is not
possible to reverse IUGR, some treatments may help slow or minimize
the effects. Treatments may include changing a mothers' nutrition or
lifestyle, bedrest (to improve circulation to the fetus) or treatment
of the underlying cause. In certain cases, a premature delivery is the
best course of action. Care must be individualized. Our specialists
closely examine each patient to identify the specific cause(s) of IUGR
and administer the appropriate therapy. More Information from the Children's Hospital of The King's Daughters
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