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Intrauterine growth retardation or small for term baby
Intrauterine growth retardation is a condition also termed as dysmaturity, IUGR or small for term babies. In this pregnancy, the baby’s weight is below the expected weight for that of gestational age. For example if the weight at 32 weeks of pregnancy should be 1.5 Kg it is much below that weight.
Causes of intra uterine growth retardation
This condition usually occurs due to chronic placental insufficiency. Examples of such states are chronic disorder of the mother like decompensated heart disease, nephritis, hypertension, pregnancy related conditions like pre-eclampsia. There may also be placental abnormalities. Multiple pregnancies also often produce IUGR babies.
Another important cause of small babies in especially in India and other developing countries is malnutrition and anemia. Infection in the mother like German measles, cytomegalo inclusion disease, toxoplasmosis, urinary tract infections, teenage pregnancy or elderly pregnancy also predisposes to intrauterine growth retardation of fetus.
Smoking, alcohol intake and other such personal habits also adversely affect growth of fetus and may lead to intrauterine growth retardation.
In rare cases of chromosomal abnormalities too, there may be retarded growth of baby leading to condition, intrauterine growth retardation of small for term baby.
Diagnosis of Intrauterine growth retardation or small for term babies
The doctor who is keeping check on a patient, monitors a number of factor during the antenatal period. If a mother is at risk of having an IUGR problem he or she looks out for it.
A few routine parameters in IUGR are that, the pregnant woman’s weight gain remains stationary, or in some case begins to fall. The height of the uterus as measured by abdominal examination is also less than the date suggested. The increase in abdominal girth also becomes stationary of less.
Once again ultrasonography, the most useful diagnostic aid in obstetrics, is the key investigation. It reveals the baby’s head measurement, amount of amniotic fluid volume etc. There are other tests, which includes examination of urine for certain hormonal level and is done if any specific cause is doubted.
How intrauterine growth retardation can be prevented
There is no specific way to prevent intrauterine growth retardation (IUGR) if inherent factors are present. However some measures can easily be taken by the patient. These are
• Smoking and alcohol should be absolutely avoided.
• A balanced and nutritious diet should be taken on time. If the patient faces problem in eating she should take small but frequent diet.
• Patient should be in adequate bed rest.
• The most important is the sleeping posture of the patient. The patient must sleep in left lateral position. Sleeping on the back or supine position should be avoided, as the uterus puts pressure on large abdominal blood vessels, which are supplying the uterus, thus causing less blood supply and less blood supply means less oxygen to the baby. The basic idea is to ensure adequate oxygen and nutrition to the growing fetus all the time.
Management of intrauterine growth retardation
A baby facing intrauterine growth retardation is managed under specialist care, as the pregnancy is usually terminated by 38 weeks, The right time to terminate a pregnancy is decided by the doctor, keeping in mind and investigating fetal movement, fetal heart rate and urinary excretion of certain hormones like oestriol. These days EFM or electronic fetal monitoring is available, which is of a great help during final days before the decision is taken on termination.
A caesarean section is often decided as the preferred mode of delivery. The baby needs intensive care after delivery like a pre term baby.
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Dr. S. Choudhary
Health is wealth
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|Author: Dr. Apurva Tamhane 05 Aug 2009||Member Level: Gold Points : 1|
Can it be said that pregnant women suffering from PreEclampsia may have a higher chance of giving birth to IUGR babies?
|Author: Dr.Sanjeev(Sandy) 05 Aug 2009||Member Level: Gold Points : 1|
|Hi Dr Apurva|
Any factor leading to placental insufficiency can cause IUGR as there is less oxygenation and less nutrition for the fetus and toxemia of pregnancy which includes pre eclampsia and eclampsia is the major cause of palcental insufficiency.