Intrauterine Growth Restriction occurs when a fetus developing in the mother’s womb grows significantly slower than is expected for fetuses of the same gestational age. It may be uniform, or disproportionately affect the head and body.
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Intrauterine Growth Restriction
Intrauterine Growth Restriction (IUGR), also known as “fetal growth restriction,” occurs when the fetus is developing inside the mother’s womb, and is 90% smaller than other babies of the same age. The current WHO criterion for low birth weight is 2,500 grams, or 5 pounds 8 ounces. This is the 10th percentile for gestational age. Roughly 350,000 babies born in the U.S. have low birth weight. Approximately 1/3 have IUGR, and the other 2/3 are born to mothers who weigh less than 100 lbs, who live at high altitudes, or have a genetic cause.
Types of IUGR
- Symmetric or primary IUGR, characterized by a uniformally small fetus. This accounts for 20-25% of all cases.
- Asymmetric or secondary IUGR, characterized by the head and brain being normal size, but the abdomen significantly smaller. This is usually not diagnosed until the third trimester of pregnancy.
Complications of IUGR
Babies that are growth-restricted may have lower levels of oxygen and nutrients while they are developing in the womb. They may have a difficult time during labor, so many physicians recommend that they be delivered via Caesarian-section at around 37 weeks. When they are born, many develop normally and do eventually catch up with their peers, though many babies that are born prematurely have developmental problems, such as cerebral palsy.
What Causes Intrauterine Growth Restriction?
Causes of IUGR include certain medications taken during pregnancy, high altitudes, multiple pregnancy (twins, triplets, etc), placenta problems, and preeclampsia or eclampsia (when the pregnant woman develops high blood pressure and protein in the urine after the 20th week of pregnancy).
Risk-Factors for IUGR
Research has found that maternal weight and weight gain during pregnancy are strong indicators of infant birth weight. Women who have prolonged malnutrition or protein deficiency typically have smaller babies. In addition, maternal smoking may account of 30-40% of low birth weight babies. Early maternal use of alcohol has been associated with fetal alcohol syndrome, while second- or third-trimester use results in IUGR.
Diagnosis of IUGR
A pregnant woman may feel that the baby is not as big as it should be. When a health care provider examines the woman, he or she will notice that the measurement from the mother’s pubic bone to the top of the uterus is smaller than expected. An ultrasound can usually confirm this suspicion. During an ultrasound, the developing baby may appear symmetrically smaller, or have a head that is a normal size but a body that is significantly smaller than it should be for its age.
Treatment & Prognosis
IUGR increases the chance of a miscarriage or fetal death. A woman who is diagnosed with IUGR will need to be monitored with several ultrasounds to monitor the baby’s growth, movements, blood flow, and fluids. It may be necessary to deliver the baby prematurely. After delivery, prognosis depends on how much the baby was able to grow. Prognosis will be different for each individual, but babies with IUGR often have severe complications.
The complications a newborn may experience are:
- Increased risk of hypoxia (low oxygen when the baby is born)
- Increased risk of meconium aspiration (when the baby swallows part of its first bowel movement)
- Hypoglycemia (low blood sugar)
- Polycythemis (high number of red blood cells)
- Hyperviscosity (decreased blood flow due to high number of red blood cells)
- Increased risk of motor and neurological disabilities
Do I Have an Intrauterine Growth Restriction Lawsuit?
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