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Ultrasound, normal fetus - abdomen measurements
Ultrasound, normal fetus - abdomen measurements


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Ultrasound, normal fetus - arm and legs


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Ultrasound, normal fetus - face


Ultrasound, normal fetus - femur measurement
Ultrasound, normal fetus - femur measurement


Ultrasound, normal fetus - foot
Ultrasound, normal fetus - foot


Ultrasound, normal fetus - head measurements
Ultrasound, normal fetus - head measurements


Ultrasound, normal fetus - arms and legs
Ultrasound, normal fetus - arms and legs


Ultrasound, normal fetus - profile view
Ultrasound, normal fetus - profile view


Ultrasound, normal fetus - spine and ribs
Ultrasound, normal fetus - spine and ribs


Ultrasound, normal fetus - ventricles of brain
Ultrasound, normal fetus - ventricles of brain


Intrauterine growth restriction

Definition:

Intrauterine growth restriction (IUGR) refers to the poor growth of a baby while in the mother's womb during pregnancy. Specifically, it means the developing baby weighs less than 90% of other babies at the same gestational age .



Alternative Names:

Intrauterine growth retardation; IUGR



Causes, incidence, and risk factors:

Many different things can lead to intrauterine growth restriction (IUGR). An unborn baby may not get enough oxygen and nutrition from the placenta during pregnancy because of:

  • High altitudes
  • Multiple pregnancy (twins, triplets, etc.)
  • Placenta problems
  • Preeclampsia or eclampsia

Congenital or chromosomal abnormalities are often associated with below-normal weight. Infections during pregnancy that affect the developing baby, such as rubella, cytomegalovirus, toxoplasmosis, and syphilis can also affect the weight of the developing baby.

Risk factors in the mother that may contribute to IUGR include:

  • Alcohol abuse
  • Clotting disorders
  • Drug addiction
  • High blood pressure or heart disease
  • Kidney disease
  • Poor nutrition
  • Smoking

If the mother is small, it may be normal for her baby to be small, but this is not due to IUGR.

Depending on the cause of IUGR, the developing baby may be symmetrically small, or have a head that is normal size for gestational age, while the remainder of its body is small.



Symptoms:

A pregnant woman may feel that her baby is not as big as it should be. The measurement from the mother's pubic bone to the top of the uterus will be smaller than expected for the baby's gestational age. This measurement is called the uterine fundal height.



Signs and tests:

Intrauterine growth restriction (IUGR) may be suspected if the size of the pregnant woman's uterus is small. The condition is usually confirmed by ultrasound.

Further tests may be needed to screen for infection or genetic problems if IUGR is suspected.



Treatment:

IUGR increases the risk that the baby will die inside the womb before birth. If your doctor thinks you might have IUGR, you will be closely monitored with regular pregnancy ultrasounds to measure the baby's growth, movements, blood flow, and fluid around the baby.

Non-stress testing will also be done.

Depending on the results of these tests, delivery of your baby may be necessary.



Support Groups:



Expectations (prognosis):

After delivery, growth and development of the newborn depends on the severity and cause of IUGR. The baby's outlook should be discussed with your obstetrician and pediatrician.



Complications:

Depending on the specific cause, IUGR increases the risk of pregnancy and newborn complications. Babies may have an abnormal fetal heart rate during labor, requiring delivery by C-section.



Calling your health care provider:

Contact your provider right away if you are pregnant and notice that the baby is moving less than usual.

Also call your health care provider if your infant or child does not seem to be growing or developing normally.



Prevention:

Do not drink alcohol, smoke, or use recreational drugs. Eat healthy foods. Get regular prenatal care. If you have a chronic medical condition or take prescribed medications regularly, see your doctor before you get pregnant. This can help reduce any effects of your medical condition on your pregnancy and the baby.



References:

Baschat AA, Galan HL, Ross MG, Gabbe SG. Intrauterine growth restriction. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 31. 

Carlo WA. Prematurity andintrauterine growth restriction. In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders;2011:chap 91. 

Figueras F, Gardosi J. Intrauterine growth restriction: newconcepts in antenatal surveillance, diagnosis, and management. Am J Obstet Gynecol. 2011;204(4):288-300.




Review Date: 11/8/2012
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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