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


Ultrasound, normal fetus - arm and legs
Ultrasound, normal fetus - arm and legs


Ultrasound, normal fetus - face
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


Definition:

Intrauterine growth restriction refers to the poor growth of a baby while in the womb. Specifically, it refers to a fetus whose weight is below the 10th percentile for its 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 nutrition because of:

  • Heart disease in the mother
  • High altitudes
  • Multiple pregnancies (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 fetus, such as rubella, cytomegalovirus, toxoplasmosis, and syphilis may also affect the weight of the developing baby.

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

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

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

Depending on the cause of IUGR, the fetus may be symmetrically small, or have a head that is normal size for gestational age, while the remainder of the fetus is growth restricted.



Symptoms:
  • Currently pregnant with a feeling that the baby is not as big as it should be
  • Uterine fundal height less than expected for gestational age


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 for intrauterine death. If this condition is suspected, the pregnant woman will be closely monitored with several 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 may be necessary.



Support Groups:



Expectations (prognosis):

The prognosis for normal newborn growth and development varies by the degree and cause of IUGR. Prognosis should be discussed with your obstetrician and pediatrician.



Complications:

Depending on the specific cause, IUGR increases the risk for a variety of pregnancy and newborn complications. Infants may have a non-reassuring 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:

Control risk factors during pregnancy, when possible. Avoid alcohol, smoking, and drug use, and get regular prenatal care.



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. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2007:chap 29.

Williams DE, Pridjian G. Obstetrics. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 29.




Review Date: 2/19/2009
Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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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Phone: (603) 742-5252
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