- 1 WHAT IS IT?
- 2 WHAT CAUSES IT?
- 3 WHY IS IT A PROBLEM?
- 4 WHAT MAKES US SUSPECT IT?
- 5 CLINICAL WORKUP
- 6 AT WHAT POINT DO WE FEEL CONFIDENT IN MAKING THE DIAGNOSIS?
- 7 WHAT ELSE ARE WE WORRIED ABOUT?
- 8 HOW DO WE TREAT IT?
- 9 HOW WELL DO THE PATIENTS DO?
- 10 WAS THERE A WAY TO PREVENT IT?
- 11 OTHER FACTS?
- 12 FURTHER READING
WHAT IS IT?
Fetal growth restriction (FGR)/Intrauterine growth restriction (IUGR) is a term whose criteria are often inconsistent. With this in mind, FGR can often refer to:
- Fetus with estimated weight < 10th percentile for gestational age
- Fetus with growth compromised by abnormal or pathological process (compared to constitutionally small fetus)
WHAT CAUSES IT?
This condition can often be an idiopatic complication of preganncy. With this in mind, it is beleived that some element of poor perfusion/poor nutriiton to the fetus is responsible for causing restricted growth. This can be secondary to a:
- Abnormal fetal karyotype: such as trisomy 21
- Abnormal placentation
- Complication of pregnancy: such as hypertensive complciations
- Intrauterine infections such as those causes by cytomegalovirus
WHY IS IT A PROBLEM?
Fundamentally a fetus that is not growing (receiving proper nutrition) is an ominous sign, and the life of the fetus may be in danger due to this condition.
WHAT MAKES US SUSPECT IT?
Prior FGR pregnancy, malnutrition, hypertensive disorders of pregnancy
- Smaller then expected fundus height during pregnancy visits
- Decreasing serial fetal weight measurements
History Of Present Illness
Poor maternal weight gain may be a point of history observed in women with FGR.
Physical Exam Findings
- Decreased symphysis fundal height: discrepancy of ≥ 3 between gestational age and symphysis fundal height measurements can raise suspicions.
Ultrasound assessment of fetal biometry:
- Commonly a fetus with estimated weight < 10th percentile for gestational age is used as the parameter for making the diagnosis.
AT WHAT POINT DO WE FEEL CONFIDENT IN MAKING THE DIAGNOSIS?
WHAT ELSE ARE WE WORRIED ABOUT?
HOW DO WE TREAT IT?
HOW WELL DO THE PATIENTS DO?
WAS THERE A WAY TO PREVENT IT?
Page Updated: 09.07.2016