Fetal growth retardation is when the baby's size determined by ultrasound throughout pregnancy is below the 10% percentile for gestational age (last menstrual period). This condition is also called intrauterine growth restriction (IUGR) or small for gestational age (SGA).
Types of IUGR
1-Symmetrical IUGR: . If intrauterine growth retardation affects the entire body and organs of the baby, it is called symmetric growth retardation.
2-Asymmetric IUGR: The development of the head area is normal, but if it causes a decrease in the fat tissues around the abdomen, it is called asymmetric growth retardation.
IUGR Risk Factors
-Genetic factors
-Maternal weight below 45 kg
-Inadequate nutrition during pregnancy, low weight gain
-Smoking, alcohol use
-Infections transmitted from mother to baby (CMV, rubella, parvovirus infections) in the early stages of pregnancy (especially before the 20th week of gestation).
-Chromosomal disorders in the baby (most commonly trisomy 18, trisomy 13, trisomy 21) and congenital malformations.
-Multiple pregnancies.
-Hypertension in pregnancy
IUGR Diagnosis
p>The most important factor in the diagnosis of IUGR is the correct determination of gestational age. Gestational age is calculated according to the last menstrual date and early ultrasound (especially 8 and 9 weeks).
Detection of fetal growth retardation after the gestational age is determined precisely;
-Expected gestational age in ultrasound measurements If the baby's measurements are small for its age,
- Abnormal findings on Doppler ultrasound are evaluated.
Management of Pregnancy
In babies with intrauterine growth retardation There is a risk of both death in the womb and hypoxia and metabolic acidosis during birth. For this reason, it is necessary to follow the growth and well-being of the baby in the womb very closely.
Gestational age (gestational week) and the baby's condition are very important in determining the appropriate birth time. The decision to give birth can be easily made for babies who are at term or near term (term). The real problem is babies whose gestational age is too small. For these babies, biophysical profile test (BPP), amniotic fluid amount, NST and Doppler ultrasonography of fetal vessels Various tracking methods such as i are used.
Biophysical profile: Made with USG. It is especially evaluated in terms of low amniotic fluid. In this case, birth is usually given.
Doppler Ultrasound: Especially umbilical artery flow is very important. In cordocentesis performed on fetuses without end diastolic flow, hypoxia (lack of oxygen) was observed in 80% of them.
IUGR Treatment
There is no specific treatment for growth restriction in the period far from term (time of birth). .
It is thought that giving oxygen to the mother reduces hypoxia that may develop in the baby.
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