IUGR, also known as intrauterine growth restriction, is a condition whereby the size of the fetus is smaller than it should be for those specific weeks of the pregnancy. Fetal growth restriction is the other term used to describe IUGR. When a baby is born with IUGR he is often described as being too small for the gestational age.

A fetus with IUGR has fetal weight that is ten percentiles less than normal, and can be born prematurely (before the 37 weeks) or at term (after the 37 weeks). Newborns that have IUGR often look pale, thin and have dry, loose skin. The umbilical cord is also often dull and thin rather than fat and shiny. Even so, there are some babies with IUGR that do not have a malnourished appearance, but are still small.

Why Should IUGR Be a Concern?

Delayed growth normally puts your baby at risk of some health problems during pregnancy and delivery and even after birth. Some of these health problems include:

• Decreased levels of oxygen
• Difficulty during vaginal delivery because it becomes hard to handle the stresses involved.
• Low birth weight
• Low blood sugar (hypoglycemia)
• Low infection resistance
• Low Apgar scores (they are the tests newborns are given to determine their physical condition and whether they require any special medical attention)
• Difficulty maintaining the body temperature
• An abnormal RBC count
• Meconimum aspiration which can cause problems (this is when the baby inhales stools passed when in the uterus)
• In severe cases, IUGR causes stillbirth and growth problems (long-term)

What Causes IUGR?

IUGR results when an abnormality or problem prevents tissues and cells from growing or when it causes cells to reduce in size. This can occur when the fetus receives insufficient oxygen and nutrients responsible for development and growth of tissues and organs. It can also be the result of an infection. Although there are babies that are born small because of their genes (their parents have small bodies), IUGR is caused by other factors. These factors include:

• Chronic Kidney disease
• Infection
• Anemia, malnutrition
• Respiratory or heart disease
• Advanced diabetes
• Cigarette smoking
• Substance abuse (drugs, alcohol)

Factors involving placenta and uterus:

• Infection of tissues that surround the uterus
• Placenta previa (where the placenta attaches itself low in the uterus)
• Placenta abruption (where the placenta detaches itself from uterus)
• Decreased flow of blood in the placenta and uterus

Factors related to development of the fetus (baby):

• Chromosomal abnormality
• Birth defects
• infection
• Multiple gestation (example triplets or twins)

What Are the Symptoms and the Diagnosis of IUGR?

1. Symptoms

The main symptom is a baby who is small for that specific gestational age. More specifically, the baby’s weight is less that the weight of 90% of all babies in the same gestational age. The baby may also look malnourished or small. The baby may be pale, thin and have loose dry skin. The umbilical cord in IUGR babies also looks dull and thin instead of looking shiny and thick.

2. Diagnosis

While there are many ways of estimating a baby’s size during birth, one of the most common and simplest ways is to measure the distance from the fundus (top of uterus of the mother) to the pubic one. After twenty weeks of pregnancy, that measurement should correspond with the number of weeks. If the measurement is lower than expected it is a sign that the baby’s growth is not as it should be. Other procedures to diagnose IUGR include the followings:

Procedures	Description
Ultrasound	It is done to determine the measurement of the baby’s abdomen and head. It is also used to tell the amount of amniotic fluid that is in the uterus. If the amniotic fluid is low, it could signify IUGR.
Doppler flow	It is the use of sound waves to determine the speed and mount of blood that is flowing through the baby’s blood vessels. Doctors can also use this to check the blood flow via the vessels in your baby’s brain and umbilical cord.
Weight checks	Doctors make routine weight checks of the pregnant woman and the weight gain is also used to measure the growth of the baby. If the mother does not gain weight, it could mean that there is a problem with the baby.
Fetal monitoring	This is where sensitive electrodes are places on the pregnant woman’s abdomen. The electrodes are kept in place by a lightweight stretching band and the band attached to the monitor. The sensors measure the baby’s heart pattern and rate.
Amniocentesis	This is a procedure whereby a needle is pierced in the mother’s abdomen to the uterus to withdraw some amniotic fluid. The fluid is used in tests, which may detect any chromosomal abnormalities or infection that could cause IUGR.

What Are the Treatments for IUGR?

Management of IUGR mostly depends on the growth restriction severity and how early in pregnancy that problem began. Generally, the earlier the problem begins and the more severe it is, the more harmful it will be to your unborn baby. Even though it is impossible to reverse IUGR, the following can be done to minimize or slow the effects:

1. Delivery

If your baby’s well-being is put at risk by the IUGR, your doctor may decide that it is best to deliver your baby early. Should it happen that the baby is too weak to handle the stresses involved during normal delivery, a cesarean section is a safer option of delivery.

2. Improve Nutrition

There are some studies that have shown that when a mother increases her nutrition, the baby is able to grow and gain weight in the uterus.

3. Bed Rest

Whether at home or in hospital, bed rest can help to improve fetal circulation.

Check the video below and see how nutrition helped this family out:

How Can IUGR Be Prevented?

Although IUGR can occur even when the mother is completely healthy, there are some things that she can do to reduce the risks of having IUGR:

• Attend all prenatal appointments. When a problem is detected early, it is able to be treated before much damage is done.
• Listen to the baby’s movements. If the baby does not move or stops moving, chances are there is something wrong. If you notice any changes, do not fail to mention it on your next doctor’s appointment.
• Check the medication you are taking. There are times when you may be taking medication to treat some other condition and it brings problems to your unborn baby.
• Eat ample calories and healthy foods so that your baby will be well nourished.
• Get lots of rest as it helps your unborn baby grow.
• Practice healthy lifestyle habits. Stop taking drugs, alcohol and smoking for your baby’s health.

When to Seek Medical Help: Contact your doctor immediately if you are expectant and notice that your baby’s movements are less than normal. Also, call your doctor if your infant’s growth and development is not normal.