Approximately every tenth woman in position, the doctor diagnoses "fetal growth restriction" (IUGR). The specialist determines the presence of deviations, characterized by a discrepancy between the size of the baby and the normative indicators for a particular week of development. How dangerous this pathology is in reality and how it threatens the child, it is important for every mother to know, because absolutely no one is immune from such a phenomenon.
What is an IUGR?
Intrauterine growth retardation is usually diagnosed by ultrasound. Pathology is determined if the weight of the baby is less than the normative indicators characteristic of this period of development. In medical practice, specially designed tables are used that indicate the weight of the fetus in accordance with its gestational age.age, that is, the time since fertilization. This indicator is usually determined in weeks. In other words, there are certain norms for each stage of pregnancy. The basic unit of measure in such tables is the percentile. If the fetus is less than the 10th percentile on this table, the doctor confirms the presence of pathology.
Intrauterine growth retardation: causes
Sometimes parents don't have to worry when diagnosed with IUGR. It happens that the baby is born small in size, since his father and mother are not very tall. This physiological feature does not affect the activity of the child, his mental and physical development. During pregnancy and after birth, such a baby does not need narrowly targeted therapy.
In all other situations, special attention should be paid to the diagnosis. This condition can lead to deviations in the development of the child or even death of the fetus. IUGR may indicate that the baby in the womb is not eating well. This means that it does not receive sufficient nutrients and oxygen. Nutritional deficiencies are usually attributed to the following reasons:
- Wrong chromosome set.
- Bad habits of the mother (smoking, drinking alcohol and drugs).
- Pathogenic diseases (hypertension, anemia, diseases of the cardiovascular system).
- Incorrect position and subsequent formation of the placenta.
In addition, doctors name a number of other reasons thatcan also provoke intrauterine growth retardation syndrome:
- Multiple pregnancy.
- Use of drugs without a doctor's prescription.
- Delivery after 42 weeks.
- Irrational nutrition. Many women do not want to get better during pregnancy, so they exhaust themselves with diets. By doing this, they provoke the exhaustion of the body, which leads to the development of pathology.
- Diseases of an infectious nature (toxoplasmosis, rubella, syphilis).
Clinical picture
What are the symptoms of intrauterine growth retardation? Signs of pathology appear most often in the early stages (approximately 24-26 weeks). A woman is not able to determine them on her own, this can only be done by a doctor. IUGR syndrome is diagnosed when the following indicators do not meet the standards:
- Baby head and femur size.
- The circumference of the abdomen at a certain level, the height of the uterine fundus.
- Amniotic fluid volume.
- Violation of the functioning of the placenta (its structure and size change).
- Fetal heart rate.
- Velocity of blood flow in the placenta and umbilical cord.
In some cases, the pathology develops quite quickly and progresses without any special disturbances, that is, it is asymptomatic.
Degrees of severity
- I degree. Retardation of intrauterine development of the fetus 1degree is considered relatively mild, since the developmental lag from anthropometric data corresponding to a certain gestational age is only two weeks. Timely prescribed therapy can be effective and minimize the likelihood of negative consequences for the baby.
- II degree. Developmental delay is approximately 3-4 weeks, serious treatment is required.
- III degree. It is considered the most severe form due to the delay in fetal parameters by one month or more. This condition is usually accompanied by so-called organic changes. Degree 3 intrauterine growth retardation often ends in death.
Asymmetric form of pathology
In this case, there is a significant decrease in the weight of the fetus with its normal growth. The child is diagnosed with a lag in the formation of soft tissues of the chest and abdomen, and an abnormal development of the trunk. Uneven growth of internal organ systems is possible. In the absence of adequate therapy, a gradual decrease in the size of the head and a lag in the development of the brain begin, which almost always leads to the death of the fetus. The asymmetric variant of the IUGR syndrome occurs mainly in the third trimester against the background of general placental insufficiency.
Symmetrical form of pathology
With a symmetrical form, a uniform decrease in the mass, size of organs and growth of the fetus is observed. This pathology most often develops in the early stages of pregnancy due to fetal diseases (infection, chromosomalanomalies). Symmetrical intrauterine growth retardation increases the likelihood of having a child with a defective CNS.
Diagnostic measures
If this pathology is suspected, a woman is recommended to undergo a full diagnostic examination. First of all, the doctor collects the patient's history, clarifies the previous gynecological diseases, the features of the course of the previous pregnancy. Then a physical examination is carried out with the obligatory measurement of the circumference of the abdomen, the fundus of the uterus, the height and weight of the woman.
Additionally, ultrasound, dopplerometry (assessment of blood flow in the arteries and veins) and cardiotocography (continuous recording of the fetal heart rate, its activity and directly uterine contractions) may be required. Based on the results of the tests, the specialist can confirm the diagnosis or refute it.
What treatment is needed?
To determine the subsequent management of pregnancy after confirming the diagnosis of intrauterine growth retardation, the causes of the pathology, the form and degree of the disease should be taken into account. The main principles of therapy should be focused on improving blood flow in the uterus-placenta-fetus system. All therapeutic measures are carried out in stationary conditions. First of all, a woman needs to ensure peace, good nutrition and a good long sleep. An important element of therapy is the control of the current state of the fetus. Forfor these purposes, ultrasound examination every 7-14 days, cardiotocography and dopplerometry of blood flow are used.
Drug treatment includes taking angioprotectors to protect blood vessels, tocolytics against muscle tension of the uterus ("Papaverine", "No-shpa"), restorative agents. In addition, all women, without exception, are prescribed drugs that reduce neuropsychic excitation (tincture of motherwort, valerian) and improve blood flow in the placenta (Actovegin, Curantil).
Depending on the severity of the pathology, the results of treatment may vary. Delayed intrauterine development of the fetus of the 1st degree usually responds well to therapy, the likelihood of further negative consequences is minimized. For more serious pathologies, a different approach to treatment is needed, while its results are difficult to predict.
Abortion
Early delivery regardless of gestational age is recommended in the following cases:
- No fetal growth for 14 days.
- A noticeable deterioration in the condition of the baby inside the womb (for example, a slowdown in blood flow in the vessels).
Pregnancy is maintained up to a maximum of 37 weeks in the event that, due to drug therapy, there is an improvement in performance, when it is not necessary to talk about the diagnosis of intrauterine growth retardation.
Consequences and possible complications
Baby with this pathology afterbirths may have deviations of varying severity, their subsequent compatibility with normal life will largely depend on their parents.
The first consequences appear already during delivery (hypoxia, neurological disorders). The intrauterine growth retardation of the fetus inhibits the maturation of the central nervous system and its functions, which affects all systems. In such children, the body's defenses are usually weakened; at a more mature age, there is an increased likelihood of ailments of the cardiovascular system.
Children under the age of five are often diagnosed with slow weight gain, psychomotor retardation, abnormal formation of internal organ systems, and hyperexcitability. Teenagers are at high risk of developing diabetes. Such children are usually overweight, they have problems with blood pressure. This does not mean that their daily existence will be reduced to taking medications and living in hospitals. They just need to pay a little more attention to their own nutrition and daily physical activity.
Some babies who have been diagnosed with grade 2 intrauterine growth retardation and treated appropriately are no different from their peers. They lead a normal life, play sports, communicate with friends and get an education.
How can IUGR be prevented?
The best prevention of this pathology is the planning of an upcoming pregnancy. Approximately forsix months, future parents must undergo a comprehensive examination and treat all existing chronic diseases. Giving up bad habits, a proper lifestyle, a balanced diet and daily dosed physical activity is the best way to prevent IUGR.
A visit to the antenatal clinic on a regular basis after registration plays an important role in the diagnosis of intrauterine growth retardation. Treatment of a timely detected pathology minimizes the risk of negative consequences.
Pregnant women should have a well-organized work and sleep schedule. Proper and proper rest means 10 hours of sleep at night and 2 hours during the day. This regimen improves circulation and nutrient transport between mother and baby.
Daily walks in the fresh air, dosed physical activity not only improve the overall well-being of a pregnant woman, but also normalize the condition of the fetus inside the womb.
Conclusion
You should not ignore such a pathology as intrauterine growth retardation, the consequences of which can be the saddest. On the other hand, parents should not take this diagnosis as a sentence. If it is delivered in a timely manner, the future woman in labor will take all necessary measures to eliminate its cause and will follow all the doctor's recommendations, the prognosis may be favorable. There are no obstacles in the world that cannot be overcome. It is important to remember thatthe happiness of motherhood is incomparable!
