The diagnosis of FGR is made by doctors to all children who at birth are underweight relative to their gestational age. Many women learn about this pathology during pregnancy. From the materials of this article, you will learn what symptoms accompany the syndrome of fetal growth retardation, why it occurs.
SZRP - what is it?
Fetal growth retardation syndrome (FGR) is a pathology characterized by a lag in the size of the baby from the average values fixed as the norm for a certain period of pregnancy. In Russia, the prevalence of this disorder ranges from 5 to 18%. The small size of the child does not always indicate this syndrome. About 70% of children diagnosed with this diagnosis are naturally small. Their father or mother may be small in stature. In addition, gender should be taken into account (girls are usually 5% smaller than boys, which is approximately 200 g) and nationality.
As a rule, the condition of the baby is compensated during the firstyears of life. He is gradually gaining weight and gaining height, approaching the normative indicators. If a diagnosis confirmed by a doctor becomes the main cause of a child’s developmental delay, affects his he alth and quality of life, a special treatment complex is considered.
There are two forms of FGR: symmetrical and asymmetric. Each type of pathology has its own characteristics. We will talk about them later in this article.
Asymmetric shape of FGR
Pathology usually occurs in the second trimester and is characterized by a lack of fetal weight with normal growth. The child has a lag in the development of the tissues of the abdomen and chest. Asymmetric FGR is sometimes characterized by uneven formation of internal organ systems. In the absence of timely treatment, there is a decrease in the size of the child's head and a lag in the development of the brain, which can provoke his death.
Symmetric shape of FGR
Pathology is characterized by a proportional decrease in the size of the child's body relative to the average values for a particular gestational age. It is usually diagnosed in the second trimester. The symmetrical form of the syndrome in most cases is due to intrauterine infection of the fetus, chromosomal abnormalities. Children with this diagnosis are born with inferior development of the central nervous system.
Main causes of pathology
A baby can be born small for several reasons. We should not exclude the fact that this is its physiological feature. Short height babycan inherit from parents. However, even in this case, the doctor will diagnose "fetal growth retardation syndrome." If, after birth, the child's body is fully functioning, and his reflexes are in accordance with the norms, specific treatment is not required.
Doctors identify certain causes of FGR, which can lead to hypoxia and even fading of pregnancy. Developmental delay is observed if the baby inside the womb does not receive oxygen and the necessary nutrients. Without them, it is impossible to imagine the full life of the body.
Reducing the amount of inputs can be caused by many factors:
- Placental problems. This organ is responsible for transporting oxygen to the fetus in the womb. If the placenta is deformed, it cannot function fully.
- Pathologies in the work of internal organs in a future woman in labor (high blood pressure, anemia, heart and respiratory diseases, diabetes mellitus).
- In the development of the fetus, a special role belongs to the chromosome set that it receives from its parents.
- Bad habits. Many of the fair sex smoke and drink alcohol. Bad habits, even if a woman has given up them shortly before conception, can cause FGR during pregnancy.
- Doctors constantly say that a pregnant woman should literally eat for two. It really is. Dieting or a sharp reduction in calorie intake can adversely affect the child. If the fetus lacks nutrients, it starts themtake from the mother's body. Eating for two doesn't mean you have to eat everything. The diet should be balanced and consist exclusively of he althy foods. During pregnancy, you should not be afraid to get better, it is strictly forbidden to sit on strict diets.
- Medication taking. From medicines during the bearing of the baby should be discarded. You can take drugs only on the advice of a doctor, when nothing else can help.
- Infectious diseases transferred during pregnancy (rubella, toxoplasmosis, syphilis) can stop the development of the fetus. That is why doctors strongly advise getting vaccinated long before conception.
- FGR 2 degrees are often given to women who live in areas high above sea level. In such regions, the pressure is increased, and this often leads to hypoxia in the fetus and its slow development.
Timely determination of the cause of the syndrome and its subsequent elimination allow the doctor to choose an effective treatment.
What are the symptoms of fetal growth retardation syndrome?
The clinical picture of this pathology is usually erased. A pregnant woman is unlikely to be able to suspect such a diagnosis on her own. Only regular follow-up with a gynecologist for nine months allows you to identify the problem in a timely manner.
There is an opinion that if a woman gains little weight during pregnancy, most likely the fetus is small. This is partly true, but it is rarely true. Whenthe future woman in labor limits the daily diet to 1500 kcal, is fond of diets, the probability of the appearance of fetal sdfd is quite high. On the other hand, the occurrence of pathology should not be excluded in those women who experience excessive weight gain.
Rare and sluggish fetal movements are considered a clear sign of the syndrome. Such a symptom should alert and become a reason for an emergency visit to a specialist.
Examination for fetal growth retardation
If the pathological development of the baby is suspected, the doctor may be alerted by the discrepancy between the height of the fundus of the uterus and the normative indicators characteristic of this particular gestational age. The most reliable diagnostic option is an ultrasound examination of the fetus, during which a specialist evaluates its size and weight. In addition, with the help of ultrasound, you can determine the state of the systems of the internal organs of the child.
Doppler is also prescribed for suspected sdfd. What it is? This examination is carried out to assess the blood flow in the vessels of the baby and the placenta. Fetal cardiotocography (heartbeat study) is considered an important diagnostic method. Normal heart rate ranges from 120 to about 160 beats per minute. When a baby in the womb experiences a lack of oxygen, his heart rate gradually increases.
Based on the results of the examination, the doctor can confirm the diagnosis and determine the severity of the disease.
- SZRP of the 1st degree is considered the easiest, characterized by a developmental lag from the average anthropometric data by twoweeks.
- FGR 2 degrees differs from the normative indicators within two to four weeks.
- The most severe is the 3rd degree of FGR. The size and weight of the baby in the womb are not within the norm for more than four weeks. In most cases, grade 3 FGR results in fetal freezing.
Treatment methods
To treat this syndrome in obstetrics, a large arsenal of drugs is used that are aimed at normalizing uteroplacental blood flow.
- Tocolytic agents for relaxing the uterus (Ginipral, Papaverine).
- Drugs for the normalization of metabolism in tissues ("Kurantil", "Actovegin").
- Infusion therapy using glucose and blood substitute solutions.
- Vitamin therapy.
All drugs are prescribed for a long time with constant monitoring of the fetus.
Special attention in the treatment of FGR during pregnancy is given to nutrition. The diet should be as balanced as possible. It is not recommended to lean on certain products. You can eat absolutely everything. Meat and dairy products should not be excluded, as they contain a large amount of animal protein. It is in it that by the end of pregnancy the need increases by about 50%. It is important not to forget that the main goal of therapy is not to fatten the child, but to provide him with full growth and harmonious development.
Pregnant women are also recommended daily walks, emotional calmness. It is traditionally believed that midday sleep has a beneficial effect not only on the condition of the future woman in labor, but also on the baby inside the womb.
Management of pregnancy with FGR
After confirming the final diagnosis, the future woman in labor needs constant monitoring by specialists. Ultrasound is prescribed at least twice a month. A detailed study is necessary to identify the anatomy of the child and structural defects that may be the cause of delays. Also, future women in labor are prescribed an amniocentesis procedure to assess chromosomal abnormalities if pathologies were detected on ultrasound.
Regardless of what factors contributed to the occurrence of FGR, the consequences for the child may be irreversible. To prevent them, a woman should undergo an ultrasound examination every two weeks. It is necessary to assess the size of the fetus and its growth rate.
When a woman is in her 37th week, doctors usually decide to induce labor. Until this period, pregnancy management depends on the condition of the crumbs inside the womb. If a woman develops symptoms of preeclampsia, doctors decide to have a preterm birth.
Possible complications and consequences
In children with this syndrome, serious complications are often recorded, not only during intrauterine life, but also after birth. The degree of risk directly depends on the causes of the pathological process, its severity and time of onset. According to statistics, the presencecomplications are most likely in those children whose birth weight does not exceed 1 kg.
Due to the fact that the fetus with this syndrome does not receive enough oxygen and nutrients, such children may be born already dead. They are often unable to withstand the strain of labor, so doctors usually decide to have a caesarean section.
In children born with FGR, the consequences of this diagnosis are directly reflected in the work of the main systems of the internal organs. They usually have hypoglycemia, poor resistance to infections. They are prone to jaundice and meconium aspiration, which is the inhalation of original feces.
If doctors diagnose grade 2 FGR, the consequences of the pathology are almost impossible to predict. The quality of life of the child primarily depends on the underlying causes of the syndrome. Some babies gradually catch up with their peers in development. Others have serious he alth problems. They are diagnosed with obesity early, which subsequently leads to heart failure, diabetes and hypertension.
Prevention measures
Should not be left without attention to FGR. What is it, we have already told. Can it be prevented?
The best prevention of FGR is advance pregnancy planning. Before the direct conception of a child, future parents must pass a number of tests, treat chronic diseases. Sexual ailments and caries should not be ignored.
Regular visits togynecologist after registration for pregnancy play an important role in the prevention of sdfd. The sooner the doctor detects the pathology, the higher the likelihood of eliminating dangerous complications in the development of the baby during gestation and after birth.
A pregnant woman should take care of her work and rest schedule. Full sleep should be at least 10 hours at night and 2 hours during the day. If you can’t sleep after dinner, you can allow yourself to lie down in a horizontal position for a while. Daytime sleep helps to normalize blood circulation between the baby and mother, improve the transfer of nutrients.
Outdoor walks, a balanced diet and moderate exercise are excellent prevention of FGR. What does it mean? A woman should eat exclusively he althy food, rich in vitamins and minerals. For some women, doctors recommend a diet high in carbohydrates, as these substances improve the mood of the pregnant woman and the well-being of the fetus inside the womb. As for the issue of physical activity, yoga classes, swimming in the pool are an excellent solution.
Fetal growth retardation syndrome is not a sentence for future parents who are looking forward to the arrival of a baby. A huge role in the treatment of this pathology belongs to the timeliness of the diagnosis. However, its seriousness is not a reason to abandon the child. There are no obstacles that loving parents cannot overcome. Especially when it comes to true maternal happiness.
