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Intrauterine growth retardation

from Latin: intra - within, uterus - womb, retardus - retarded, delayed
Synonym: IUGR, prenatal dystrophy, fetal hypotrophy
German: Intrauterine Wachstumsretardierung

1 Definition

Intrauterine growth retardation, in short IUGR, is a pathological retardation of the growth of a fetus in the uterus. The affected fetuses or newborns are called SGA children ("small for gestational age").

2 Background

You talk about an IUGR when size and weight of the fetus lie below the 10th percentile. However, only in a part of these fetuses, there are actually pathological factors to be found. A more specific threshold would be one oriented on the 5th percentile - however, a number of endangered infants would eventually be overlooked then.

3 Etiology

Causes can be genetic or due to environmental factors. They can lie with the infant or be caused by the mother or her placenta, respectively.

3.1 Fetal causes

3.2 Placental causes

3.3 Maternal causes

4 Classification

You can differentiate between two forms of IUGR:

  • asymmetrical form
  • symmetrical form

In the more frequent assymmetrical form (app. 70% of cases), at first, only the body weight is affected - size is normal, but the abdominal girth is significantly reduced. Due to the lack of subcutaneous fatty tissue, the body is thin and small, and its proportions donít fit to the head.

In the more rare symmetrical form (20-25%), the body weight as well as the body length (size) of the fetus are reduced. The head circumference has the right relation to the rest of the body, but the growth of the fetus in total is retarded.

5 Diagnostics

IUGR is detected during the prenatal care exams, with the fetometry carried out during sonography in The 2nd or 3rd trimester.

Further diagnostics and supervision of the child comprises among others:

6 Consequences

Intrauterine growth retardation is responsible for around 1/4 of all stillbirths. Also, after a successful birth, the affected children have a higher risk of mortality. There are CNS damages that, further on, lead to neurological deficits and delayed speech development. IUGR also increases the risk for cardiovascular diseases and diabetes mellitus later in life.

7 Therapy

Therapy depends on the cause. The primary measure is to take out possible noxious agents (alcohol, nicotine etc.). A goal of further treatment is the improvement of placental perfusion. Bedrest is often prescribed preventively - sometimes with hospital admission. In severe cases, birth is inducted already before the 37th Week of pregnancy.

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