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Intrauterine Growth Restriction (IUGR)

What is Intrauterine Growth Restriction, IUGR, Menopause Center of Los AngelesIntrauterine growth restriction (IUGR) occurs when the baby grows at a slower pace than normally expected, and is unable to reach its full growth potential while in utero.

It’s difficult to say exactly how much a fetus weighs when it’s inside the mother, but if its estimated weight is below the 10th percentile, it’s considered to have IUGR. Babies with IUGR may be born small and/or undernourished.

Risks of IUGR

IUGR can put the baby at risk for complications during pregnancy, birth, and even after delivery.  Some of these risks include:

  • Low birth weight
  • Decreased oxygen
  • Low blood sugar (hypoglycemia)
  • Difficulty enduring the stresses of natural vaginal birth
  • High red blood cell count
  • Fluctuating body temperature
  • Susceptibility to infection
  • Meconium aspiration. These are breathing problems caused by the newborn inhaling its first stool, which can be prematurely expelled during a stressful labor, instead of after birth.
  • Low Apgar scores. Apgar tests evaluate a newborn’s health and assess its need for specialized care.

Causes of IUGR

Many factors can contribute to intrauterine growth restriction, but the common denominator of these causes is usually the placenta.

The placenta is responsible for feeding the baby, providing it with oxygen, and eliminating its waste. If the placenta can’t do its job, the baby won’t get enough nutrients to grow to a healthy weight. Here are some common conditions that interfere with the placenta:

  • Hypertension (high blood pressure)
  • Heart disease
  • Diabetes
  • Kidney disease
  • Lung disease
  • Anemia
  • Malnutrition
  • Infections such as toxoplasmosis, rubella, or syphilis
  • Smoking, alcohol use, or substance abuse

Carrying multiples (twins, triplets, etc.) also increases the likelihood that at least one baby will have IUGR.

How Will My Doctor Assess for IUGR?

Since we can’t take the baby out of its mother to weigh it, we’ve developed a handful of methods to arrive at a reasonable estimate of the baby’s size.

High-Risk Obstetrics, Intrauterine Growth Restriction, IUGR, Menopause Center of Los AngelesUltrasound

This is the most commonly used method for monitoring the baby’s progress.  Ultrasound imaging can be used to measure the fetus’s head and abdomen, which can provide a basis for calculating weight. It can also measure the volume of amniotic fluid in the uterus.

Weight of the mother

Your weight is measured and recorded at each prenatal appointment. If you are not gaining enough weight, it can be a sign that your baby isn’t gaining enough as well.  Your physician will be able to tell you how much weight you should be putting on at each phase of your pregnancy.

Doppler flow

A Doppler flow is a special ultrasound that uses sound waves to measure the rate of blood flow through the vessels. With the Doppler flow, your OB-GYN can estimate the amount of blood flowing through the umbilical cord and into the vessels of your baby’s brain.

Amniocentesis

This is when the doctor tests the amniotic fluid to check for infections and other abnormalities. The doctor retrieves the fluid through a needle inserted through the mother’s abdomen and into the uterus.

Electronic fetal monitoring

In this test, the doctor will place small electrodes on the skin of your abdomen to measure the baby’s heart rate.

Preventing IUGR

Intrauterine Growth Restriction can happen to even the healthiest of women, but there are some steps you can take to minimize the risk.

In general, take good care of yourself in order to take good care of your baby. Eat nutritiously and strive to get at least eight hours of sleep each night. As always, avoid alcohol, tobacco, and other unhealthy substances. And last, be sure to attend all of your prenatal appointments so that your doctor can keep an eye on your baby’s development.

IUGR Treatment

Improve your diet

Research has shown that when the mother improves her nutrition, those healthful effects are passed onto her fetus.

Get plenty of rest

It is always important to get a good night’s sleep.  However, in some cases, your doctor may recommend bed rest to conserve your energy for the baby’s growth.  Whether at home or in the hospital, bed rest has been shown to improve circulation to the fetus, enabling it to get more oxygen and nutrients from the placenta.

Deliver the baby

In severe cases, the doctor may recommend an early delivery. Your medical team may induce labor, or perform a Cesarean section depending on your individual case.

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