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IUGR

IUGR, or intrauterine growth restriction, refers to poor growth of the fetus in the womb, with birth weight below the 10th percentile for gestational age. There are two main types - asymmetrical growth retardation, where weight or abdominal circumference is lower than head size, often due to inadequate placental nutrition late in pregnancy. Symmetrical IUGR equally reduces all growth, suggesting prolonged poor growth and potential causes include fetal abnormalities or maternal health issues. Complications can include intrauterine hypoxia, birth asphyxia, hypoglycemia and hypothermia. Diagnosis involves maternal history, fetal exams and ultrasounds to monitor growth, activity and fluid levels. Management focuses on early diagnosis, monitoring

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4K views11 pages

IUGR

IUGR, or intrauterine growth restriction, refers to poor growth of the fetus in the womb, with birth weight below the 10th percentile for gestational age. There are two main types - asymmetrical growth retardation, where weight or abdominal circumference is lower than head size, often due to inadequate placental nutrition late in pregnancy. Symmetrical IUGR equally reduces all growth, suggesting prolonged poor growth and potential causes include fetal abnormalities or maternal health issues. Complications can include intrauterine hypoxia, birth asphyxia, hypoglycemia and hypothermia. Diagnosis involves maternal history, fetal exams and ultrasounds to monitor growth, activity and fluid levels. Management focuses on early diagnosis, monitoring

Uploaded by

Anastasiafynn
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
  • Intrauterine Growth Restriction (IUGR): Introduces the concept of Intrauterine Growth Restriction, setting the stage for detailed exploration of causes and management.
  • Definition: Defines IUGR, describing its characteristics and criteria for diagnosis based on foetal growth metrics.
  • Types: Explains the asymmetrical and symmetrical types of IUGR, with details on growth patterns and possible causes.
  • Problems: Highlights problems associated with IUGR before and after birth, emphasizing hypoxia, hypoglycemia, and other metabolic issues.
  • Diagnosis: Outlines diagnostic approaches for IUGR including clinical examination and ultrasound studies to evaluate foetal growth and condition.
  • Management: Discusses management strategies for IUGR, focusing on monitoring techniques and preemptive care to prevent complications.
  • Outcome or Prognosis: Explores the long-term outcomes and prognosis for children born with IUGR, with attention to potential developmental challenges.

INTRAUTERINE GROWTH RESTRICTION/RETARDATION (IUGR)

DEFINITION
Poor growth of the foetus in-utero Birth weight below the 10th percentile for gestational age is said to be Small for Gestational age (SGA) or Small for Date. Includes 3 categories of neonates: [Link] to foetal malnutrition [Link] intrauterine events 3. Normal but lighter than 90% of the population. Majority of these neonates are normal but small

TYPES
Classically 2 groups ASYMMETRICAL GROWTH RETARDATION -More common -weight or abdominal circumference lies on a lower centile than that of the head -occurs when there is inadequate placental supply of nutrition late in pregnancy

-Brain growth is relatively spared at the expense of liver glycogen and skin fat -Associated with maternal pre-eclampsia, cardiac or renal disease, multiple gestation OR Idiopathic -Infants rapidly put on weight after birth,(catch-up weight) usually from age 3mths

SYMMETRICAL
Head circumference is equally reduced Suggests a prolonged period of poor IU growth Causes: -small but normal baby -foetal chromosomal disorder -congenital infection -maternal smoking, drug and alcohol abuse, chronic medical condition or malnutrition Likely to remain small permanently.

PROBLEMS
IN UTERO: Intrauterine hypoxia and death Birth asphyxia AFTER BIRTH Hypothermia due to relatively large surface area Hypoglycaemia from poor fat and glycogen stores Hypocalcaemia Polycythaemia

DIAGNOSIS
INTRAUTERINE Maternal history and clinical [Link] estimation of feotal size and weight,foetal activity,serial fundal height measurements Ultrasound studies [Link] of amniotic fluid etc. Foetal heart rate monitoring-late decelerations etc. Biochemical and biophysical tests of feotoplacental function

NEONATAL Mainly physical signs -low birth weight for gestational age -wasted, tissue wasting -decreased skin-fold thickness -decreased breast tissue, -head circumference may be low - Peeling of skin, long nails

MANAGEMENT
INTRAUTERINE Early diagnosis and monitoring is key for decisions -feotal size assessment, -Antenatal cardiotocography (CTG) - serial ultrasound measurements of growth,activity, breathing and amniotic fluid volume - Doppler ultrasound for blood flow studies

BIRTH RISKS: -Intrapartum death, Low Apgar scores, Meconium staining and aspiration syndrome -SKILLED RESUSCITATION -Prevention of heat loss -Monitoring for hypoglycaemia and treatment

OUTCOME OR PROGNOSIS
Increased risk for long term neurological and behavioural handicaps for survivors SGAs are more vulnerable to perinatal complications than others Morbidity and mortality are increased More likely to be readmitted to hospital within 2 yrs of birth Many will ultimately be slimmer and shorter than their peers.

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