Intrauterine Growth Restriction Definition, Reason, Symptoms, Treatment & Prevention
Definition
Intrauterine growth retardation ( IUGR ) is a condition that describes a fetus in the womb experiencing growth retardation. In IUGR, the size of the fetus does not match the size it should be based on the gestational age.
The condition of intrauterine growth retardation is medically also referred to as intrauterine growth restriction or stunted fetal growth.
There are two types of IUGR, namely:
- Symmetrical IUGR, namely IUGR which is characterized by proportional baby body parts but overall small body size.
- Asymmetric IUGR, namely IUGR which is characterized by the normal size of the baby’s head but other body parts that are smaller than they should be.
Symptom
Intrauterine growth retardation (IUGR) does not cause any symptoms during pregnancy. In some mothers, sometimes it can be seen that the size of the stomach does not look as big as it should. But this is very subjective. IUGR is usually only discovered when the doctor conducts an examination.
However, if left unchecked, IUGR can cause complications in the baby – both during pregnancy and after the baby is born.
Complications during pregnancy can be premature birth, lack of oxygen while in the womb, or it can also lead to intrauterine fetal death ( IUFD ).
Meanwhile, if the baby manages to survive until it is finally born, complications that can occur include:
- Necrotizing enterocolitis (severe intestinal inflammation in newborns due to bacterial infection)
- Thrombocytopenia (lower than normal platelet count)
- Unstable body temperature
- Respiratory failure
- Nervous disorders and developmental disorders
- Kidney failure
Reason
Intrauterine growth retardation (IUGR) can be caused by maternal factors or placental and umbilical cord factors.
Things from the mother that can cause IUGR include hypertension, congenital heart disease, autoimmune disease, diabetes, malnutrition, blood clotting disorders, abnormal uterine shape, toxoplasmosis, rubella infection, cytomegalovirus infection, or smoking habits.
Meanwhile, problems in the placenta or umbilical cord that can cause IUGR include placental abruption, anatomical abnormalities of the umbilical cord, abnormalities of the blood vessels in the umbilical cord, and twin pregnancies.
Diagnosis
Intrauterine growth retardation (IUGR) is usually known by doctors when the mother undergoes a pregnancy control examination. At the time of routine examination, the doctor will assess the increase in fetal growth.
This can be done by measuring the height of the uterus with a measuring instrument, then confirming it with an ultrasound examination (USG). During an ultrasound examination, the doctor will measure the length of the bones, the diameter of the baby’s head, the amount of amniotic fluid, and several other parameters to determine whether IUGR is present or not.
If the diagnosis of IUGR has been confirmed by a doctor, then it is necessary to do an examination to find out the causes and complications that can occur. You do this by doing:
- CTG ( cardiotocography ) examination to measure fetal heart activity, fetal movement, and uterine contractions.
- Screening for infection, such as by carrying out a TORCH examination.
- Amniocentesis (sample of amniotic fluid)
Treatment
Intrauterine growth retardation (IUGR) therapy varies greatly, depending on the condition of the baby and the gestational age of the mother. The sure thing to do is that pregnancies will be monitored more closely than they should. Mothers should go to the doctor and do ultrasound more often to see the progress of fetal growth.
If IUGR is caused by an infection in the mother, treatment for the infection should be carried out as soon as possible. In addition, mothers will generally also be asked to consult with a nutritionist to improve their food intake. In some cases, the mother is also asked to rest or reduce activity to increase blood flow to the fetus.
If there is no significant growth improvement in the baby, sometimes doctors will suggest that the baby be born earlier.
Childbirth in babies who experience IUGR can be done by way of vaginal delivery (spontaneous delivery), it can also be by Caesarean section, depending on the condition of the mother, fetus, and birth canal. However, if the fetus is in distress which is characterized by an abnormal heart rate, usually a Caesarean section will be preferred.
Prevention
Not all cases of IUGR can be prevented. However, to reduce the risk of IUGR, mothers should do the following:
- Eat healthy foods, such as vegetables, fruit, and enough protein
- Sleep 6–8 hours at night
- Do not consume alcohol and drugs
- Avoid exposure to secondhand smoke