Foetal Growth Restriction

There are two types of IUGR:

• In symmetrical IUGR, the whole body grows smaller than normal.
• In asymmetrical IUGR, the head grows normally, but the rest of the body is smaller.

Mothers usually do not experience symptoms themselves, so regular prenatal check-ups are essential. Doctor’s may notice:

• A smaller baby bump than expected for the stage of pregnancy.
• Low levels of amniotic fluid (the fluid surrounding the baby) may be detected.

Several factors can lead to IUGR:

• Placental issues occur when the placenta, which delivers oxygen and nutrients to the baby, does not function properly, affecting the baby’s growth.
• Maternal health conditions such as hypertension, diabetes, or certain infections may increase the risk of IUGR.
• Lifestyle factors including smoking, drinking alcohol, or poor nutrition during pregnancy can contribute to growth restriction.
• Multiple pregnancies may cause babies to compete for space and nutrients, which increases the risk of IUGR.
• Chromosomal abnormalities may also restrict foetal growth due to genetic issues.

Doctors may use one or more tests to diagnose IUGR:

• Measuring the fundal height, which is the distance from the top of the uterus to the pubic bone, helps determine the foetal size. If the measurement is smaller than expected for your stage of pregnancy, further investigations are required.
• An ultrasound provides a detailed view of the foetal growth and gives accurate measurements of the head, abdomen, and femur length, which helps identify possible growth restrictions.
• Doppler ultrasound checks the blood flow in the umbilical cord and other vessels to assess whether the baby is receiving enough oxygen and nutrients.
• A non-stress test monitors the baby’s heartbeat to ensure that the baby is not under stress.
• Amniocentesis may be performed to detect genetic abnormalities affecting foetal growth.

Here are the key approaches:

• Close monitoring involves frequent ultrasounds and check-ups to track the baby’s growth.
• Managing the mother’s health, such as controlling high blood pressure, diabetes, or other conditions, helps reduce risks.
• Healthy nutrition through a balanced diet or supplements is recommended if needed to support the baby’s growth.
• Bed rest may be advised in some cases to improve blood flow to the baby.
• Early delivery may be necessary if the baby’s health is at risk; doctors may induce labour or perform a caesarean section. 

The availability of high-risk pregnancy care is crucial for the timely detection and management of IUGR.

Regular prenatal visits are key to detecting IUGR early. However, you should seek medical advice if:

• You notice a significant decrease in foetal movements (you should feel approximately 10 movements every 12 hours in the later stages of pregnancy).
• You have sudden or severe symptoms like intense headaches, vision changes, or swelling, especially if you have conditions like hypertension (high blood pressure).

One or more of the following methods are recommended for the prevention of IUGR:

• Healthy diet throughout pregnancy greatly helps support the baby’s growth.
• Quitting smoking and avoiding alcohol completely helps protect your baby’s development.
• Attending all your scheduled appointments and following your doctor’s advice ensures both your health and your baby’s growth are monitored.
• Managing chronic illness such as hypertension (high blood pressure), diabetes, or other disorders with your doctor’s guidance reduces the risk of IUGR.
• Doing gentle, regular exercise promotes healthy blood flow, which benefits both you and your baby.

For IUGR, you should consult an obstetrician. In high-risk cases, you may also be referred to a maternal–foetal medicine specialist, who focuses on complicated pregnancies.