Fetal Growth Restriction (FGR) is typically defined as a condition where a fetus is smaller than expected for its gestational age, often indicated by a weight below the 10th percentile. This condition may also be referred to as being small for gestational age (SGA) or intrauterine growth restriction (IUGR).
Types of FGR
FGR can generally be categorized into two types:
- Symmetric FGR: This type is characterized by a uniform reduction in the size of all internal organs and accounts for about 20% to 25% of IUGR cases.
- Asymmetric FGR: In this case, the head and brain maintain a normal size while the abdomen appears smaller. This is usually not detectable until the third trimester.
Risk Factors for FGR
Several factors may increase the likelihood of developing FGR:
- Maternal weight under 100 pounds
- Poor nutritional intake during pregnancy
- Birth defects or chromosomal abnormalities
- Use of drugs, tobacco, or alcohol
- Pregnancy-induced hypertension
- Placental abnormalities
- Umbilical cord issues
- Multiple pregnancies
- Gestational diabetes
- Low amniotic fluid levels (oligohydramnios)
Diagnosis of FGR
Accurate diagnosis of FGR is crucial, starting with confirming the due date. This can be established using the first day of the last menstrual period or early ultrasound measurements. Following this, healthcare providers may use the following methods to diagnose FGR:
- Measuring the uterine height against gestational age
- Ultrasound measurements that are smaller than expected for the gestational age
- Abnormal results from Doppler ultrasound studies
Treatment Options for FGR
Despite ongoing research, the ideal treatment for FGR remains complex and often varies based on the gestational age. If the pregnancy has reached 34 weeks or more, healthcare providers may recommend inducing labor to deliver the baby. For those under 34 weeks, regular monitoring will typically continue until reaching that point. The health of the fetus and the volume of amniotic fluid will be closely observed during this time. If any concerning signs arise, immediate delivery may be advised. Depending on the situation, you might have check-ups every 2 to 6 weeks until delivery. In cases where early delivery is necessary, an amniocentesis might be performed to assess fetal lung maturity.
Risks Associated with FGR
Newborns diagnosed with FGR face several increased risks, including:
- Cesarean delivery
- Hypoxia (oxygen deprivation at birth)
- Meconium aspiration (when a baby inhales a mixture of meconium and amniotic fluid)
- Hypoglycemia (low blood sugar)
- Polycythemia (increased red blood cell count)
- Hyperviscosity (thickened blood from excess red blood cells)
- Neurological and motor disabilities
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In summary, Fetal Growth Restriction is a serious condition that requires careful monitoring and management to ensure the health of both mother and baby.