Fetal growth restriction (FGR) is typically defined as a fetal weight that falls below the 10th percentile for the gestational age, as determined through ultrasound assessments. This condition is often referred to as small-for-gestational-age (SGA) or intrauterine growth restriction (IUGR).
Types of Fetal Growth Restriction
Fetal growth restriction is classified into two main types:
- Symmetric (Primary) Growth Restriction: This type involves a uniform reduction in the size of all internal organs and accounts for about 20% to 25% of FGR cases.
- Asymmetric (Secondary) Growth Restriction: In this case, while the head and brain develop normally, the abdomen is smaller. This condition typically becomes noticeable during the third trimester.
Risk Factors
Certain factors may elevate the risk of developing fetal growth restriction, including:
- Maternal weight below 100 pounds
- Poor nutritional intake during pregnancy
- Birth defects or chromosomal issues
- Substance use, such as drugs, alcohol, or smoking
- Pregnancy-induced hypertension (PIH)
- Abnormalities in the placenta
- Issues with the umbilical cord
- Multiple gestations
- Gestational diabetes
- Low amniotic fluid levels (oligohydramnios)
Diagnosis
Accurate dating of the pregnancy is crucial for diagnosing fetal growth restriction. This is typically established using the first day of the last menstrual period (LMP) along with early ultrasound measurements. Following that, the diagnosis may involve:
- Fundal height measurements that do not align with the expected gestational age
- Ultrasound measurements indicating a smaller size than anticipated for the gestational age
- Abnormal results from Doppler ultrasound tests
Treatment Options
The treatment for fetal growth restriction varies based on the stage of pregnancy:
- If the pregnancy is at or beyond 34 weeks, healthcare providers may suggest early labor induction.
- For pregnancies under 34 weeks, continuous monitoring is recommended until the pregnancy reaches 34 weeks or beyond. This includes checking fetal well-being and the amount of amniotic fluid.
- If any concerns arise, immediate delivery may become necessary. Regular appointments, typically every 2 to 6 weeks, will be scheduled until delivery. If delivery is recommended before 34 weeks, an amniocentesis may be performed to assess fetal lung maturity.
Risks to the Baby
Babies diagnosed with fetal growth restriction face several potential risks, including:
- Increased likelihood of cesarean delivery
- Hypoxia (oxygen deprivation at birth)
- Meconium aspiration (where the baby inhales a mixture of meconium and amniotic fluid, leading to potential respiratory issues)
- Hypoglycemia (low blood sugar levels)
- Polycythemia (an elevated red blood cell count)
- Hyperviscosity (thickened blood due to increased red blood cells)
- Neurological and motor disabilities
Want to Learn More?
If you’re interested in further exploring pregnancy complications, including those related to multiple births or high-risk pregnancies, you might find this resource helpful: Understanding a High-risk Pregnancy.
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In summary, fetal growth restriction is a condition that requires careful monitoring and management to ensure the health of both the mother and the baby. Understanding the types, risks, and treatment options can help expectant parents navigate this challenge effectively.