Intrauterine Growth Restriction

Question 1

IUGR Definition

Answer 1

A condition where a baby’s growth slows or cases when it is in the uterus
-Can be either SGA, IUGR or both, not mutually exclusive or synonymous

Question 2

IUGR Aetiology

Answer 2

• Maternal, placental, foetal or genetic factors
• Any mismatch between placental supply and foetal demand
• Maternal; age, SE status, parity (0 or >5), small inter-pregnancy interval, PHx, substance abuse, medication, low or high BMI…
• Foetal; chromosomal, genetic syndromes, congenital abnormalities, multiple gestation, congenital infection, metabolic disorders
• Placental; pre-eclampsia, abruption
• Genetic factors

Question 3

IUGR Classification

Answer 3

Symmetrical
-Earlier in pregnancy, symmetrical proportional reduction in measurements
-Weight, length and head circumference all reduced
-Features of malnutrition less pronounced but prognosis poor
Asymmetrical
-Later in pregancy
-Usually just abdominal circumference affected
-Brain sparing growth
Mixed IUGR
-When IUGR is further affected by placental causes

Question 4

IUGR Complications

Answer 4

• Short term birth complications
• Long term growth and neurodevelopmental problems
• IUGR neonates prone to complications after birth

Question 5

IUGR Management

Answer 5

Prevent SGA (see SGA)