IUGR

Question 1

Define IUGR, how does it differ from small for gestational age babies?

Answer 1

• Intrauterine growth restriction: failure to reach their full genetically detirmined growth potential
  
  • appear thin, malnourished
• Small for date/ small for gestational age: babies with a birthweight below the 10th centile for their gestational age.
  
  • Majority normal, but small
  • preterm

Question 2

List the common causes of IUGR

Answer 2

• asymmetrical IUGR (head > weight/ abdo circumference)- likely to put on weight after birth- catch up growth
  
  • uteroplacental insufficiency
    
    • placenta fails to provide adequate nutrition in late pregnancy
    • brain growth relatively spared at expense of liver glycogen and skin fat
    • pre-eclampsia
    • multiple pregnancy
    • maternal smoking
    • idiopathic
• symmetrical IUGR (head circumference equally reduced)- likely to remain small
  
  • early pregnancy (prolonged IUGR) or gestational age is incorrect
    
    • syndrome/ chromosomal abnormality
    • congenital infection
    • drug/ alcohol abuse
    • chronic maternal medical condition/ malnutrition
      *

Question 3

Short term and long term complications of IUGR

Answer 3

• Short term
  
  • _​_intrauterine hypoxia
  • ‘unexplained’ intrauterine death
  • asphyxia during labour/ delivery
  • hypothermia (large SA:V ratio)
  • hypoglycaemia (poor fat and glycogen stores)
  • hypocalcaemia
  • polycythaemia (venous haematocrit > 0.65)
• Long term
  
  • CVD and the related disorders
    
    • hypertension, stroke, and type-2 diabetes​