Intrauterine Growth Restriction (IUGR)

What is Intrauterine Growth Restriction (IUGR)

Intrauterine growth restriction is when a baby is not growing normally during pregnancy. A baby with IUGR is smaller than it should be and may weigh less than normal at birth.

IUGR can result from a problem with the organ that supplies the unborn baby (fetus) with oxygen and nutrition (placenta). Usually, there is no way to prevent this type of problem. Babies with IUGR are at higher risk for early delivery and needing special (intensive) care after birth.

What are the causes?

The most common cause of IUGR is a problem with the placenta or umbilical cord that causes the fetus to get less oxygen or nutrition than needed. Other causes include:

  • The mother eating a very unhealthy diet (poor maternal nutrition).
  • Exposure to chemicals found in substances such as cigarettes, alcohol, and some drugs.
  • Some prescription medicines.
  • Other problems that develop in the womb (congenital birth defects).
  • Genetic disorders.
  • Infection.
  • Carrying more than one baby.

What increases the risk?

This condition is more likely to affect babies of mothers who:

  • Are over the age of 35 at the time of delivery.
  • Are younger than age 16 at the time of delivery.
  • Have medical conditions such as high blood pressure, preeclampsia, diabetes, heart or kidney disease, systemic lupus erythematosus, or anemia.
  • Live at a very high altitude during pregnancy.
  • Have a personal history or family history of:
    • IUGR.
    • A genetic disorder.
  • Take medicines during pregnancy that are related to congenital disabilities.
  • Come into contact with infected cat feces (toxoplasmosis).
  • Come into contact with chickenpox (varicella) or German measles (rubella).
  • Have or are at risk of getting an infectious disease such as syphilis, HIV, or herpes.
  • Eat an unhealthy diet during pregnancy.
  • Weigh less than 100 pounds.
  • Have had treatments to help her have children (infertility treatments).
  • Use tobacco, drugs, or alcohol during pregnancy.

What are the signs or symptoms?

IUGR does not cause many symptoms. You might notice that your baby does not move or kick very often. Also, your belly may not be as big as expected for the stage of your pregnancy.

How is this diagnosed?

This condition is diagnosed with physical exams and prenatal exams. You may also have:

  • Fundal measurements to check the size of your uterus.
  • An ultrasound done to measure your baby’s size compared to the size of other babies at the same stage of development (gestational age). Your health care provider will monitor your baby’s growth with ultrasounds throughout pregnancy.

You may also have tests to find the cause of IUGR. These may include:

  • Amniocentesis. This is a procedure that involves passing a needle into the uterus to collect a sample of fluid that surrounds the fetus (amniotic fluid). This may be done to check for signs of infection or congenital defects.
  • Tests to evaluate blood flow to your baby and placenta.

How is this treated?

In most cases, the goal of treatment is to treat the cause of IUGR. Your health care providers will monitor your pregnancy closely and help you manage your pregnancy.

If your condition is caused by a placenta problem and your baby is not getting enough blood, you may need:

  • Medicine to start labor and deliver your baby early (induction).
  • Cesarean delivery, also called a C-section. In this procedure, your baby is delivered through an incision in your abdomen and uterus.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider. This includes vitamins and supplements.
  • Make sure that your health care provider knows about and approves of all the medicines, supplements, vitamins, eye drops, and creams that you use.

General instructions

  • Eat a healthy diet that includes fresh fruits and vegetables, lean proteins, whole grains, and calcium-rich foods such as milk, yogurt, and dark, leafy greens. Work with your health care provider or a dietitian to make sure that:
    • You are getting enough nutrients.
    • You are gaining enough weight.
  • Rest as needed. Try to get at least 8 hours of sleep every night.
  • Do not drink alcohol or use drugs.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Get help right away if you:

  • Notice that your baby is moving less than usual or is not moving.
  • Have contractions that are 5 minutes or less apart, or that increase in frequency, intensity, or length.
  • Have signs and symptoms of infection, including a fever.
  • Have vaginal bleeding.
  • Have increased swelling in your legs, hands, or face.
  • Have vision changes, including seeing spots or having blurry or double vision.
  • Have a severe headache that does not go away.
  • Have sudden, sharp abdominal pain or low back pain.
  • Have an uncontrolled gush or trickle of fluid from your vagina.

Summary

  • Intrauterine growth restriction (IUGR) is when a baby is not growing normally during pregnancy.
  • The most common cause of IUGR is a problem with the placenta or umbilical cord that causes the fetus to get less oxygen or nutrition than needed.
  • This condition is diagnosed with physical and prenatal exams. Your health care provider will monitor your baby’s growth with ultrasounds throughout pregnancy.
  • Make sure that your health care provider knows about and approves of all the medicines, supplements, vitamins, eye drops, and creams that you use.
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