McKesson Clinical Reference Systems: Women's Health Advisor 2002.2

What is intrauterine growth retardation?

Intrauterine growth retardation (IUGR) means the unborn baby is not growing properly. The baby's weight is lower than it should be for its stage of the pregnancy.

How does it occur?

Women whose babies are more likely to develop this problem include:

• women who don't have a balanced diet or whose health is poor
• teenagers
• women who smoke
• women who weigh very little before they become pregnant
• women with a history of small babies in other pregnancies
• women who take certain drugs and medications.

Conditions that can cause IUGR include:

• high blood pressure
• kidney disease
• diabetes (abnormal blood sugar levels)
• heart disease
• diseases in which the body has an immune response to itself and tries to fight its own tissue (for example, lupus)
• a placenta that is unable to provide proper nourishment to the growing baby
• a condition of the placenta in which part of it no longer functions because the blood supply has been cut off and tissue has died
• certain infections that affect the baby
• inherited or congenital abnormalities, such as heart, kidney, or chromosome problems in the baby
• a double uterus
• other chronic medical conditions.

What are the symptoms?

Often the mother does not gain weight as expected. Examination by the doctor may show that the uterus is not growing at the rate it should.

How is it diagnosed?

When the doctor suspects growth retardation, he or she may order an ultrasound scan to measure the baby. Sometimes the uterus is smaller because you are not as far along in your pregnancy as you thought. Your doctor will try to determine the baby's correct age.

How is it treated?

When IUGR is suspected:

• Your doctor will examine you, measure the size of your uterus, and estimate the size of the baby.
• Your doctor may order ultrasound scans done at regular intervals.
• You may be told to stop or reduce working, rest more often or stay in bed, stop smoking, or consult a dietitian to improve your diet.
• Your doctor will examine you and may do blood or other tests to see if you have an infection or other medical problem that may be slowing the baby's growth.
• Nonstress tests may be done once or twice a week during the last 2 months of the pregnancy to check on your baby's condition.

Ultrasound scans help to detect problems and also follow the baby's growth during the pregnancy. Important measurements are the size of the baby's head, thighs, and stomach, and how big the baby's head is in proportion to the body. This information helps the doctor determine what may be causing the slow growth. The doctor can estimate the weight of the baby using these measurements.

Signs that the baby may develop more serious complications include an abnormal fetal heart rate and failure to grow in 2 or 3 weeks. In these cases, the doctor may consider delivering the baby immediately (or as soon as the baby could survive). The baby may grow better in an intensive care nursery.

A cesarean section may be necessary because labor could be hard for the baby. The baby may need to be delivered by c-section before the mother goes into labor or when inducing labor is not possible or successful.

How long will the effects last?

The risk of problems for the baby will exist as long as the baby's growth problems continue, or until some form of intervention or delivery takes place.

Some of the possible problems for the baby can include:

• not enough oxygen in the blood and tissues
• low blood sugar
• low levels of calcium in the blood
• pneumonia from getting meconium (fetal stool) in the lungs before birth
• high levels of bilirubin (a substance made from the breakdown of blood cells) in the blood
• delivery complications
• abnormal fetal heart rate, particularly during labor
• death, in extreme cases.

How can I take care of myself?

The best way to take care of yourself is to remain calm and follow the directions of your doctor and the nurses. Your baby may be perfectly normal. Be sure to discuss any concerns you have with your doctor so you can maintain a positive outlook during the remainder of your pregnancy.

What can be done to help prevent intrauterine growth retardation?

Growth retardation may be associated with factors that cannot be totally controlled. However, other factors such as nutrition, rest, and exercise can be controlled. Eating balanced meals, quitting smoking, minimizing stress, not taking drugs, and getting regular exercise, rest, and sleep can help prevent serious complications.

Early and regular prenatal visits with your doctor allow this condition to be discovered early. Then you and the baby can be carefully checked throughout the rest of your pregnancy.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.