Fetal Growth Restriction

Fetal growth restriction is characterized by wherein the fetus does not achieve full intrauterine growth and development. FGR refers to a fetus with an EFW less than 10th percentile of the average for the gestational age on ultrasound.

 

Causes of FGR:

 

Maternal causes-

 

•   Constitutional

•   Malnutrition

•   Maternal disease- Anemia, hypertension, heart disease, chronic renal disease etc.

•   Smoking, alcohol or any addiction

 

Fetal causes-

 

•   Congenital anomalies either cardiovascular or renal or others

•   Chromosomal abnormality

•   Intrauterine infections

 

Placental causes-

 

•   Placenta praevia, abruption etc.

Diagnosis:

•   Your weight gain during pregnancy – remain stationary or at falling trends.

•   Per abdominal examination done by your doctor by checking fundal height at your every ANC visit.

•   Abdominal girth- remain stationary or at falling trends.

•   Ultrasound for fetal well-being with color Doppler is confirmatory.

 

Complications of FGR:

 

•   Intra uterine death of fetus

•   Still birth

•   Fetal distress

•   Meconium passage – It can leads to meconium aspiration syndrome.

•   Other metabolic complications after birth

•   Late complications- retarded neurologic & intellectual development, increase risk of development of cardiovascular disease ,type 2 diabetes etc. in their adulthood

 

Management – No definitive treatment has been demonstrated to be of benefit in growth restriction, assessment of fetal wellbeing and timely delivery remain the main management strategy.

 

•   If mother is malnutrition- increase her total calories intake by increasing her diet, add high protein in diet like milk & milk products, pulses, egg, meat etc.

•   Rest in left lateral position

•   Quit alcohol, smoking or any drug addiction

•   Fetal growth monitored by ultrasound according to severity of FGR.

•   Plan time & mode of delivery accordingly.