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Intrauterine growth restriction.

Tony Y T Tan¹, George S H Yeo

¹Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore.

Current Opinion in Obstetrics & Gynecology

|March 11, 2005

Summary

Intrauterine growth restriction (IUGR) significantly impacts neonatal outcomes and long-term mental health. Optimal timing for delivery in IUGR fetuses, especially in monochorionic twins, remains a critical challenge in obstetrics.

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Area of Science:

Obstetrics and Gynecology
Fetal Medicine
Neonatology

Background:

Intrauterine growth restriction (IUGR) is a significant obstetric complication with substantial neonatal mortality and morbidity.
IUGR is linked to long-term psychiatric sequelae, including depression and suicidal behaviors.

Purpose of the Study:

To review recent literature on intrauterine growth restriction.
To summarize current understanding and challenges in managing IUGR.

Main Methods:

Literature review of recent published studies on intrauterine growth restriction.
Analysis of findings related to fetal Doppler markers, delivery timing, and twin pregnancies.

Main Results:

Fetal Doppler changes in the ductus venosus and umbilical vein serve as markers for fetal academia.
Delayed delivery in IUGR fetuses up to 30 weeks may reduce cerebral palsy rates.
Selective fetocide in dichorionic twins with severe IUGR can prolong pregnancy.
Absent or reversed end-diastolic flow in monochorionic twins indicates increased risk of fetal death and brain damage.

Conclusions:

The optimal timing for delivery of preterm growth-restricted fetuses is still debated.
Assessing IUGR in monochorionic twins with abnormal umbilical artery Doppler flow presents diagnostic challenges.

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