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Published on: June 29, 2013
Intrauterine growth restriction--diagnosis and management
1School of Rural Health, University of Melbourne, Australia. cms@mcmedia.com.au
Insights
Accurate fetal growth assessment using customised charts helps detect intrauterine growth restriction (IUGR). Optimal management balances prematurity risks against continued intrauterine existence for the best newborn outcome.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Fetal Medicine
Background:
- Fetal growth disorders, including intrauterine growth restriction (IUGR), contribute significantly to perinatal morbidity and mortality.
- Long-term health implications exist for survivors of IUGR.
- Advances in fetal growth assessment enhance obstetric care for antenatal patients and newborns.
Purpose of the Study:
- To provide an overview of detecting fetal growth problems during pregnancy.
- To discuss determining the causes of IUGR and its antenatal/intrapartum management.
- To outline monitoring and management strategies based on pathophysiology.
Main Methods:
- Utilizing customised fetal growth charts for accurate assessment.
- Clarifying gestational age early in pregnancy.
- Excluding infections and anomalies to differentiate fetal conditions.
Main Results:
- Early gestational age clarification and customised charts improve fetal growth assessment accuracy.
- Distinguishing healthy small fetuses from growth-restricted ones is crucial.
- Optimal management focuses on delivering the newborn in the best condition.
Conclusions:
- Accurate fetal growth assessment relies on early gestational age determination and customised charts.
- Differentiating healthy small fetuses from those with IUGR is imperative after excluding other causes.
- Management aims to optimize newborn condition at delivery, balancing prematurity risks with continued intrauterine life.
Background:
Fetal growth disorders are an important cause of perinatal morbidity and mortality with long term health implications for the survivors of intrauterine growth restriction (IUGR). The accurate assessment of fetal growth during pregnancy is difficult, but recent advances have improved this important aspect of obstetric care with positive implications for antenatal patients and their babies.
Objective:
This article provides an overview of the detection of fetal growth problems in pregnancy, the determination of the likely cause, and the antenatal and intrapartum care of women with pregnancies identified as being affected by IUGR. The role of customised fetal growth assessment in the detection of IUGR is considered and followed by an outline of the appropriate monitoring and management of these pregnancies based on the underlying pathophysiology.
Discussion:
Accurate assessment of fetal growth is improved by early clarification of gestational age and the use of customised fetal growth charts. Once infections and anomalies have been excluded, it is imperative to distinguish the healthy small fetus from the growth restricted fetus. While treatment options are limited, the optimal management of the IUGR affected fetus aims to achieve the delivery of the newborn in the best possible condition, balancing the risks of prematurity against those of continued intrauterine existence.
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