[Intra-uterine growth retardation: etiologic factors and management]

The aim of this study is to define the etiologic factors, the diagnostic proceduresand obstetrical rules to be observed during a pregnancy in relation with low birth weight.

This is a retrospective study of 124 cases, carried out at the military hospital of Tunis, between January 1st 1999 and December 31 st 2001.

The frequency of intra-uterine growth retardation (IVGR) was 2.1%. 46.8% of the patients were primiparous. The mean age of the patients was 30 years. 25.8% of the patients developed toxemia. The etiology was predominantly renovascular-syndromes, urinary infections, and idiopathic hypotrophy. The positive diagnosis was suggesred by the measure of the uterine height in 96% and was confirmed by sonogaphy in all cases. The ombilical Doppler was pathological in 17.76% of the cases. A corticosteroid administration for pulmonary maturation was prescribed in 28% of the cases. Obstetrical common rule was fetal extraction: 42.7% of the patients were delivered by cesarean.

There is a real need to insist on the importance of early detection of fetal hypotrophy and of better management of the women at risk.