[Foetal growth retardation]

Intrauterine growth : restriction (IUGR) occurs in 3-10% of all pregnancies : The condition has different adverse effects on the foetus, during childhood and even in adult life.

Literature was retrieved from the Pub Med and Cochrane databases.

The most common limit for IUGR and severe growth restriction is a neonatal weight < 10th percentile. Placental failure, infections or foetal anomalies may cause IUGR before the 32 nd gestational week (early IUGR). Chromosome abnormalities may be the cause of up to 20% of all growth-restricted infants. About 20% of early-onset preeclampsia may cause low birth weight. Up to 10% of infections may also cause IUGR (e.g. HIV, cytomegalovirus, toxoplasmosis, peridontitis, malaria). Monochorial twin pregnancy carries a risk for twin-to-twin transfusion with uneven foetal growth. Systemic vessel diseases (diabetes mellitus with nephropathy and retinopathy, Crohn's disease, systemic lupus erythematosus disseminatus, and antiphospholipid syndrome) may cause growth restriction. The anamnesis and a low symphysis to fundus increment may give suspicion of growth restriction. The diagnosis is verified by ultrasound examination. Preterm delivery carries a risk for neonatal respiratory distress and cerebral haemorrhage. Therefore, two doses of corticosteroid should be given to the mothers in risk of preterm delivery before the 34 th gestational week. Growth restriction between 34 to 37 weeks gestation, associated with serious preeclampsia, is an indication for delivery. Other indications are arrest of foetal growth, pathological cardiotocography or Doppler findings, oligohydramnion or worsening of the maternal condition.