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Prenatal diagnosis and treatment of intrauterine growth retardation
Insights
Prenatal treatment improved fetal growth in 30 patients with intrauterine growth restriction (IUGR). Over half of infants achieved normal birth weight after bedrest, diet, and allylestrenol therapy.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Reproductive Endocrinology
Background:
- Intrauterine growth restriction (IUGR) poses significant risks to fetal development and neonatal outcomes.
- Accurate fetal weight estimation is crucial for managing IUGR pregnancies.
- Effective prenatal interventions for IUGR are essential to improve fetal growth and birth weight.
Purpose of the Study:
- To evaluate the efficacy of a prenatal treatment regimen for intrauterine growth restriction (IUGR).
- To assess the impact of bedrest, high-protein diet, and allylestrenol on fetal weight gain.
- To determine changes in maternal hormonal levels following the intervention.
Main Methods:
- A prospective study involving 30 pregnant patients diagnosed with IUGR based on ultrasonically estimated fetal weight (<10th percentile).
- Gestational age confirmed in the first trimester; fetal weight estimated using Biparietal Diameter (BPD) and Abdominal Circumference (AC) in the third trimester.
- Treatment included daytime bedrest, high-protein diet, and oral allylestrenol, followed by ultrasonic and biochemical assessments.
Main Results:
- Average estimated fetal weight increased from 1,362 g at 32.9 weeks to 2,678 g at 39.2 weeks.
- Average weekly fetal weight gain was significantly higher than standard values.
- 53.3% of infants (16/30) reached above the 10th percentile for birth weight; a strong correlation (r=0.94) was observed between estimated fetal weight and birth weight.
- Significant increases in maternal plasma and urinary estriol, plasma Human Placental Lactogen (HPL), and progesterone levels were noted post-treatment.
Conclusions:
- The combined prenatal treatment of bedrest, high-protein diet, and allylestrenol effectively promotes fetal growth in IUGR pregnancies.
- This therapeutic approach leads to significant improvements in fetal weight gain and a higher proportion of infants achieving normal birth weight.
- The observed hormonal changes suggest a positive impact on the maternal-fetal endocrine environment, contributing to improved fetal development.
Abstract:
Prenatal treatment consisting of daytime bedrest, high protein diet and oral administration of allylestrenol was assessed in a prospective study of 30 patients with IUGR infants whose ultrasonically estimated body weight was less than the 10th percentile. In these pregnancies, the gestational age was confirmed in the first trimester, and the fetal weight was estimated from the BPD and AC measurements in the third trimester (Fig. 1). Following treatment, ultrasonic and biochemical determinations were performed. As results: The estimated fetal weight of 1,362 g at 32.9 g gestational weeks increased to 2,678 g at 39.2 weeks on average. The average weekly weight gain was significantly higher than the standard, and 16 cases (53.3%) were more than 10th percentile at birth (Tab. I, Fig. 2). A significant correlation (r = 0.94) between the estimated fetal weight and the birth weight was found. Following prenatal treatments, maternal plasma and urinary estriol, plasma HPL and progesterone increased significantly (Tab. II).