Intra-uterine growth and fatal fetal abnormality

To study intra-uterine growth in pregnancies complicated by fatal abnormality of the fetus, 73 pregnancies involving fetal or neonatal death caused by malformation, chromosomal aberration or Mendelian disease were evaluated. Small-for-gestational age newborns were found in 45% of the patients, and this finding was typical of 18-trisomies, amnion adhesion syndrome fetuses and multimalformed fetuses. Pregnancies affected by a Mendelian disease or a single fetal malformation mostly presented normal intra-uterine growth. In 25% of the patients, the symphyseal-fundal growth was retarded; this retardation started on average in the 25th gestational week. Polyhydramnios was present in 30% of the patients and was expressed in growth acceleration of the symphyseal-fundal measurement from the 28th gestational week. In 45% of the small-for-gestational-age fetuses the biparietal growth showed low profile type retardation. The brain-sparing phenomenon in growth was found in 21%. To assess the prospects of the conceivable modes of treatment, the need for an exact diagnostic evaluation of all pregnancies complicated by intra-uterine growth retardation and a consideration of the need for diagnostic amniocentesis in cases of early growth retardation is emphasized. This also applies to the time after legal abortion.