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Diagnosis and management of intrauterine growth retardation
1Service de Gynécologie-Obstétrique, Hôpital Saint-Vincent-de-Paul, Paris, France. j.lep@svp.ap-hop-paris.fr
Insights
Intrauterine growth retardation (IUGR) impacts fetal health, leading to potential complications. Accurate gestational age assessment and fetal evaluation are crucial for managing IUGR risks and determining optimal delivery timing.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Neonatal Perinatal Medicine
Background:
- Intrauterine growth retardation (IUGR) is a significant concern in perinatal medicine, linked to increased morbidity and mortality.
- Potential causes of IUGR include genetic disorders, fetal infections, uteroplacental insufficiency, and constitutional smallness.
- IUGR is notably more prevalent in multiple-gestation pregnancies, affecting 23-34% of these cases.
Purpose of the Study:
- To emphasize the critical role of accurate gestational age determination in screening for growth-retarded fetuses.
- To outline the necessity of comprehensive fetal assessment for evaluating IUGR etiology and prognosis.
- To highlight the importance of determining optimal delivery timing for fetuses at risk of perinatal asphyxia due to IUGR.
Main Methods:
- Review of current understanding and diagnostic approaches for intrauterine growth retardation.
- Emphasis on the significance of gestational age assessment as a primary screening tool.
- Discussion of fetal assessment strategies for etiology, prognosis, and delivery timing.
Main Results:
- Accurate gestational age determination is the foundational step in identifying growth-retarded fetuses.
- Fetal assessment is essential for understanding the cause and predicting the outcome of IUGR.
- Identifying fetuses at risk of perinatal asphyxia guides the optimal timing for delivery.
Conclusions:
- There is no direct medical treatment for intrauterine growth retardation (IUGR).
- Early aspirin administration may reduce IUGR incidence in high-risk groups but is not recommended for routine use.
- Management of IUGR necessitates accurate diagnosis, thorough fetal evaluation, and careful consideration of delivery timing.
Abstract:
Intrauterine growth retardation (IUGR) is associated with significant perinatal morbidity and mortality. This condition can be a sign of genetic disorders, fetal infection, uteroplacental insufficiency, or constitutionally small fetuses. Correct determination of gestational age is the first step in prenatal screening of growth-retarded fetuses. The discovery of a small-for-gestational age fetus necessitates fetal assessment for the evaluation of the etiology and prognosis, and for the determination of the optimal timing for delivery of these fetuses at risk of perinatal asphyxia. IUGR is more frequent in multiple-gestation pregnancies (23-34%) and will be discussed separately. There is no medical treatment for IUGR. Early aspirin treatment reduces the incidence of IUGR in a high-risk population but should not be used routinely in all pregnant women.