Intrauterine Growth Restriction
A 28 year old woman who was in her 30th week of pregnancy developed a viral infection with high fever and chills. She was rushed to the hospital where she was put on intravenous fluids and necessary medication.Her health returned to normalcy in a week. Subsequently, when she crossed her due date she did not get labor pains naturally. The doctor did a C-section and delivered the baby who was born with low birth weight and weakness. This was the result of viral infection during pregnancy that caused Intrauterine Growth restriction (IUGR).
When the baby is not growing at the normal growth rate inside the womb, then it is termed as intrauterine growth restriction (IUGR). The babies with IGUR have health problems during pregnancy and also at birth. The problems include high risk of being still born, high stress during delivery through vagina, low blood sugar level at birth, low body weight(below 10th percentile for its gestational age), low immunity to fight infections, difficulty in maintaining body temperature and abnormally high red blood cell count.
Intrauterine growth restriction may be due to the mother having kidney disease, infections caused by cytomegalovirus, syphilis, toxoplasmosis and syphilis; heart disease, high blood pressure, diabetes, sickle cell anemia, problem in placenta (tissue that supplies nutrients and oxygen from mother to baby), chromosomal and congenital abnormalities; alcohol abuse, smoking, drugs, prescribed medication, high altitudes, twins and triplets in the womb; low socioeconomic status resulting in poor nutrition; preeclampsia (condition with high blood pressure and protein in urine at 20th week of pregnancy) and eclampsia (seizures during pregnancy).
Identifying an IUGR baby
To check the growth of the baby in the womb, the doctor performs ultrasound in which sound waves of high frequency are passed through the abdomen which gives you images of the baby inside. With the help of the ultrasound the doctor measures the baby’s head, abdomen and legs, and checks if the baby is growing normally. In babies with IUGR, the amniotic fluid (protective fluid present in the amniotic sac holding the baby) may be low. This can also be checked with the help of an ultrasound. Only 1/3rd of the babies who are smaller than normal have IUGR. Babies can also be small because of genetic factors (having small babies running in the family).
To check the health of the baby inside the uterus, a test called as fetal monitoring is done. You are made to lie down for 30 minutes and your uterus is strapped. The baby’s heartbeat is then recorded. The doctor can make out if the baby’s heart beat is normal or not, by listening to the recording. A normal heartbeat tells you that the baby is in good health. In a procedure known as amniocentesis, a fine needle is passed into the uterus through the skin and few teaspoons of amniotic fluid is withdrawn which is tested to detect the cause of IUGR, infections, genetic problems and chromosomal abnormalities if any. If the uterus in a pregnant woman is found to be small in size, then the doctor suspects intrauterine growth restriction.
Delivering an IUGR baby
If your baby has intrauterine growth restriction, it is not necessary that you have to deliver the baby before the due date. The delivery depends on how well the baby is growing inside. If the baby’s growth is growing but slowly, then the doctor will not consider early delivery, but if the baby‘s growth is completely stopped, then the doctor will induce labor and deliver the baby before term. If the baby is doing well, then normal vaginal delivery is done; but if the baby is weak, then it cannot take the stress of normal vaginal delivery. In such cases, the doctor will perform a cesarean section or (c-section). If you take good care of yourself and prevent illnesses before and during the pregnancy term then you can avoid another IUGR baby.
Monitoring IUGR baby after delivery
If your baby was born before time, then it will have to stay in the hospital for longer time than usual. The baby’s heart rate, breathing and growth are monitored by the doctor. The baby is kept in the hospital and monitored till it reaches a weight of 5 pounds. The baby should be able to breathe and feed normally. The baby may grow to normal height when it reaches 2 years of age.
The best way you can prevent an intrauterine growth restriction is to take good care of your health during pregnancy, by eating nutritious food and getting adequate rest. You must avoid habits like smoking, drugs and drinking alcohol during pregnancy. Monitor your baby’s movements. If your baby is kicking, then it shows that you have a healthy baby. If you do not feel it moving or kicking then you must at once report it to your doctor. Detecting IUGR early can help in better treatment so do not hesitate to call your doctor.