Growth retardation and fetal development - Causes, Symptoms and Treatment .MF .
delay development of the fetus - is lagging prenatal physical development of the fetus.
Such babies are often referred to as "low-weight".In 30% of cases they are born as a result of premature birth (before 37 weeks of gestation), and only in 5% of cases at term (at 38-41 weeks).
There are two main forms of intrauterine growth retardation (IUGR abbreviated): symmetric and asymmetric.How do they differ from each other?
If the fetus has a shortage of body weight, it lags behind in growth length and head circumference of the positions of the normal parameters for a given gestational age, then diagnosed IUGR symmetrical shape.
asymmetric shape IUGR observed in cases where the fetus despite underweight no lag parameters from normal growth length and head circumference.Asymmetrical shape of IUGR is more common than symmetrical.
Also, there are three degrees of severity of IUGR:
I degree - lag fruit for 2 weeks;
II degree - lag of 2-4 weeks;
III degree - the lagging development of the fetus for more tha
What reasons could lead to the development of IUGR?
Speaking of symmetric IUGR, then, as a rule, it is due to chromosomal abnormalities, genetic metabolic disorders, hypothyroidism and pituitary dwarfism.An important role is also played by viral infections (rubella, herpes, toxoplasmosis, cytomegalovirus).
asymmetrical shape IUGR caused by abnormalities of the placenta in the third trimester of pregnancy, or rather, placental insufficiency (abbreviated FPN).FPN - a pathology, in which the placenta can not fully supply the fetus with nutrients that circulate in the mother's blood.As a result, FPN can cause fetal hypoxia, ie oxygen starvation.
FPN may occur as a result of: late gestosis, developmental abnormalities of the umbilical cord, multiple pregnancy, placenta previa, placental vascular lesions.
provoke any form of IUGR may be adverse external factors - medication, exposure to ionizing radiation, smoking, alcohol and drug consumption.Also, the risk of IUGR is increased in the presence of a history of abortion.
In many cases, the true cause of IUGR and can not be established.
symptoms of growth retardation and fetal development
Unfortunately, the symptoms of IUGR sufficiently erased.To suspect at such a diagnosis pregnant is unlikely to own.Only regular monitoring at the obstetrician-gynecologist during pregnancy helps to diagnose and treat IUGR.
widely believed that if a pregnant little gaining weight during pregnancy, the more likely and small fruit.This is partly true.However, this is not always true.Of course, if a woman limiting food intake to 1500 calories per day diet and is interested in, it may lead to IUGR.But IUGR is also common among pregnant women, who, on the contrary, there is too much weight gain.Therefore, this feature is not valid.
In marked IUGR future mom can alert the rarer and more sluggish than usual, fetal movements.This is the reason for the emergency treatment to the gynecologist.
survey at zadrezhke
fetal growth When viewed from a doctor with a pregnant IUGR can alert height mismatch standing uterus with the regulations of the pregnancy, the uterus has the size to be a bit smaller than normal size.
The most reliable method for diagnosing IUGR - is an ultrasound of the fetus, during which the doctor uzist measures the circumference of the fetal head, abdominal circumference, femur, estimated fetal weight.In addition, by using ultrasound can be determined as a function of fetal organs.
case of suspected IUGR necessarily spend Doppler study (US variety) to assess blood flow in the vessels of the fetus and placenta.
important method of research is cardiotocography (CTG) of the fetus, which also allows suspected IUGR.With the help of CTG recorded baby's heartbeat.The fetal heart rate ranges from 120 to 160 beats per minute.If the fetus lacks oxygen, the heart rate quickens or slows.
Regardless of gestational age and the severity of the disease - IUGR should be treated in any case to maintain the vital functions of the fetus.In some cases, if there is a slight lag of the fetus from the norm (about 1-2 weeks by ultrasound), it should be seen as a variant of the norm, or as a "tendency to ZRVP".In this case, carried out dynamic monitoring.
Treatment of growth retardation and fetal development
to treat IUGR in obstetrics use a large arsenal of medicines that improve the utero-placental blood flow.
- tocolytic drugs that promote uterine relaxation: beta-agonists (ginipral, Salbutamol), antispasmodics (papaverine, no-spa);
- infusion therapy with the appointment of glucose-blood substitute solutions for reducing the viscosity of the blood;
- drugs to improve microcirculation and metabolism in tissues (Aktovegin chimes);
- vitamin therapy (Magne B6, vitamins C and E).
drugs prescribed for a long period of careful control of KTG for the condition of the fetus.
Power pregnant with IUGR should be balanced.The food must contain protein, fats and carbohydrates.No need to "lean" on certain products.You can eat and all you need.Especially do not neglect meat and dairy products because they often contain the greatest amount of animal protein, the demand for which is increasing towards the end of pregnancy by 50%.
But do not forget that the main goal of treatment of IUGR not "fatten" the child, and provide him with the normal growth and development.Therefore, there is no need to overeating.
Pregnant recommend daily walks in the fresh air, the emotional peace.Traditionally, it is believed that an afternoon nap (if you want, of course), a beneficial effect on the physical condition of the fetus and the mother.
From IUGR non-drug methods of treatment used hyperbaric oxygenation (inhalation of air enriched with oxygen) and medical ozone.
urgent is the issue of delivery in the presence of IUGR.In each case, it should be decided individually on the basis of the status of the fetus by ultrasound and CTG, as well as on the state of health of the mother.If there is no certainty that a weakened child can be born alone, preference is given to Caesarean section.In severe cases, surgery is performed on an emergency basis.
- intrauterine fetal death;
- hypoxia (oxygen starvation) of the fetus;
- fetal abnormalities.
- a healthy lifestyle, avoiding harmful habits before the planned pregnancy;
- the rejection of abortion;
- timely examination and treatment of infectious diseases at the gynecologist before the planned pregnancy.
Consultation obstetrician-gynecologist on fetal growth retardation:
1. According ultrasound placenta is too small, but the growth of fetal weight and head circumference are normal.The doctor said that I FPN.Is it so?
No.Only on the basis of the size of the placenta such a diagnosis do not put.
2. Is there a cure IUGR, if there is a lot?
Unless IUGR is not related to chronic malnutrition.In other cases the power must be balanced together with the main treatment.
3. whether fetal weight by weight mothers Depends?
part, fetal weight depends on many factors, including the weight of the mother.
4. , then the child should be small if the parents of a small height and weight?
likely, and it is the norm.The diagnosis of IUGR in these cases, do not put.
5. I put on the ultrasound diagnosis of "fetal malnutrition."What does it mean?
Wasting IUGR fetus and mean the same thing - the lag in the development of the fetus.
6. Do I have to go to the hospital in the presence of IUGR?
This should solve your obstetrician, based on the data of ultrasound and CTG in dynamics.When IUGR I extent if no signs of fetal hypoxia, no need for hospitalization.When IUGR II or III level required hospitalization.
7. I have 35 weeks of pregnancy, but when viewed from the height of uterine fundus is 32 weeks.What is it?IUGR?
There are some errors in the measurement of the height of uterine fundus doctor.If the ultrasound and CTG abnormalities have been identified, it's okay.
8. I was told at the last ultrasound, that fetal abdominal circumference lags for 3 weeks from the due date, but all other indicators are normal.It IUGR?It should be treated?
Most likely, it is a characteristic of the fetus, if other parameters are within normal limits.If the CTG and Doppler abnormalities are not detected, then there is no IUGR treatment is not necessary.
9. What test "count to 10", which is recommended for IUGR?
Test "count to 10" - this is a test for the evaluation of fetal movement.It is recommended that all pregnant women with 28-30 weeks, and it is particularly relevant when IUGR.The woman should be in the interval from 9:00 am to 21:00 pm every day count fetal movements.Normally, there should be 10 or more.If they are less than is the evidence of oxygen starvation baby.
10. On US data the child lags behind in the parameters for 2 weeks.CTG and Doppler are normal.Do I need to be treated?
slight lag fetal parameters 1-2 week possible and normal.You need to look at the dynamics.
Obstetrician-gynecologist, Ph.D.Christina Frambos.