Foetal Growth Restriction/Intrauterine Growth Restriction Home A-Z Health Information Health Library A-Z Foetal Growth Restriction/Intrauterine Growth Restriction Overview Foetal growth restriction (intrauterine growth restriction; IUGR), refers to the failure of the foetus to grow at the expected rate during pregnancy. Essentially, this means that the baby is smaller than it should be for its gestational age, i.e., the number of weeks into the pregnancy. Babies with IUGR often weigh less than 90% of other babies at the same stage of pregnancy. Nevertheless, it is important to note that just because a baby is “smaller in size” (than usual), it does not necessarily mean that it has IUGR; in some cases, the parents may have certain underlying medical conditions that result in the foetus being smaller than usual. Often, IUGR not only affects the size of the baby but also the growth of organs and tissues. Thus, if not managed properly, IUGR could lead to several complications, such as breathing problems, increased susceptibility to infections and heart/blood vessel problems, and/or premature delivery or emergency C-section; in some serious cases, stillbirth or death could also occur. Types There are two types of IUGR:Symmetrical IUGR: The baby’s entire body is growing smaller than normal.Asymmetrical IUGR: The baby’s head is growing at a normal rate, but the rest of the body is smaller. Causes Several factors can contribute to IUGR. Some are related to the baby’s health, others to the placenta, and some to the mother’s overall health. Here are a few common causes:Placental issues: The placenta is responsible for delivering oxygen and nutrients to your baby. If the placenta is not functioning as it should, the baby’s growth can be affected.Maternal health conditions: Hypertension, diabetes, or some infections may increase the risk of the development of IUGR.Lifestyle factors: Smoking, drinking alcohol, or poor nutrition during pregnancy can contribute to growth restriction.Multiple pregnancies: If you are carrying twins or more than 2 babies, the babies may have to compete for space and nutrients, increasing the risk of IUGR.Chromosomal abnormalities: Sometimes, a baby’s growth is restricted because of genetic issues. Symptoms The tricky part about IUGR is that usually, there are no outward symptoms that a mother can feel. This makes regular prenatal check-ups essential. However, there are signs your doctor can detect, such as:Smaller-than-expected baby bump: If your belly is measuring smaller than expected for your stage of pregnancy, it might indicate IUGR.Low amniotic fluid levels: This can be another clue that your baby is not growing at the usual pace. Diagnosis IUGR is typically diagnosed through careful monitoring during your prenatal check-ups; one or more of the following methods may be used:Measuring the fundal height: Your doctor measures your belly from the top of the uterus to the pubic bone. If the measurement is smaller than expected for your stage of pregnancy, further investigations are needed.Ultrasound: An ultrasound yields a more detailed view of the foetal growth; the foetal head, abdomen, and femur can be measured to check for signs of growth restriction.Doppler ultrasound: This test is used to check the blood flow in the umbilical cord and other vessels to see if the baby is getting enough oxygen and nutrients.Non-stress test: The baby’s heartbeat is monitored to ensure that it is not under stress.Amniocentesis: In rare cases, this test may be performed to check for any genetic abnormalities that could be affecting the baby’s growth. Treatment Here are the key approaches:Frequent monitoring: If the IUGR is mild, the doctors may recommend close monitoring with more frequent ultrasounds and tests to keep a close watch on your baby’s growth.Improving maternal health: If high blood pressure or diabetes is the cause, the doctors will focus on normalising blood pressure and diabetes treatment.Nutritional support: A healthy, balanced diet is crucial. In some cases, extra nutritional support or supplements might be needed.Bed rest: In some situations, bed rest is advised, which can help in improving the blood flow to baby.Early delivery: If the baby’s health is at risk, sometimes, it is safer for the baby to be delivered early. This might involve inducing labour or performing a caesarean section delivery. The timing of delivery will depend on how far along the patient is and how the baby is coping inside the womb.The availability of high-risk pregnancy care is extremely important for the timely detection and treatment of IUGR. When to see a doctor Regular prenatal visits are key to detecting IUGR early. However, you should seek medical advice if:You notice a significant decrease in foetal movements (you should feel about 10 movements every 12 hours in the later stages of pregnancy).You have sudden or severe symptoms like intense headaches, vision changes, or swelling, especially if you have conditions like hypertension (high blood pressure). Prevention One or more of the following methods are recommended for the prevention of IUGR:Healthy diet: Baby’s growth depends on a nutritious and balanced diet throughout pregnancy.Quitting smoking and avoiding alcohol: These substances directly affect your baby’s development and should be avoided entirely during pregnancy.Regular prenatal care: Keep all your scheduled appointments and follow your doctor’s recommendations to check your health and your baby’s development.Manage chronic illness: During pregnancy, work closely with your doctor to manage the chronic illness such as hypertension, diabetes, or other disorders.Stay active: Gentle, regular exercise can promote healthy blood flow, which benefits both you and your baby.