INTRAUTERINE GROWTH RESTRICTION (IUGR)

TERMINOLOGY

Formerly IUGR: Intrauterine Growth Retardation not used anymore“RETARDATION” Abnormal mental function

“RESTRICTION” Slow growth/ceases•Fetal weight ≤ 10th percentile for gestational age and sex/SGA•Present of pathological process

PATHOGENESIS

Abnormal placental development it caused:• Supply of O2 hypoxia free radicals

organ system disorder• Nutrient inputs • Abnormal metabolic outcomes

IUGR

1. METABOLIC DISORDER2. ASYMMETRIC AND SYMMETRIC

GROWTH RESTRICTION3. INCREASED MORBIDITY AND

MORTILITY

RISCK FACTOR

1. Constitutionally small mother2. Poor maternal weight gain and nutrition3. Social deprivation4. Fetal infections5. Congenital malformations 6. Chromosomal abnormalities7. Trisomi 168. Primary disorders of cartilage and bone9. Chromosomal abnormalitie10. Congenital malformation

9. Chemical teratogens10.Vascular disease11.Chronic renal disease12.Chronic hypoxia13.Maternal anemia14.Plasental and cord abnornalities15.Multiple fetuses16.Antiphospholipid antibody syndrome17.Extrauterine pregnancy

IDENTIFICATION OF IUGR

1. FUNDAL HEIGHT2. MEASUREMENT SONOGRAPHY3. VELOCITOMETRY DOPPLER

PREVENTION

Prevention before conception occurs, by:1. Optimizing maternal health conditionS2. Correction of nutritional deficiencies3. Treatment4. Smoking cessation5. Antimalarial prophylaxis for women living in endemic

areas6. Women with hypertension in pregnancy /with a

history of previous IUGR prophylaxis with low-dose aspirin in early pregnancy (-) 10% IUGR