Understanding Intra-Uterine Growth Restriction (IUGR)

Intra-Uterine Growth Restriction (IUGR) occurs when the developing fetus is smaller than average size for gestation, during pregnancy. It is generally a term used to describe a baby that is not growing properly in the uterus and thus is small for its age. It is slow to develop. If the fetus is not growing properly, it has a higher chance of complications and even death or injury at birth.

IUGR can be diagnosed by your midwife or obstetrician. This is one reason why routine prenatal care is important; it would be easy to miss this if you did not have a trained professional watching over you. At every appointment you should be weighed and your uterus measured. You provider will feel the top of your uterus and measure it with a tape measure. A rule of thumb is your gestational week should correlate with the length when measured by centimeters so at 27 weeks you should measure 27 cm. This is not always the case and what is important is that your uterus is getting bigger each time, indicating that your fetus is growing as well. Each month your growth is recorded and if at any time it does not go up the way it was or you get too big too fast, your provider will likely insist on other testing to see what is going on.

Ultrasound is usually the next step if IUGR is thought to be occurring. An ultrasound will be used to determine the fetus growth and size and look for any abnormalities that could be causing any problems.

If IUGR is diagnosed a plan will be put in place to keep yourself rested and healthy. You should avoid things that will keep your baby from growing properly such as smoking, drugs, alcohol and stress. This will give your baby the highest chance of normal development. Bed rest may be advised as resting enables the baby to receive a better flow of blood which will improve its growth. If there is a possible known cause it will be evaluated and reversed or treated quickly so your baby can resume growing properly.

Babies with IUGR have a higher risk of death before or during delivery so it may be necessary to take the baby out before its due date. A c-section may be recommended as many babies with IUGR are not able to tolerate a vaginal birth so a cesarean birth may be beneficial. There are times when a fetus will be better off outside the uterus, even when it will be very premature.

Some causes of IUGR include: Kidney disease, smoking during pregnancy, poor weight gain for the mother-to-be, maternal blood flow problems, Altitude, alcohol and drug use, multiple fetuses, anemia, abnormal umbilical cord or problems with the placenta, history of IUGR for past pregnancies, and infection in the fetus.

If the reason for IUGR is confirmed there will be a higher chance of treatment and finishing the pregnancy so you don't have to deliver prematurely. Other times the cause is unknown or there is no way to prevent death or injury and the baby is better off being born as soon as possible. We are lucky that our medical advances have saved even the earliest of babies, a 25 week old fetus can survive and each week they stay inside increases the risk of survival.