1. INTRAUTERINE GROWTH
RESTRICTION
FAHAD ZAKWAN

5. Sex
• term
males
150 gm.
heavier
and 0.9
cm
longer
than
females
Parity
• 1st born
infants
smaller
• effect
loss
after
3rd
birth
Race, ethnicity,
nationality Altitude
• Denver
population
growth
curves under
estimate
weights of
infants born
at sea level
Maternal size
• maternal pre-
pregnancy
weight and
pregnancy
weight gain
correlate
with fetus
size

7. Toxoplasmosis
Rubella

10. Trisomy 18 Turner syndrome

11. Trisomy 13

12. SYMMETRICAL IUGR ASYMMETRICAL IUGR
EARLY ONSET. SEEN IN 20% CASES LATE ONSET. SEEN IN 80% CASES
ETIOLOGY: GENETIC DISEASE/ INFECTION (INTRINSIC
TO FETUS)
ETIOLOGY: CHRONIC PLACENTAL
INSUFFICIENCY(EXTRINSIC TO FETUS)
TOTAL CELL NUMBER : LESS,
CELL SIZE : NORMAL
TOTAL CELL NUMBER : NORMAL,
CELL SIZE : SMALLER
USG : ALL PARAMETERS (HC, BPD, AC, FL) SMALLER
THAN EXPECTED
USG : HEAD SPARING EFFECT, BUT ABDOMEN IS SMALL
NEONATAL COURSE: COMPLICATED WITH POOR Px USUALLY UNCOMPLICATED HAVING GOOD Px

17. BIOPHYSICAL TEST : THE FIRST EXAM SHOULD CONFIRM THE CLINICAL
ESTIMATION OF THE GESTATIONAL AGE

20. 1. Fetal distress / death.
2. Asphyxia & RDS.
3. Hypoglycemia.
4. Meconium aspiration syndrome.
5. Hypothermia.
6. Pulmonary hemorrhage.
7. May have retarded growth .
8. May have cardiac disease, diabetes, in adulthood, if
survives.
Long term complications Lower IQ, learning & behavior problems,
major neurological handicap seizures, cerebral palsy, mental retardation

21. Increased meconium aspirationDecreased surfactant deficiency

22. Adequate bed rest.
Nutritional diet / iron, vitamins, calcium.
No smoking / alcohol allowed.
Aspirin in low dose (50 mg daily).
Ultrasound monitoring of fetus should be done every 4th wks.
Termination of pregnancy – beyond 37 week.
Before 37 week – conservative t/t to increase placental function till fetus
becomes viable.

23. Severe degree of IUGR – termination is to be done if
lung maturation is achieved.
- If lung maturation has not been achieved
corticosteroid therapy (betnasol 12 mg i.m. 24 hrs
apart – 2 doses given to reduce the risk of
neonatal RDS)
9. CS – to be done in the case of preterm delivery &
unfavorable cervix.
10. Baby should be shifted to intensive neonatal
care unit.