What is IUGR
Intrauterine growth restriction (IUGR) is when the unborn baby is smaller than expected and isn’t growing at a normal rate inside the womb. Some people might think ‘great, a smaller baby is easier to birth’ but there are some complications in pregnancy, delivery and after birth that can come from this diagnosis. IUGR babies run the risk of difficulty handling stress in labour, decreased oxygen levels, low blood sugar, difficulty maintaining temperature after delivery, low birth weight, and low APGARS (an evaluation of the newborn baby’s physical appearance immediately after birth).
How often does it occur and why?
IUGR occurs in about 3-7% of the total population. The most common cause of IUGR is the placenta. The placenta job is to deliver oxygen and nutrients to the baby while removing unnecessary waste products. For IUGR to occur the placenta will struggles to give the unborn baby the oxygen and nutrients babe requires to grow at a normal rate. Sometimes there’s no direct answer for why the placenta isn’t working as it should and other times there are specific medical conditions that can contribute to its struggle. These medical conditions include diabetes, high blood pressure, maternal malnutrition, smoking and/or multiple gestations (twins or triples or more).
How is it diagnosed and what monitoring is required?
In the office your doctor or midwife will measure your belly. After the 20th week of gestation the measurement, in centimeters, from the top of the uterus and pubic bone should correspond with the week gestation you are at. If that measurement is small future investigation is needed including ultrasounds and fetal monitoring. During the ultrasound the technicians will measure the baby’s head circumference, abdominal circumference, and femur length as well as the amount of amniotic fluid around the baby. This is done every two weeks while just the blood flow through the umbilical cord is done weekly. All these pieces of the puzzles tell us how the placenta is functioning in the moment and baby’s well-being.
You will also be scheduled appointments to monitor baby. This test is called a Non-Stress Test (NST) where a registered nurse will connect two monitors on to your stomach. One monitor will connect with baby’s heart beat and the other will monitor if you are having any tightening in you uterus. The monitor will be on for at least 20 minutes until the baby meets the criteria necessary to pass the test. Depending if baby is diagnosed with mild, moderate or severe IUGR will determine how many times a week the NST is required.
What happens if my baby is diagnosed with IUGR?
Even though IUGR can occur when the mother is health there are a few things you can do to increase the health of the baby and pregnancy. The most important tasks a mother can do is eat healthy and get plenty of rest (or at least the recommended 8 hours of sleep at night) and avoid any alcohol, tobacco or substance use. And don’t forget to keep all of your medical appointments; there will be a lot on your calendar from now on.