Intrauterine Growth Restriction in Singleton Pregnancy-Surveillance and Delivery: An Overview

Background: Intrauterine growth restricted (IUGR) fetuses are at higher risk of developing neonatal complications and also known to develop metabolic syndrome in adult life. So, an early antenatal detection, choosing the optimal time and method of delivery and intervention when required could minimize the risk significantly. Objective: To find out the prenatal outcome and the maternal and placental risk factors. Methods: A prospective study was conducted from January 2010 to January 2019, at a Teaching Hospital. A singleton pregnancy, above 28 weeks of gestation with clinical diagnosis of IUGR and confirmed by ultrasonography were included in the study. The statistical analysis was performed by Statistical Package of Social Sciences (SPSS) 23.0 software. Results: Maternal risk factors like low pregnancy body mass index, preeclampsia, anaemia, hypothyroidism and placental factors like retro placental hemorrhage were mainly responsible for intrauterine growth restriction. Conclusions: The early identification of risk factors and management of the same antenatal is an important issue to prevent adverse prenatal outcomes associated with IUGR.

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The association of antenatal D-dimer and fibrinogen with postpartum hemorrhage and intrauterine growth restriction in preeclampsia

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04082-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hailing Shao ◽

Shichu Gao ◽

Dongru Dai ◽

Xiaomin Zhao ◽

Ying Hua ◽

...

Keyword(s):

Postpartum Hemorrhage ◽

Plasma Levels ◽

Intrauterine Growth Restriction ◽

Odds Ratio ◽

Growth Restriction ◽

Severe Preeclampsia ◽

Singleton Pregnancy ◽

Intrauterine Growth ◽

Mild Preeclampsia ◽

D Dimer

Abstract Background D-dimer and fibrinogen were verified to be altered in preeclampsia. This study was to evaluate the associations of D-dimer and fibrinogen plasma levels with postpartum hemorrhage or intrauterine growth restriction in preeclamptic women. Methods This was a retrospective study that recruited 278 preeclamptic women with singleton pregnancy from January 2016 to December 2019. Patients were allocated into five groups: mild preeclampsia (mPE) (n=68), mild preeclampsia with postpartum hemorrhage (mPE+PPH) (n=13), severe preeclampsia (sPE) (n=112), severe preeclampsia with postpartum hemorrhage (sPE+PPH) (n=17) and severe preeclampsia with intrauterine growth restriction (sPE+IUGR) (n=68). The antenatal D-dimer and fibrinogen plasma levels were analyzed among the groups. Logistic regression was used to determine the correlation between serum indexes and PPH or IUGR in preeclampsia. Results The antenatal D-dimer plasma levels were significantly higher in the sPE+PPH group than that in the sPE group (2.02 μg/ml versus 1.37 μg/ml, P = 0.001), but there was no difference in fibrinogen. Elevated D-dimer was associated with PPH among severe preeclamptic women (adjusted odds ratio (aOR) [95% CI]: 3.093 [1.527-6.264], P = 0.002). No differences in D-dimer and fibrinogen were found between the mPE and mPE+PPH groups or between the sPE and sPE+IUGR groups. Conclusions Elevated antenatal plasma D-dimer level may be associated with postpartum hemorrhage in severe preeclampsia, but not with intrauterine growth restriction. Future prospective clinical trials are needed to investigate the predictive value of D-dimer in postpartum hemorrhage in severe preeclampsia.

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USE OF SLIDENAFIL CITRATE IN CASES OF INTRAUTERINE GROWTH RESTRICTION AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

10.36106/8229589 ◽

2021 ◽

pp. 23-24

Author(s):

Anshu Anshu ◽

Usha Kumari ◽

Debarshi Jana

Keyword(s):

Intrauterine Growth Restriction ◽

Randomized Study ◽

Perinatal Outcomes ◽

Growth Restriction ◽

Control Group ◽

Singleton Pregnancy ◽

Intrauterine Growth ◽

Umbilical Artery Doppler ◽

Doppler Indices ◽

Antenatal Treatment

Objective: Intrauterine growth restriction (IUGR) is one of the most serious complications of pregnancy. Up to date, there is no evidence of achieving antenatal treatment of IUGR with abnormal placentation. Although, Sildenal citrate has shown promising results, there are no rm conclusion till now. The aim of our study is to evaluate the use of Sildenal citrate in the treatment of IUGR cases associated with impaired placental circulation. Materials And Methods: this was a prospective non-randomized study conducted at JLNMCH, Bhagalpur, Bihar starting from February 2019 to January 2020. The studied population included singleton pregnancy and suffering from IUGR associated with impaired placental circulation. Results: This study included 30 pregnant women. Cases were divided into two groups. The rst group received sildenal citrate and the second control group did not receive sildenal citrate. After 4 weeks after the 1st dose of Sildenal signicant decrease in umbilical artery Doppler indices. There was a statistically signicant difference in the mean birth weight at delivery and neonatal admission to the NICU in sildenal group. Conclusion: sildenale citrate treatment may present a new hope towards better perinatal outcomes for pregnancies complicated by IUGR and impaired placental circulation that may help to decrease neonatal admission to the NICU.

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Analysis of frequency and risk factors for intrauterine growth restriction

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20175936 ◽

2017 ◽

Vol 4 (1) ◽

pp. 11

Author(s):

Abha Shrestha

Keyword(s):

Risk Factors ◽

Intrauterine Growth Restriction ◽

Perinatal Outcome ◽

Neonatal Intensive Care ◽

Adult Life ◽

Growth Restriction ◽

University Hospital ◽

Singleton Pregnancy ◽

Maternal Risk ◽

Intrauterine Growth

Background: Intrauterine growth restricted (IUGR) fetuses are at greater risk of developing fetal hypoxia, neonatal complications, impaired neurodevelopment, and also neonatal intensive care unit stay and neonatal mortality. They are also known to develop metabolic syndrome in adult life. So, the main objective of this study was to find out the frequency of intrauterine growth restriction, to identify the maternal and placental risk factors associated with intrauterine growth restriction and its perinatal outcome amongst pregnant women attending the Obstetric Outpatient Department in Dhulikhel Hospital, Kathmandu University Hospital.Methods: A prospective study was conducted from June 2011 to June 2017, at Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal. A singleton pregnancy, above 28 weeks of gestation with clinical diagnosis of IUGR and confirmed by ultrasonography were included in the study. The statistical analysis was performed by Statistical Package of Social Sciences (SPSS) 20.0 software. Results: Maternal risk factors like preeclampsia, anaemia, low pregnancy body mass index and placental factors like retroplacental hemorrhage were mainly responsible for intrauterine growth restriction.Conclusions: Antenatal risk factors responsible for IUGR are important for the management of IUGR pregnancies and to prevent adverse perinatal outcome.

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Arterial stiffness in women who subsequently developed isolated intrauterine growth restriction and preeclampsia

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0033-1354933 ◽

2013 ◽

Vol 34 (S 01) ◽

Author(s):

A Brückmann ◽

C Seeliger ◽

E Schleußner ◽

D Schlembach

Keyword(s):

Arterial Stiffness ◽

Intrauterine Growth Restriction ◽

Growth Restriction ◽

Intrauterine Growth

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Pathological features of the sequence in pregnant women with delayed fetal growth

HEALTH OF WOMAN ◽

10.15574/hw.2019.140.50 ◽

2019 ◽

pp. 50-54

Author(s):

V.O. Golyanovskiy ◽

◽

Ye.O. Didyk ◽

Keyword(s):

Pregnant Women ◽

Intrauterine Growth Restriction ◽

Normal Development ◽

Intrauterine Infection ◽

Normal Pregnancy ◽

Growth Restriction ◽

Control Group ◽

Intrauterine Growth ◽

Increased Risk ◽

Infection And Inflammation

Pregnant women with intrauterine growth restriction (IUGR) have an increased risk of adverse perinatal and long-term complications compared with the birth of children with normal body weight. Thus, IUGR is one of the main challenges for the global health system, especially in poor and developing countries. Morpho-functional studies of the placentas help in determining the causes of IUGR, and therefore, timely prevent complications in pregnant women with IUGR. The objective: The purpose of this study is to investigate various morphometric and pathomorphological changes in the placenta, including inflammatory, in cases of IUGR, and to establish a correlation of these results with the etiology and complications for the fetus. Materials and methods. In the current study, 54 placentas of the fetuses with IUGR (the main group) were compared with 50 placentas of the fetuses with normal development (control group). The criteria for the inclusion of IUGR were gestational age more than 30 weeks and all fetuses with a weight less than 10th percentile for this period of pregnancy. The placenta material was studied pathomorphologically with laboratory screening for infection and inflammation. Similarly, the results were determined for placentas of the fetuses with normal development compared to placentas with IUGR. Results. The placenta study showed the presence of calcification in the case of IUGR, as well as in the case of prolonged pregnancy. However, calcification of the placenta in the case of IUGR was more progressive compared with placenta in the normal pregnancy. In addition, the presence of intrauterine infection and inflammation was observed, which could also lead to an adverse outcome for the further progression of pregnancy with IUGR. Conclusion. A comparative macro- and microscopic pathomorphological study of the placentas in the two groups has shown a significant increase in the pathological changes in all the anatomical structures of the fetuses with IUGR. Key words: Intrauterine growth restriction (IUGR), fetal weight, pathomorphological changes of the placenta.

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