scholarly journals Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

2016 ◽  
Vol 10 ◽  
pp. CMPed.S40070 ◽  
Author(s):  
Deepak Sharma ◽  
Sweta Shastri ◽  
Pradeep Sharma
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Perinatal Asphyxia ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Growth Potential ◽  
Intrauterine Growth ◽  
Health And Disease ◽  
Neonatal Problems

Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR.

scholarly journals Blood Ferritin Levels in Pregnant Women and Prediction of the Development of Fetal Intrauterine Growth Restriction

2011 ◽  
Vol 30 (4) ◽  
pp. 317-322
Author(s):  
Nemanja Višnjevac ◽  
Ljiljana Segedi ◽  
Aleksandar Ćurčić ◽  
Jovana Višnjevac ◽  
Dragan Stajić
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Ferritin Level ◽  
Newborn Infants ◽  
Maternal Blood ◽  
Growth Restriction ◽  
Intrauterine Growth

Blood Ferritin Levels in Pregnant Women and Prediction of the Development of Fetal Intrauterine Growth RestrictionIntrauterine growth restriction is one of the leading causes of perinatal morbidity and mortality. Prediction of intrauterine growth restriction is one of the priority tasks of perinatal protection. The purpose of this study was to evaluate the levels of serum ferritin in pregnant women, which could point to a group of patients in whom possible development of fetal growth restriction could have been expected. In this investigation, we conducted a prospective study of healthy pregnant women between 30 and 32 gestational weeks, who were estimated for ferritin values. Newborn infants of low birth weight for gestational age were recorded in 8.1%. Anemia was not present in any of the patients who delivered low birth weight babies. Ferritin serum levels in mothers of the babies with low birth weight were on average 6.42 μg/L higher than in the mothers with appropriate for gestational age babies (p<0.005). ROC analysis of newborn infants birth weight and maternal blood ferritin levels showed that blood ferritin level had good predictive value. In case the recorded maternal blood ferritin values are above 13.6 μg/L, we can assume with the sensitivity of 64.7% and specificity of 91.7%, that the pregnant woman will develop a condition of intrauterine growth restriction. The missing decrease of ferritin values, erythrocytes, hemoglobin and hematocrit in the blood of healthy pregnant women between 30 and 32 gestational weeks, can with high probability point to the development of fetal intrauterine growth restriction.

Intrauterine growth restriction affects z-scores of anthropometric parameters during the first 6 years in very low-birth-weight-children born at less than 30 weeks of gestation

2019 ◽  
Vol 11 (1) ◽  
pp. 44-48
Author(s):  
Hiromichi Shoji ◽  
Akiko Watanabe ◽  
Atsuko Awaji ◽  
Naho Ikeda ◽  
Mariko Hosozawa ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Very Low Birth Weight ◽  
Growth Restriction ◽  
Z Score ◽  
Anthropometric Parameters ◽  
Intrauterine Growth ◽  
Z Scores

AbstractObjective:Little is known about physical constitution outcomes for very preterm infants. Here, we compare z-scores of anthropometric parameters up to 6 years of age in children born with very low birth weight (VLBW) at less than 30 weeks of gestation, with or without intrauterine growth restriction (IUGR).Design:Participants were divided into four subgroups: male (M), small for gestational age (SGA) (n = 30); M, appropriate for gestational age (AGA) (n = 59); female (F), SGA (n = 24); and F, AGA (n = 61). z-Scores of body weight (BW), body length (BL), and body mass index (BMI) were assessed at birth, 1 year corrected age, 3 years of age, and 6 years of age.Results:For boys, BW and BMI were significantly lower among SGA children than among AGA children at all assessments, but there was no difference in BL at 3 or 6 years. For girls, BW and BL were significantly lower among SGA children than among AGA children at all assessments, but no difference was detected in BMI after 1.5 years. No significant variation in the z-score of BW or BMI in either SGA group was observed after 1 year. BL z-score in all groups gradually increased until 6 years of age.Conclusion:IUGR affects BW and BMI in boys and BW and BL in girls during the first 6 years in VLBW children born at less than 30 weeks of gestation. SGA children did not catch up in BW or BMI from 1 to 6 years of age.

scholarly journals Aberrant Hematopoiesis and Morbidity in Extremely Preterm Infants With Intrauterine Growth Restriction

2021 ◽  
Vol 9 ◽  
Author(s):  
Nora J. Reibel ◽  
Christof Dame ◽  
Christoph Bührer ◽  
Tobias Muehlbacher
Keyword(s):  
Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
High Rate ◽  
Retrospective Case ◽  
Intrauterine Growth ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Background and Objective: Intrauterine growth restriction (IUGR) poses additional challenges in extremely low gestational age newborns (ELGANs). We assessed disturbed hematopoiesis and morbidities associated with this disorder.Methods: This single-center retrospective case–control study compared perinatal hematological profiles, major morbidities, and mortality of 49 infants (gestational age &lt;28 weeks, birth weight ≤ 3rd percentile, and compromised placental function) and 98 infants (birth weight &gt;10th percentile) matched for gestational age, year, and sex.Results: IUGR-ELGANs had significantly elevated nucleated red blood cells and lower neutrophil and platelet counts at birth and on the third day of life. During the first week of life, IUGR-ELGANs received more red blood cell, platelet, and plasma transfusions and were more intensively treated with antibiotics. Rates of infections acquired during the first week (59.2 vs. 17.3%, p &lt; 0.001), severe bronchopulmonary dysplasia or death (42.9 vs. 17.3%, p &lt; 0.01), and mortality (36.7 vs. 7.1%, p &lt; 0.001) were markedly elevated in IUGR-ELGANs, but not of hemorrhages or other morbidities.Conclusions: IUGR-ELGANs have high rates of acquired infections during the first week of life and display severe pulmonary morbidity leading to bronchopulmonary dysplasia or death. The high rate of transfusions observed in these infants warrants further scrutiny.

scholarly journals Increased Fetal Plasma Erythropoietin in Monochorionic Twin Pregnancies With Selective Intrauterine Growth Restriction and Abnormal Umbilical Artery Doppler

2016 ◽  
Vol 19 (4) ◽  
pp. 383-388 ◽  
Author(s):  
Yao-Lung Chang ◽  
An-Shine Chao ◽  
Hsiu-Huei Peng ◽  
Shuenn-Dyh Chang ◽  
Sheng-Yuan Su ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Adult Life ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Fetal Plasma ◽  
Group 3 ◽  
Twin Pregnancies

Hypoxia is the primary stimulus for the production of erythropoietin (EPO) in both fetal and adult life. Here, we investigated fetal plasma EPO concentrations in monochorionic (MC) twin pregnancies with selective intrauterine growth restriction (sIUGR) and abnormal umbilical artery (UA) Doppler. We diagnosed sIUGR in presence of (1) birth-weight discordance >20% and (2) either twin with a birth weight <10th percentile. An abnormal UA Doppler was defined as a persistent absent-reverse end diastolic flow (AREDF). The intertwin EPO ratio was calculated as the plasma EPO level of the smaller (or small-for-gestational-age) twin divided by the EPO concentration of the larger (or appropriate-for-gestational-age (AGA)) twin. Thirty-two MC twin pairs were included. Of these, 17 pairs were normal twins (Group 1), seven pairs were twins with sIUGR without UA Doppler abnormalities (Group 2), and eight pairs were twins with sIUGR and UA Doppler abnormalities (Group 3). The highest EPO ratio was identified in Group 3 (p< .001) but no significant differences were observed between Groups 1 and 2. Fetal hemoglobin levels did not differ significantly in the three groups, and fetal EPO concentration did not correlate with gestational age at birth. We conclude that fetal plasma EPO concentrations are selectively increased in MC twin pregnancies with sIUGR and abnormal UA Doppler, possibly as a result of uncompensated hypoxia.

Intrauterine growth retardation (upavishataka garbhavyapad) and it’s ayurved and modern management – review of literatures.

2020 ◽  
Vol 8 (02) ◽  
Author(s):  
Snehal Snehal
Keyword(s):  
Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Intrauterine Growth Retardation ◽  
Modern Science ◽  
Neonatal Morbidity ◽  
Signs And Symptoms ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Basic Principles ◽  
Intrauterine Growth

According to modern science , intrauterine Growth Restriction (IUGR) is an important causes of fetal and neonatal morbidity and mortality.    In IUGR development and maturity of foetus delayed or impaired . Fetal growth restriction is said to be present in those babies whose birth weight is below the 10th percentile of the average for the gestational age. Growth restriction can occure in preterm , term, or post term babies.(1)  Placental insufficiency or utero placental insufficiency is most imp. Cause of intrauterine growth restriction.    The signs and   symptoms of IUGR and Upavishtaka are same .In Ayurveda Upavishtak is described under Garbhavyapads.In ayurvedic literature , there are many natural formulations ,various drugs have been described  for treatment is based upon basic principles such as rasa , guna ,veerya,vipak of drugs.Hence to study the consept of IUGR (upavishtaka) according to modern and Ayurveda; this topic has been selected for study.

scholarly journals Significance of serum ferritin level in the prediction of delivery of low birth weight newborns for gestational age

2013 ◽  
Vol 141 (5-6) ◽  
pp. 337-343
Author(s):  
Ljubomir Milasinovic ◽  
Nemanja Visnjevac ◽  
Mirjana Bogavac ◽  
Zorica Grujic ◽  
Ljiljana Mladenovic-Segedi ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Serum Ferritin ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Growth Restriction ◽  
Intrauterine Growth

Introduction. Intrauterine growth restriction is one of the leading causes of prenatal morbidity and mortality. As there is no causal therapy, prediction of intrauterine growth retardation is one of the priorities of prenatal healthcare. Objective. The purpose of this study was to analyze blood ferritin level, and erythrocyte, hemoglobin and hematocrit count in pregnant women between 30?32 weeks of gestation and to set apart those with a possible development of intrauterine growth restriction. Methods. A prospective study was conducted that included 220 healthy pregnant women between 30?32 gestational weeks. The study was done at the Clinical Center of Vojvodina, Department of Obstetrics and Gynecology Novi Sad and Clinical laboratory from March 1, 2008 to November 30, 2009. Serum ferritin level, hemoglobin, hematocrit and erythrocyte count were determined from blood samples of all pregnant women. Results. After term delivery, 8.1% of pregnant women gave birth to low birth weight babies for gestational age but without anemia. The value of ferritin, hemoglobin, hematocrit and erythrocyte was significantly higher in women with low birth weight babies. In mothers with low birth weight newborns serum ferritin level was on the average for 6.4 g/l higher than in mothers with normal weight newborns (p<0.005). Statistically, ROC curve analysis showed that the pregnant women with the ferritin level above 13.6 ?g/L, and with erythrocyte count >3.76?1012/L, hemoglobin >117 g/L and hematocrit >32.9%, in the period of 30?32 weeks of gestation, also had a significantly higher probability of having a low birth weight newborn for gestational age (p<0.05). Conclusion. Based on the level of ferritin and other parameters in the period of 30?32 weeks of gestation, we can predict pregnant women in whom we can expect development of intrauterine growth restriction.

scholarly journals A retrospective interventional study for evaluation of efficacy and safety of sildenafil citrate in improving intrauterine growth restriction and oligohydramnios using ultrasound Doppler velocimetry

2019 ◽  
Vol 8 (12) ◽  
pp. 2736
Author(s):  
Kedar N. Ganla ◽  
Rana A. Choudhary ◽  
Kavita N. Desai ◽  
Santoshi B. Kadam ◽  
Krutika Arunachalam
Keyword(s):  
Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Morbidity And Mortality ◽  
Sildenafil Citrate ◽  
Common Finding ◽  
Interventional Study ◽  
Intrauterine Growth

Background: Intrauterine growth restriction (IUGR) is one of the major reasons for neonatal morbidity and mortality. Oligohydramnios is a common finding in IUGR. In majority of these cases diminished utero-placental blood flow is observed. However, in spite of this understanding and identification of high-risk patients, the management options are limited. Sildenafil citrate, a phosphodiesterase type-5 inhibitor improves utero-placental perfusion.Methods: We present a retrospective interventional study involving 50 adult pregnant women diagnosed with early-onset IUGR (n=38) and oligohydramnios (n=12). Vaginal sildenafil citrate 25 mg t.i.d. was started from the day of diagnosis till delivery. Primary efficacy endpoints included changes in Doppler parameters i.e., amniotic fluid index (AFI), uterine artery (UA)- pulsatility index (PI), resistance index (RI) and systolic diastolic ratio (S/D ratio). Secondary endpoints included live birth, birth weight, Apgar score at birth, neonatal survival to hospital discharge and adverse maternal side effects.Results: There was a statistically significant improvement in UA-PI, RI and S/D ratios (p<0.0001) in all cases. In oligohydramnios cases, treatment showed a statistical significant increase in AFI score (2.86±1.33 cm). The mean birth weight on delivery was 2200 gm with good Apgar scores. No major adverse effects were reported by women using sildenafil citrate vaginally.Conclusions: Sildenafil citrate, by increasing utero-placental perfusion, improves uterine artery Doppler patterns, AFI, fetal weight and overall better neonatal survival rates by reducing neonatal morbidity and mortality. Sildenafil citrate may hold a promising treatment strategy for management of IUGR and oligohydramnios.

scholarly journals Intrauterine growth restriction in a cohort of migrants in Germany

2020 ◽  
Author(s):  
Juliane Ankert ◽  
Tanja Groten ◽  
Mathias W. Pletz ◽  
Sasmita Mishra ◽  
Gregor Seliger ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Caesarian Section ◽  
Growth Restriction ◽  
Delivery Mode ◽  
Intrauterine Growth

Abstract Background: Migrant women may have an increased risk of adverse birth outcomes. This study analyses the occurrence of low birth weight, preterm birth and intrauterine growth restriction (IUGR) in pregnant migrants. Method: Cross-sectional study of 82 mother-child pairs of pregnant migrants attending medical care in Germany.Results: Median age was 27 years, 49% were of oriental-asian ethnicity and median year of migration was 2015. At least one previous pregnancy was reported in 76%. Delivery mode was caesarian section in 40%. Median gestational age was 39.7 weeks. Preterm birth occurred in 6.1%. Median gestational age for preterm birth was 32.3 weeks. Low birth weight (<2500 g) occurred in 6.1%. Birth weights below the 10th percentile of birth weight for gestational age were observed in 8.5% of the total cohort. Conclusions: Compared to German data no increased occurrence of low birth weight, preterm birth or IUGR was found. Of note, rate of caesarian section was higher than in the general population for reasons yet to be identified. The authors propose stratification according to migration status for the national documentation of birth outcomes in Germany.Trial registration: ClinicalTrails.gov, NCT03158298. Registered 18 May 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03158298

INTRAUTERINE GROWTH RETARDATION - A REVIEW ARTICLE

2018 ◽  
pp. 184-195
Author(s):  
Minh Son Pham ◽  
Vu Quoc Huy Nguyen ◽  
Dinh Vinh Tran
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Growth Potential ◽  
National Guidelines ◽  
Intrauterine Growth ◽  
No Gold Standard

Small for gestational age (SGA) and fetal growth restriction (FGR) is difficult to define exactly. In this pregnancy condition, the fetus does not reach its biological growth potential as a consequence of impaired placental function, which may be because of a variety of factors. Fetuses with FGR are at risk for perinatal morbidity and mortality, and poor long-term health outcomes, such as impaired neurological and cognitive development, and cardiovascular and endocrine diseases in adulthood. At present no gold standard for the diagnosis of SGA/FGR exists. The first aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines. Another aim to summary a number of interventions which are being developed or coming through to clinical trial in an attempt to improve fetal growth in placental insufficiency. Key words: fetal growth restriction (FGR), Small for gestational age (SGA)

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