Doctors give the diagnosis of “SZRP” to all children who, at birth, are deficient in body weight relative to their gestational age. Many women learn about such a pathology during pregnancy. From the materials in this article, you will find out what symptoms are accompanied by fetal growth retardation syndrome, why it occurs.
SZRP - what is it?
Fetal development retardation syndrome (FDS) is a pathology characterized by a lag in the size of the baby from the average values recorded as the norm for a certain period of pregnancy. In Russia, the prevalence of this disorder ranges from 5 to 18%. The small size of the child does not always indicate this syndrome. About 70% of children who have been diagnosed with this are naturally low in body weight. Their father or mother may be short. In addition, gender should be considered (girls are usually 5% less than boys, which is approximately 200 g) and nationality.
As a rule, the baby's condition is compensated during the first year of life. He is gradually gaining weight and gaining growth, approaching normative indicators. If the diagnosis confirmed by the doctor becomes the main reason for the lag in the development of the child, affects his health and quality of life, a special treatment package is considered.
There are two forms of SZRP: symmetric and asymmetric. Each pathology variant has its own characteristic features. We will talk about them later in this article.
Asymmetric form of SZRP
Pathology usually occurs in the second trimester and is characterized by a deficiency of the fetal mass during normal growth. The child has a lag in the development of tissues of the abdomen and chest. Asymmetric SZRP is sometimes characterized by uneven formation of systems of internal organs. In the absence of timely treatment, there is a decrease in the size of the child’s head and a lag in the development of the brain, which can provoke its death.
Symmetric form of SZRP
Pathology is characterized by a proportional decrease in the size of the child’s body relative to the average values for a particular gestation period. She is usually diagnosed in the second trimester. The symmetric form of the syndrome in most cases is due to intrauterine infection of the fetus, chromosomal abnormalities. Children with this diagnosis are born with inferior development of the central nervous system.
The main causes of pathology
A baby can be born small for several reasons. The fact that such is its physiological feature should not be ruled out. A small growth baby can inherit from parents. However, even in this case, the doctor will diagnose “fetal growth retardation syndrome”. If after birth the baby’s body is fully functioning, and its reflexes are in accordance with the norms, specific treatment is not required.
Doctors identify specific causes of SZRP, which can lead to hypoxia and even miscarriage. A developmental delay is observed if the baby inside the womb does not receive oxygen and necessary nutrients. Without them, it is impossible to imagine the full activity of the body.
Reducing the amount of incoming substances can be caused by many factors:
- Placental problems. This body is responsible for transporting oxygen to the fetus in the womb. If the placenta is deformed, it cannot function fully.
- Pathologies in the work of the systems of internal organs in a future woman in labor (high blood pressure, anemia, heart and respiratory diseases, diabetes mellitus).
- In the development of the fetus, a special role belongs to the chromosome set, which he receives from his parents.
- Bad habits. Many women smoke and drink alcohol. Bad habits, even if a woman abandoned them shortly before conception, can cause SZRP during pregnancy.
- Doctors constantly say that a woman in a position should eat literally for two. It really is. Following a diet or a sharp decrease in calorie intake can negatively affect a child. If the fetus lacks nutrients, it begins to take them from the mother's body. Food for two does not mean that you need to eat everything. The diet should be balanced and consist exclusively of healthy foods. During pregnancy, one should not be afraid to recover, strict diets are strictly forbidden.
- Taking medications. From medicines while carrying the baby should be discarded. You can take drugs only on the advice of a doctor, when nothing else can be done.
- The diseases of an infectious nature transferred during pregnancy (rubella, toxoplasmosis, syphilis) can stop the development of the fetus. That is why doctors are strongly advised to be vaccinated long before the conception of the baby.
- MFAP 2 degrees are often given to women who live in areas high above sea level. In such regions, pressure is increased, and this often leads to fetal hypoxia and its slow development.
Timely determination of the cause of the syndrome and its subsequent elimination allow the doctor to choose an effective treatment.
What symptoms indicate fetal growth retardation?
The clinical picture of this pathology is usually erased. A pregnant woman is unlikely to be able to suspect a similar diagnosis on her own. Only regular monitoring by a gynecologist for nine months allows a timely identification of the problem.
It is believed that if a woman during pregnancy gains little weight, most likely the fetus is small. This is partly true, but it is rarely true. When a future woman in labor limits her daily diet to 1,500 kcal, is fond of diets, the likelihood of fetal szrp is quite high. On the other hand, the occurrence of pathology should not be ruled out in those women who have an excessively large weight gain.
A clear sign of the syndrome are rare and sluggish fetal movements. Such a symptom should alert and become the reason for an emergency appeal to a specialist.
Screening for fetal growth retardation
If a doctor’s pathological development is suspected, the doctor may alert the discrepancy between the height of the uterine fundus and the normative indicators specific to this period of pregnancy. The most reliable diagnostic option is considered an ultrasound examination of the fetus, during which the specialist estimates its size and weight. In addition, with the help of ultrasound it is possible to determine the state of the systems of the internal organs of the child.
Dopplerometry is also prescribed for suspected SZRP. What it is? This examination is carried out to assess blood flow in the vessels of the baby and the placenta. An important diagnostic method is cardiotocography of the fetus (a study of heartbeat). Normally, heart rate ranges from 120 to approximately 160 beats per minute. When the baby in the womb lacks oxygen, his heartbeat gradually increases.
Based on the results of the examination, the doctor can confirm the diagnosis and determine the severity of the disease.
- The first-degree SZRP is considered the easiest, characterized by a two-week developmental delay from the average anthropometric data.
- SZRP 2 degrees differs from the normative indicators within two to four weeks.
- The most severe is the 3rd degree of SZRP. The size and weight of the baby in the womb do not meet the norms for more than four weeks. In most cases, SZRP 3 degrees leads to fetal freezing.
Treatment methods
To treat this syndrome in obstetrics, a large arsenal of drugs is used that are aimed at normalizing the uteroplacental blood flow.
- Tocolitic agents for uterine relaxation (Ginipral, Papaverine).
- Preparations for the normalization of metabolism in tissues (Curantil, Actovegin).
- Infusion therapy using glucose and blood substitute solutions.
- Vitamin Therapy.
All drugs are prescribed for a long time with constant monitoring of the fetus.
Particular attention in the treatment of SZRP during pregnancy is given to nutrition. The diet should be as balanced as possible. It is not recommended to lean on certain products. You can eat absolutely everything. Meat and dairy products should not be ruled out, as they contain large amounts of animal protein. It is in it that by the end of pregnancy, the need increases by about 50%. It is important not to forget that the main goal of therapy is not to feed the baby, but to provide him with full growth and harmonious development.
Pregnant women are also recommended daily walking, emotional calm. It is traditionally believed that midday sleep has a beneficial effect not only on the condition of the expectant mother, but also on the baby inside the womb.
Pregnancy Management for SZRP
After confirming the final diagnosis, the future woman in labor requires constant monitoring by specialists. Ultrasound is prescribed at least twice a month. A detailed study is necessary to identify the anatomy of the child and structural defects that may cause delays. Amniocentesis is also prescribed for future mothers to evaluate chromosomal abnormalities if pathologies were detected by ultrasound.
Regardless of what factors have influenced the occurrence of SZRP, the consequences for the child may be irreversible. To prevent them, a woman should undergo an ultrasound every two weeks. It is necessary to assess the size of the fetus and its growth rate.
When a woman is in the 37th week, doctors usually decide to stimulate the birth. Until this time, the management of pregnancy depends on the condition of the crumbs inside the womb. If a woman develops symptoms of preeclampsia, doctors decide to have a preterm birth.
Possible complications and consequences
In children with this syndrome, serious complications are often recorded, not only during intrauterine life, but also after birth. The degree of risk directly depends on the causes of the pathological process, its severity and time of onset. According to statistics, the presence of complications is most likely in those children whose birth weight does not exceed 1 kg.
Due to the fact that oxygen and nutrients are not supplied to the fetus with this syndrome, such children may be born already dead. Often they are not able to withstand the load during labor, so doctors usually decide to have a cesarean section.
In children born with SZRP, the consequences of this diagnosis are directly reflected in the work of the main systems of internal organs. They usually have hypoglycemia, poor resistance to infections. They are prone to jaundice and aspiration of meconium, that is, inhalation of the original feces.
If doctors diagnose a degree 2 szrp, the consequences of the pathology are almost impossible to predict. The quality of life of a child primarily depends on the root causes of the syndrome. Some babies are gradually catching up with their peers in development. Others have serious health problems. They are diagnosed with obesity early, which subsequently leads to impaired heart function, diabetes mellitus and hypertension.
Preventive actions
It should not be ignored SZRP. What is this, we have already said. Is it possible to prevent its occurrence?
The best prevention of szdr is early pregnancy planning. Before the immediate conception of the child, future parents must pass a number of tests, treat chronic diseases. Sexual ailments and caries should not be ignored.
Regular visits to the gynecologist after registration for pregnancy play an important role in the prevention of SRO. The sooner the doctor discovers the pathology, the higher the probability of eliminating dangerous complications in the development of the baby during gestation and after it is born.
A pregnant woman should take care of the mode of work and rest. A full sleep should be at least 10 hours at night and 2 hours during the day. If you can’t sleep after lunch, you can afford to lie down in a horizontal position for some time. Daytime sleep helps to normalize blood circulation between the baby and mother, and improves nutrient transfer.
Walking in the fresh air, a balanced diet and moderate physical activity are excellent prevention of SZRP. What does it mean? A woman should eat exclusively healthy foods rich in vitamins and minerals. Doctors recommend a diet high in carbohydrates for some ladies, as these substances improve the mood of the pregnant woman and the health of the fetus inside the womb. Regarding the issue of physical activity, yoga, swimming in the pool are an excellent solution.
Fetal growth retardation syndrome is not a sentence for future parents who are looking forward to the baby. A huge role in the treatment of this pathology belongs to the timeliness of diagnosis. However, its seriousness is not a reason to abandon the child. There are no barriers that loving parents cannot overcome. Especially when the question is about true maternal happiness.