Approximately one out of every ten women in a position is diagnosed with a diagnosis of "intrauterine growth retardation" (IUGR). The specialist determines the presence of deviations, characterized by a mismatch in the size of the baby normative indicators for a particular week of development. How much this pathology is really dangerous and what it threatens the child, it is important to know every mother, because absolutely no one is safe from such a phenomenon.
What is the ZVUR?
Delayed fetal development, as a rule, is diagnosed on the basis of ultrasound. Pathology is determined if the baby's weight is less than the normative indicators characteristic of this period of development. In medical practice, specially designed tables are used that indicate the weight of the fetus in accordance with its gestational age, that is, the time since fertilization. This indicator is usually determined in weeks. In other words, there are certain norms for each period of pregnancy. The main unit of measurement in such tables is percentile. If the fetus is less than 10 percentiles according to this table, the doctor confirms the presence of pathology.
Intrauterine growth retardation: causes
Sometimes with a diagnosis of IUGR, parents need not worry. It happens that a baby is born small, as his dad and mom are not very tall. This physiological feature does not affect the activity of the child, his mental and physical development. During pregnancy and after birth, such a baby does not need narrowly targeted therapy.
In all other situations, you should pay special attention to the diagnosis. This condition may lead to deviations in the development of the child or even death of the fetus. ZVUR may indicate that the baby in the womb does not eat well. This means that it does not receive enough nutrients and oxygen. Nutritional deficiency is usually due to the following reasons:
- Wrong chromosome set.
- Bad habits of the mother (smoking, drinking alcohol and drugs).
- Pathogenic diseases (hypertension, anemia, ailments of the cardiovascular system).
- Improper location and subsequent formation of the placenta.
In addition, doctors call a number of other reasons that can also provoke a syndrome of intrauterine growth retardation:
- Multiple pregnancy.
- The use of drugs without a doctor's prescription.
- Childbirth after 42 weeks.
- Poor nutrition. Many women do not want to get better during pregnancy, so they exhaust themselves with diets. By this they provoke depletion of the body, which leads to the development of pathology.
- Infectious diseases (toxoplasmosis, rubella, syphilis).
Clinical picture
What are the symptoms of intrauterine growth retardation? Signs of pathology are most often manifested in the early stages (approximately 24-26 weeks). A woman is not able to determine them on her own, this can only be done by a doctor. ZVUR syndrome is diagnosed if the following indicators do not meet the standards:
- The size of the baby’s head and thigh .
- The abdominal circumference at a certain level, the height of the bottom of the uterus.
- Amniotic fluid volume.
- Impaired functioning of the placenta (its structure and size change).
- Heart rate of the fetus.
- Blood flow in the placenta and umbilical cord.
In some cases, the pathology develops rather quickly and progresses without any disturbances, that is, it is asymptomatic.
Severity
- I degree. The intrauterine growth retardation of the 1st degree fetus is considered relatively easy, since the lag in development from anthropometric data corresponding to a certain gestational age is only two weeks. Timely prescribed therapy can be effective and minimize the likelihood of negative consequences for the baby.
- II degree. Development delay is approximately 3-4 weeks, serious treatment is required.
- III degree. It is considered the most severe form due to the lag of the fetal parameters by one month or more. This condition is usually accompanied by so-called organic changes. Delayed fetal development of the 3rd degree fetus often ends in death.
Asymmetric form of pathology
In this case, there is a significant decrease in fetal weight with normal growth. The child is diagnosed with a lag in the formation of soft tissues of the chest and abdomen, abnormal development of the body. Uneven growth of the systems of internal organs is possible. In the absence of adequate therapy, a gradual decrease in head size and a lag in brain development begins, which almost always entails fetal death. An asymmetric variant of the IUGR syndrome occurs mainly in the third trimester against the background of general placental insufficiency.
Symmetric form of pathology
With a symmetrical shape, a uniform decrease in the mass, size of organs and growth of the fetus is observed. Such a pathology most often develops in the initial stages of pregnancy due to fetal diseases (infection, chromosomal abnormalities). Symmetric intrauterine growth retardation increases the likelihood of having a baby with a defectively formed central nervous system.
Diagnostic measures
If you suspect this pathology, a woman is recommended to undergo a full diagnostic examination. First of all, the doctor collects the patient’s history, clarifies the previously transferred gynecological diseases, especially the course of the previous pregnancy. Then a physical examination is carried out with the obligatory measurement of the circumference of the abdomen, uterine fundus, height and weight of the woman.
In addition, ultrasound, dopplerometry (assessment of blood flow in arteries and veins) and cardiotocography (continuous recording of fetal heart rate, its activity and uterine contractions directly) may be required. Based on the results of the tests performed, a specialist can confirm the diagnosis or refute it.
What treatment is required?
To determine the subsequent tactics of pregnancy after confirming the diagnosis of "intrauterine growth retardation", the causes of the pathology, the form and degree of the disease should be taken into account. The basic principles of therapy should be focused on improving blood flow in the uterus-placenta-fetus system. All therapeutic measures are carried out in stationary conditions. First of all, a woman needs to ensure peace, a balanced diet and a full, long sleep. An important element of therapy is monitoring the current condition of the fetus. For these purposes, ultrasound is used every 7-14 days, cardiotocography and Doppler blood flow.
Medication includes the use of angioprotectors to protect blood vessels, tocolytics against uterine muscle tension (Papaverine, No-shpa), and general strengthening agents. In addition, all women, without exception, are prescribed drugs that reduce neuropsychic agitation (tincture of motherwort, valerian) and improve blood flow in the placenta (Actovegin, Curantil).
Depending on the severity of the pathology, the results of treatment may vary. The intrauterine growth retardation of the 1st degree fetus usually lends itself well to therapy, the likelihood of further negative consequences is minimized. With more serious pathologies, a different approach to treatment is necessary, while its results are quite difficult to predict.
Abortion
Early delivery, regardless of gestational age, is recommended in the following cases:
- Lack of growth in fetal outcomes for 14 days.
- A noticeable deterioration in the condition of the baby inside the womb (for example, a slowdown in blood flow in the vessels).
Pregnancy is maintained up to a maximum of 37 weeks in the event that due to drug therapy there is an improvement in indicators when you do not have to talk about the diagnosis of "intrauterine growth retardation."
Consequences and possible complications
Kids with such a pathology after birth may have deviations of varying severity, their subsequent compatibility with ordinary life will largely depend on their parents.
The first consequences appear already at delivery (hypoxia, neurological disorders). The delay in fetal development inhibits the maturation of the central nervous system and its functions, which affects all systems. In such children, the body's defenses are usually weakened, at a more mature age there is an increased likelihood of the appearance of diseases of the cardiovascular system.
In children under five years of age, they are often diagnosed with slow weight gain, psychomotor retardation in development, improper formation of internal organs systems, and hyper excitability. In adolescence, a high risk of diabetes. Such children are usually prone to fullness, they have problems with blood pressure. This does not mean at all that their daily existence will be reduced to taking medications and living in hospitals. They simply need to pay a little more attention to their own nutrition and daily physical activity.
Some children who have been diagnosed with intrauterine growth retardation of the 2nd degree fetus and have been treated accordingly do not differ from their peers. They lead a familiar lifestyle, play sports, communicate with friends and receive education.
How can IUGR be prevented?
The best prevention of this pathology is planning for an upcoming pregnancy. In about six months, future parents should undergo a comprehensive examination and treat all existing chronic diseases. Refusal of addictions, the right way of life, a balanced diet and daily dosed physical activity are the best way to prevent IUGR.
A regular visit to the antenatal clinic after registration plays an important role in the diagnosis of "intrauterine growth retardation." Treatment of a timely detected pathology minimizes the risk of negative consequences.
Pregnant women should have a well-built work and sleep regimen. Proper and complete rest implies 10 hours of sleep at night and 2 hours in the daytime. This regimen improves blood circulation and the transport of nutrients between mother and baby.
Daily walks in the fresh air, dosed physical activity not only improve the overall health of the pregnant woman, but also normalize the condition of the fetus inside the womb.
Conclusion
Do not ignore such a pathology as a delay in the fetal development, the consequences of which can be the most sad. On the other hand, parents should not take this diagnosis as a sentence. If it is delivered on time, the future woman in labor will take all necessary measures to eliminate his cause and will follow all the recommendations of the doctor, the prognosis may be favorable. In the world there are no obstacles that cannot be overcome. It is important to remember that the happiness of motherhood is incomparable!