The document discusses fetal growth abnormalities such as intrauterine growth restriction (IUGR). IUGR is defined as birth weight below the 10th percentile for gestational age but this definition includes 10% of normal babies. It is better to use customized growth charts based on maternal characteristics. Features of IUGR seen on ultrasound include reduced growth velocity, oligohydramnios, and Doppler changes. Symmetrical IUGR shows equivalent reduction in head and abdominal circumference growth while asymmetrical IUGR shows differential growth. A biophysical profile score of less than 6 is abnormal.

1. Fetal growth
8th December 2013

2. Fetal growth
Intrauterine fetal growth abnormality > fetal abnormalities
Failure to detect --> neonatal morbidity to IUD
Causes:
Utero placental insufficiency
Chromosomal abnormalities
Fetal abnormality
Fetal infection

3. IUGR
Features of IUGR on ultrasound:
Reduction in growth velocity
Oligohydramnios
Reduced bio-physical profile
Mild cardiomegaly
Hyperechoic bowel and dilatation
Doppler changes

4. IUGR

5. IUGR
DEFINITION:
Birth weight <10th centile for gestational age
Problem:
10% normal also included
The majority of fetuses with uteroplacental
insufficiency has measurement above 10th
centile

7. IUGR
Solution:
Better to use customised growth chart
Based on mother's weight, parity, birth wt of
previous children
E.g. A fetus that weighs 2.9kg at 39 w is
probably growth restricted if mother is 6ft tall,
weighs 65kg and has a previous child weighing
4.2kg at birth

9. IUGR
Growth velocity:
A fetus with falling growth velocity that is crossing
centile lines
Correct pregnancy dating is essential

11. IUGR
Symmetrical growth restriction:
Equivalent reduction in growth velocity of both
fetal head circumference & abd circumference (H:A
ratio)

13. Distinguishing between normal and abnormal
pregnancy
Constitutionally small fetus- growth velocity
continues on same centile

14. Pathologically small fetuses:
Growth velocity continues to fall and cross lower
centiles

15. IUGR
Asymmetrical growth restriction:
Differential reduction in growth velocities of the
fetal head to abd circumference = uteroplacental
insufficiency

17. Biophysical profile
< 6 - abnormal
7-8 - suspicious