What does this mean
The size of the fetus is assessed by ultrasound, measuring the circumference of the head and abdomen, the length of the thigh, and the estimated weight is calculated. If the indicators are lower than expected for the period, they speak of a lag. Next, it is important to understand its nature: with constitutional low birth weight, the blood flow is not impaired, water levels are normal, the child grows evenly, although at the lower limit. With true growth retardation, the placenta works worse, blood flow changes, the amount of amniotic fluid often decreases, and the abdominal circumference lags behind other dimensions. There are early and late forms.
- Evaluation by fetometry with ultrasound
- A constitutionally low-weight fetus is a variant of the norm
- True growth retardation is due to the placenta
- Early form - up to 32 weeks, usually more severe
- Late form - after 32 weeks
- Asymmetrical option: the stomach lags further behind
Causes and risk factors
Most often, the reason is related to the placenta: it is not formed fully, the vessels of the uterus are poorly rebuilt, and the supply of oxygen is reduced. This happens with preeclampsia and arterial hypertension, kidney disease, autoimmune diseases, and coagulation disorders. Smoking, including passive smoking, as well as alcohol and drug use have a strong impact. On the part of the child, the causes include intrauterine infections, chromosomal abnormalities and developmental defects. Separately, multiple births, poor nutrition of the mother and large gaps between births are taken into account.
- Placental insufficiency
- Preeclampsia and hypertension
- Smoking, alcohol, drugs
- Chronic diseases of the mother
- Intrauterine infections
- Chromosomal abnormalities and malformations
- Multiple pregnancy
How is it detected?
The first signal is usually a lag in the height of the uterine fundus when measured at the appointment. They confirm the assumption with ultrasound with fetometry, comparing the sizes with the norm for the period and assessing the dynamics in comparison with the previous study - it is the dynamics that are especially important. At the same time, the amount of amniotic fluid is measured. Doppler ultrasound plays a key role: they study blood flow in the uterine arteries, umbilical cord arteries and middle cerebral artery of the fetus. The CTG picture is complemented by showing the reaction of the child’s heartbeat.
- Measuring the height of the uterine fundus
- Ultrasound with fetometry and dynamics assessment
- Measuring the amount of amniotic fluid
- Doppler analysis of the vessels of the umbilical cord and uterus
- Assessment of fetal cerebral blood flow
- CTG
- Screening for early infections
What does this threaten?
A child with true growth retardation receives less oxygen, therefore the risk of hypoxia increases, and with severe disorders - even more serious consequences. Such children are more likely to be born prematurely, retain heat and sugar levels worse after birth, and require observation by a neonatologist. In the long term, an increased risk of metabolic disorders in adulthood is being discussed. However, with timely detection, regular monitoring and the correct timing of delivery, most children develop well.
- Risk of intrauterine hypoxia
- Premature birth
- Difficulties in adaptation after birth
- Low birth weight
- The need for neonatologist supervision
- With timely help, the prognosis is often favorable
Observation and treatment
There is no drug that would make a child grow faster, so the basis of management is careful observation and correct timing of delivery. The doctor prescribes repeated ultrasounds, Doppler measurements and CTG at intervals depending on the severity. Be sure to eliminate what can be corrected: complete cessation of smoking, control of blood pressure, treatment of chronic diseases, good nutrition and adequate rest. If blood flow or CTG indicators deteriorate, a decision is made on early delivery, first, in case of prematurity, by preventing respiratory disorders in the child.
- Regular ultrasound and Doppler testing
- CTG and movement counting
- Complete smoking cessation
- Blood pressure control
- Treatment of maternal chronic diseases
- Prevention of respiratory distress in prematurity
- Timely delivery when indicators deteriorate
