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Have a severe case of IUGR. Pregnant. Treatment? Mother at risk?

Hello, My wife is 25 weeks pregnant and doc says she is a severe case of IUGR (Intra untrinal growth restriction) and the pregnancy wont be able to sustain as there is no treatment available for this situation.The other opinion is to give here iv fluids and steriods.Kindly guide us as what needs to be done .In case the same situation prevails what are the risk for the monther. My first priority is my wife s health and the second is that the baby being born should be a healthy one.
Asked On : Mon, 17 Dec 2012
Answers:  1 Views:  128
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OBGYN 's  Response
Mar 2013
Intrauterine growth restriction (IUGR) refers to a condition in which an unborn baby is smaller than it should be because it is not growing at a normal rate inside the uterus. IUGR causes risks to fetus in form of :

Low birth weight
Decreased oxygen levels at birth, hence decreased breathing capacity.
Hypoglycemia (low blood sugar)
Prone to infections
Low Apgar scores (a test given immediately after birth to evaluate the newborn's physical condition and determine need for special medical care)
Meconimum aspiration (inhalation of stools passed while in the uterus), which can lead to breathing problems
Trouble maintaining body temperature

In the most severe cases, IUGR can lead to stillbirth. It can also cause long-term growth problems, delayed milestones, cerebral palsy etc.

IUGR has many possible causes, such as placental dysfunction, chromosomally abnormal babies, maternal problems such as diabetes, high blood pressure, renal disease, intrauterine infectins, anemia, smoking, alcohol etc.

There are many ways to diagnose and classify IUGR - measuring fundal height of uterus, ultrasound evaluation of fetal weight, growth and amniotic fluid, Doppler flow indices etc.

The best way to manage IUGR depends on the severity of growth restriction and how early the problem began in the pregnancy. Generally, the earlier IUGR begins and the more severe it is, the greater the risks to the unborn baby. Careful monitoring of the fetus is essential

Although it is not possible to reverse IUGR, the following may help slow or minimize the effects by improving maternal nutrition and fluid intake, rest, iv fluids, steroids if the IUGR is severe and risk of intrauterine death or extreme preterm birth is there. Steroids are given to enhance lung maturity of the unborn baby.

In severe IUGR, if chances of fetal stillbirth are high, preterm delivery by cesarean section will be done. You have not mentioned details of IUGR, but as you say it is severe IUGR, prognosis of fetus is definitely not good. Prolonged neonatal care maybe required.

The mother is at risk only if she has co existing medical diseases, and the risks of C- section, which will be counselled by your obstetrician.
All the best.

Answered: Tue, 18 Dec 2012
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