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The most common definition of intrauterine growth restriction (IUGR) is a fetal weight that is

below the 10th percentile for gestational age as determined through an ultrasound. This can
also be called small-for gestational age (SGA) or fetal growth restriction.

Are there different types of IUGR?

There are basically two different types of IUGR:

Symmetric or primary IUGR is characterized by all internal organs being reduced in size.
Symmetric IUGR accounts for 20% to 25% of all cases of IUGR.

Asymmetric or secondary IUGR is characterized by the head and brain being normal in
size, but the abdomen is smaller. Typically this is not evident until the third trimester.

What are the risk factors for developing IUGR?

Pregnancies that have any of the following conditions may be at a greater risk for developing

Maternal weight of less than 100 pounds

Poor nutrition during pregnancy

Birth defects or chromosomal abnormalities

Use of drugs, cigarettes, and/or alcohol

Pregnancy induced hypertension (PIH)

Placental abnormalities

Umbilical cord abnormalities

Multiple pregnancy

Gestational diabetes in the mother

Low levels of amniotic fluid or oligohydramnios

How is IUGR diagnosed?

One of the most important things when diagnosing IUGR is to ensure accurate dating of the
pregnancy. Gestational age can be calculated by using the first day of your last menstrual
period (LMP) and also by early ultrasound calculations.
Once gestational age has been established, the following methods can be used to diagnose

Fundal height that does not coincide with gestational age

Measurements calculated in an ultrasound are smaller than would be expected for the
gestational age

Abnormal findings discovered by a Doppler ultrasound

How is IUGR treated?

Despite new research the optimal treatment for IUGR remains problematic. Most likely the
treatment will depend on how far along you are in your pregnancy.

If gestational age is 34 weeks or greater, health care providers may recommend being
induced for an early delivery.

If gestational age is less than 34 weeks, health care providers will continue monitoring
until 34 weeks or beyond. Fetal well-being and the amount of amniotic fluid will be
monitored during this time. If either of these becomes a concern, then immediate
delivery may be recommended.
Depending on your health care provider, you will likely have appointments every 2 to 6
weeks until you deliver. If delivery is suggested prior to 34 weeks, your health care
provider may perform an amniocentesis to help evaluate fetal lung maturity.

What are the risks to a baby born with IUGR?

Increased risk for cesarean delivery

Increased risk for hypoxia (lack of oxygen when the baby is born)

Increased risk for meconium aspiration, which is when the baby swallows part of the first
bowel movement. This can cause the alveoli to be over distended, a pneumothorax to
occur, and/or the baby can develop bacterial pneumonia.

Hypoglycemia (low blood sugar)

Polycythemia (increased number of red blood cells)

Hyperviscosity (decreased blood flow due to an increased number of red blood cells)

Increased risk for motor and neurological disabilities

Last Updated: 01/2007

Compiled using information from the following sources:

Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 12.
Danforths Obstetrics and Gynecology Ninth Ed. Scott, James R., et al, Ch. 38.