Intrauterine growth retardation

Causes and Risks:
A low birth weight may be suspected before delivery if the size of the mother's uterus is small, or if a small fetus is shown by ultrasound . Although the overall size of the infant is small, the organ systems are mature for age. Several factors can cause delayed growth of a fetus. Undernutrition of the fetus may occur as a result of insufficiency of the placenta, multiple pregnancies, heart disease in the mother, preeclampsia or eclampsia , and high altitude. Babies with congenital anomalies are often associated with a below-normal birth weight. Infections during pregnancy that affect the fetus, such as rubella , cytomegalovirus, toxoplasmosis and syphilis , may also affect the birth weight. Risk factors in the mother that may contribute to intrauterine growth retardation include multiple gestation, poor nutrition, heart disease or high blood pressure , smoking , drug addiction , alcohol abuse .

Prevention:
Control risk factors during pregnancy , when possible.

Symptoms:
  • currently pregnant with a feeling that the baby is not as big as it should be
  • infant is a small size for age but other physical characteristics are normal
  • abdominal wall defects



Signs and Tests:
Prenatal examination may show that the fetus is small for the gestational age (the size of the uterus is low compared to the expected size for the weeks of pregnancy ).

Newborn physical examination shows weight below the 10th percentile for age. The length and head size may be below the 10th percentile for age. There are normal physical characteristics and behavior for age.

Tests for prenatal infection may be performed if growth retardation is suspected before a baby is born.

Treatment:
There is no specific treatment. An adequate calorie intake should be maintained in these infants.

Prognosis:
There is a poorer long-term outlook for the general development in infants with intrauterine growth retardation. There may be "catch up" growth in infants whose growth retardation was caused by malnutrition .

Complications:

  • Birth asphyxia, or lack of oxygen during the birthing process may occur if the growth retardation is due to insufficiency of the placenta.
  • Meconium aspiration (aspiration of amniotic fluid that is contaminated with the infant's first stool) may occur as a result of stress during delivery.
  • There may be low blood glucose levels during the first hours or days of life.



Call Your Healthcare Provider:
Call for an appointment with the health care provider if you are pregnant and the baby seems very small.

Also call if an infant or child does not seem to be growing or developing normally.


This is a normal fetal ultrasound performed at 19 weeks gestation. Many health care providers like to have fetal measurements to verify the size of the fetus and to look for any abnormalities. This ultrasound is of an abdominal measurement. It shows a cross-section of the abdomen, and the measurements are indicated by the cross hairs and dotted lines.



This is a normal fetal ultrasound performed at 17 weeks gestation. This is the type of image pregnant mothers may see on the ultrasound screen, or that the technician may print. It shows the head on the right, and the cross hair pointing to the left ankle. The left leg and arm are visible in the center of the screen.



This is a normal ultrasound of the fetus performed at 17 weeks gestation. The fetal face can be seen in the middle of the screen. The head is tilted left toward the placenta, which can be seen as a mound in the left of the ultrasound image. Both eyes are visible, and the area of white within the eye is the lens. Other facial features, such as the nose and mouth, are also visible.



This is a normal ultrasound of the fetus performed at 19 weeks gestation. A clear view of the left femur (the large bone of the leg) can be seen in the middle, towards the top of the ultrasound screen.



This is a normal ultrasound of a fetus at 19 weeks gestation. The right foot, including the developing bones, are clearly visible in the middle of the screen.



This is a normal fetal ultrasound performed at 19 weeks gestation. Many health care providers like to have fetal measurements to verify the size of the fetus and to look for any abnormalities. This ultrasound is of a head measurement, indicated by the cross hairs and dotted lines.



This is a normal fetal ultrasound performed at 19 weeks gestation. This is the type of spilt-screen display you might see during an ultrasound, or if the technician prints a copy of the ultrasound for you. This ultrasound shows both the left arm (seen in the left side of the display), and the lower extremities (seen in the right side of the display). The white areas of the arm or legs is developing bone.



This is a normal fetal ultrasound performed at 17 weeks gestation. In the middle of the screen, the profile of the fetus is visible. The outline of the head can be seen in the left middle of the screen with the face down and the body in the fetal position extending to the lower right of the head. The outline of the spine can be seen on the right middle side of the screen.



This is a normal fetal ultrasound performed at 30 weeks gestation. In the middle of the screen, a clear outline of the spine and ribs is visible. The cross hair is between two ribs just above the spine.



This is a normal fetal ultrasound performed at 17 weeks gestation. The development of the brain and nervous system begins early in fetal development. During an ultrasound, the technician usually looks for the presence of brain ventricles. Ventricles are spaces in the brain that are filled with fluid. In this early ultrasound, the ventricles can be seen as light lines extending through the skull, seen in the upper right side of the image. The cross hair is pointing to the front of the skull, and directly to the right, the lines of the ventricles are visible.