Intrauterine growth restriction

Small sized babies don't necessarily mean there is a problem with the baby, but if its size is due to poor growth then there is a cause for concern. Some babies start off growing well and then slow down; others don't grow as well. Intrauterine growth restriction or IUGR is when your baby's estimated weight is below the 10th percentile for his gestational age. Research shows that babies are more likely to acquire multitude health problems if their weight is below the 3rd percentile.

The risks..

• Premature labor
• Shortage of oxygen reaching baby at birth
• Neurological problems for baby after birth

The causes..

• Placental problems
• If the mother is carrying twins or more babies
• Certain medications
• Certain infections
• If the mother has medical problems like kidney, heart, severe diabetes
• Sometimes there is just nothing wrong and the baby is naturally small

The detection process..

There are various ways to detect 'small for dates' baby and most of these methods are not effective on their own. They need to be combined to arrive at something concrete and relevant.

• Your doctor will feel your abdomen and/or measure your fundal height
• A detailed ultrasound will measure baby size, amniotic fluid and the rate the blood is flowing through the umbilical cord. These tests will be combined to show how well your baby is progressing.
• If the ultrasound shows that everything is normal then it is just a case of your baby being small.
• If the ultrasound shows that all is not well then you will need to go for repeat tests every 2-4 weeks
• If the detection is made in your second trimester, you may have to follow up with an amnio to rule out chromosomal abnormalities
  
• You may be offered blood tests to check for infection or blood clotting abnormalities; this depends on case to case
• Your baby will be monitored with nonstress tests, biophysical profiles and possibly Doppler sonography. You will also be asked to do daily fetal kick counts
• Measuring the trend of growth is important (this is plotted on a chart for record). After all, your baby could be small in size but healthy.
• Baby's weight and size could depend on factors such as mother's own height and weight, gender of baby, if it is the first baby or later baby (later babies tend to be bigger), ethnicity

If it is IUGR..

• If a baby is not thriving and you are near term an early delivery is very probable
• If your baby is not able to handle labor stress, c-section will be scheduled
• If you or your baby are not doing well and your pregnancy is no where close to the due date, you will be induced. Prior to being induced you may be given steroids to help your baby's lungs mature.