Explore the fascinating realm of Intrauterine Growth Restriction (IUGR) with Dr. Kekin Gala, a respected expert in Obstetrics ...

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Understanding Intrauterine Growth Restriction (IUGR): Types, Causes, Management, Care: Dr Kekin Gala

hello everyone this is Dr kin Gala consultant oberan at srcc Children Hospital managed by Nar Health I'll be talking about iugr in pregnancy intrauterine growth restriction iugr means the baby is not growing adequately as per a particular gestational period of the pregnancy in short grow for that particular month of pregnancy now this happens because the baby does not get an adequate nutrition and nourishment what is required in the pregnancy and it can be because of two reasons placenta placenta is a tissue from which the baby gets nutrition and oxygen and the umbilical cord which transfers the blood from the placenta to the baby so any problem in the placenta and the umbilical cord can lead to iugr in the baby now there are two types of iugr symmetrical ugr and asymmetrical iugr symmetrical iugr means the baby as a whole constitutionally is uh having a low birth or the low growth so the head the fetal Bones the abdominal GTH everything remains uh below the par of the pregnancy asymmetrical iugr means the baby's head and bones are adequately grown as per the gestational period but the abdominal circumference or the abdominal growth is restricted now what are the reasons for iugr babies there are multiple reasons but I will just endl in few of them the commonest ones nutritional deficiency in the mother anemia in the mother low hemoglobin pregnancy indued hypertension the high blood pressure during the pregnancy can cause iugr any genetical problems in the baby can cause iugr infection early infection in the weeks of around 14 to 24 weeks of gestational period can cause symmetrical iugr and the commonest infection would be torch Toxoplasma rubel cytomegalo virus herpes and many more other infections multiple pregnancies in multiple pregnancies can also be a cause of iugr and the lifestyle changes like smoking alcohol Etc can lead to iugr babies now how do we come to a conclusion how do we manage such patients these patients clinically we look into the normal vitals like look into the pulse the blood pressure the blood pressure is monitored if it is high it is p abdominal circumference the abdominal circumference grth we find is little decreased compared to the normal gestational period of other healthy pregnancies this is confirmed via sonography now sonography what is need to be seen is the growth parameters as compared to the last scan done we add color doler to that to see whether the blood flow to the baby is adequate what we need to see is the amniotic fluid index amno notic fluid is the fluid surrounding the baby generally in asymmetrical iugr or even even in symmetrical iugr the AFI is on a little lower side oligo hydram so the sonography can help us to detect iugr the fluid index and the color Doppler changes in the pregnancy now depending on the weeks of gestation and the period of pregnancy the iugr is baby is managed accordingly now these mothers are very frequently monitored by the doctors we need to take care of the baby the right time the baby should be delivered that is more important so there are various parameters medically which a doctor needs to see and look into the pregnancy now what happens is depending the whole IDE idea the whole aim is to continue the pregnancy in neutro as much as possible till we reach the full term but sometimes we might have to deliver the baby earlier due to maternal or fetal problems now maternal problems could be severe pregnancy induce hypertension one of the commonest problems or if there's a severe infection or in the color doler changes where we see the reversal or the absent diastolic flow so these are the indications where we might have to deliver the baby earlier okay now these babies when delivered near term or sometimes we might have to induce them or if the baby is not having a capacity to take the stress of normal labor then a C-section would be indicated now the problems of these babies generally are they are low birth weight so they require an additional stay in the hospital the best idea is to deliver them in a tertiary Center where they have a good neonatal Care Unit these babies can have problems in maintaining the temperature they might have problems in maintaining the sugar levels they are generally hypoglycemic they can catch infection very early so they need an adequate antibiotic support and various other supports which is required for the baby in the neonatal period so in short intrauterine growth restriction first of all adequate nutrition and adequate sleep to the mother is very essential to prevent it the various causes have been discussed from which if treated adequately can prevent iugr once iugr is diagnosed the doctor V doctor concentrates on the pregnancy more frequently than the routine other pregnancies and a timely delivery in a tertiary Center is essential for a healthy mother and healthy baby thank you so much

Dr.

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