Key components of management of a growth-restricted fetus:

  • Diagnosis and Evaluation
  • Identify Underlying Causes
  • Frequent Monitoring
  • Doppler Ultrasound
  • Amniotic Fluid Assessment
  • Non-Stress Tests (NST) and Biophysical Profiles (BPP)
  • Delivery Timing
  • Hospitalization
  • Steroids
  • Cesarean Delivery vs. Vaginal Birth
  • Neonatal Care
  • Postpartum Follow-Up

The management of a growth-restricted fetus, also known as intrauterine growth restriction (IUGR), involves close monitoring, timely interventions, and care to optimize the health and well-being of the fetus and pregnant person. Intrauterine growth restriction occurs when a fetus fails to grow at a normal rate, resulting in a smaller size than expected for its gestational age. This condition can lead to an increased risk of complications, and appropriate management is essential to ensure the best possible outcome. Here are the key steps in managing a growth-restricted fetus:

1. Diagnosis and Evaluation:

   – Diagnosis is often based on serial ultrasound measurements that track fetal growth and estimated fetal weight.

   – Detailed ultrasounds are performed to assess blood flow through the umbilical artery, middle cerebral artery, and other vessels to evaluate the fetus’s well-being.

2. Identify Underlying Causes:

   – It’s important to identify any underlying causes of growth restriction, which can include maternal factors (e.g., hypertension, placental disorders), fetal factors (e.g., chromosomal abnormalities), and placental insufficiency.

3. Frequent Monitoring:

   – Growth-restricted fetuses require frequent ultrasounds to monitor growth and assess the well-being of the fetus.

   – Regular monitoring of fetal heart rate and movement patterns helps assess fetal health.

4. Doppler Ultrasound:

   – Doppler ultrasound evaluates blood flow through specific fetal blood vessels, especially the umbilical artery and middle cerebral artery. Abnormal blood flow patterns may indicate compromised placental function.

5. Amniotic Fluid Assessment:

   – Regular assessment of amniotic fluid volume helps ensure that the fetus has a healthy environment for growth and movement.

6. Non-Stress Tests (NST) and Biophysical Profiles (BPP):

   – These tests assess the fetus’s heart rate, movement, muscle tone, and amniotic fluid volume. They provide an indication of the fetus’s well-being.

7. Delivery Timing:

   – The timing of delivery is a crucial consideration. It balances the risks associated with continued growth restriction against the risks of premature birth.

   – In severe cases, early delivery might be recommended to prevent further compromise to the fetus.

8. Hospitalization:

   – In some cases of severe growth restriction or abnormal fetal testing, hospitalization may be necessary for close monitoring and timely intervention.

9. Steroids:

   – If preterm delivery is anticipated due to growth restriction, administration of corticosteroids can help accelerate fetal lung maturation.

10. Cesarean Delivery vs. Vaginal Birth:

    – The mode of delivery depends on various factors, including the fetus’s size, health, gestational age, and the mother’s health.

11. Neonatal Care:

    – If the fetus is born growth-restricted, neonatal care in a specialized neonatal intensive care unit (NICU) may be needed to address potential complications associated with low birth weight.

12. Postpartum Follow-Up:

    – Postpartum monitoring of the baby’s growth and health is important to ensure that any complications are promptly addressed.

The management of a growth-restricted fetus requires a collaborative approach involving obstetricians, maternal-fetal medicine specialists, neonatologists, and other healthcare providers. Decisions regarding interventions and delivery timing are individualized based on the specific circumstances of each case. The goal is to optimize outcomes for both the fetus and the pregnant person while minimizing the risks associated with growth restriction.

BACC Hospital

69/R, Panthapath (Opposite Bashundhara City Complex), Bangladesh , Dhaka, Bangladesh

Service Hours

24/7 Emergency.  24/7 Pharmacy.