In the case of intrauterine growth retardation, there is a pathological delay in the growth of an unborn child in the uterus (uterus). The affected children are referred to as SGA children. SGA stands for "small for gestational age". Intrauterine growth retardation, also known as IUGR for short, occurs when the unborn child's weight and height are below the 10th percentile.
The causes of an IUGR may be genetic or influenced by environmental factors. The cause can be both on the child's side and emanating from the mother. The intrauterine growth retardation is usually discovered in the context of prenatal care in the first or second trimester. Around a quarter of all stillbirths are due to an intrauterine growth retardation. The growth retardation can lead to metabolic changes in the fetuses, so that the affected children have a higher mortality risk.
A fetal cause of IUGR is chromosome aberration. Chromosomal aberration is a chromosomal abnormality that affects a genome. The most common aberration is Trisomy 21, also known as Down Syndrome. Abnormalities such as agenesis or aplasia can also lead to a delay in growth. When viruses are transmitted from the mother to the child, they can affect the development and growth of the fetus.
Transmission takes place via the placenta. Infections of the mother with rubella, toxoplasma or genital herpes pose a particularly high risk of disease for the child. Intrauterine growth retardation may also originate in the placenta. A common cause of delayed growth is a multiple pregnancy.
Due to space reasons, there may be growth deficits in one or more children. Placental insufficiency also affects the child's growth. Acute placental insufficiency is caused by acute circulatory disorders. Chronic placental insufficiency is triggered by chronic diseases of the expectant mother.
If there is hypertension and proteinuria during pregnancy, there is usually pre-eclampsia. A fetal complication of preeclampsia is intrauterine growth retardation. Maternal causes of growth retardation are autoimmune diseases and kidney disease. Maternal gestational diabetes can also negatively impact the baby's growth.
The fetus also grows delayed when it receives too little oxygen. Such hypoxia can be caused by anemia, cardiovascular disease or lung disease. High blood pressure, alcohol abuse and smoking during pregnancy also damage the unborn baby and lead to delayed growth. Due to the risk of intrauterine growth retardation, some medicines are contraindicated in pregnancy.
The IUGR can distinguish between two forms. The asymmetric shape occurs in 70 percent of cases. At first only the body weight is affected by the developmental disorder. Although the height is normal, the waist circumference is reduced. The children have too little subcutaneous adipose tissue and thereby develop a very small and thin body that does not fit its proportion to the head.
In the symmetrical form of intrauterine growth retardation, body weight and body length of the unborn child are reduced. Although the circumference of the head is in the right proportion to the rest of the body, body growth does not correspond to the standard values. Intrauterine growth retardation can lead to drastic changes in the child's metabolism.
These metabolic disorders can worsen and worsen after birth and increase the risk of certain chronic diseases later in life. These diseases include, for example, coronary heart disease (CHD). This phenomenon is also referred to as fetal programming.
Suboptimal conditions during pregnancy lead to an irreversible disease susceptibility of the unborn child. Intrauterine growth retardation results in structural changes in organs, a change in the number of cells, an altered blood supply and an altered number of cell receptors. The children can compensate for these changes well, but in the course of life they develop diseases more often than children who were not affected by an IUGR.
Intrauterine growth retardation is usually detected during pregnancy screening in the second or third trimester of the ultrasound scan. Ultrasound-supported, a so-called fetometry is performed. The unborn child is measured in the womb. Routine parameters include head circumference, biparietal diameter, circumference of the fetal abdomen, and length of the femur.
In case of abnormalities further investigations are carried out. These include Doppler sonography and fetal blood gas analysis. In the fetal blood gas analysis, the oxygen content in the blood vessels of the child is checked. Cardiototography records and monitors fetal heart activity. Eventually an amniocentesis will be performed. Here, a puncture of the amniotic sac takes amniotic fluid out of the embryonic blastocyst.
Special examinations of the amniotic fluid can clarify genetic diseases of the embryo. If a mother is suspected, a TORCH serology is performed. The TORCH complex refers to various infectious diseases that can affect the unborn child during pregnancy. In the laboratory, the mother's blood is tested for toxoplasma, coxsackie virus, syphilis, HIV, parvovirus B19, listeriosis, rubella, cytomegalovirus and herpes simplex virus.
In this disease, there is already in the womb to a growth retardation. As a rule, this disease leads to extreme consequential damage after birth and thus to a significant reduction in life expectancy. First and foremost, patients suffer from greatly reduced body weight. Likewise, different lengths on the body can be deformed and it comes to damage to the internal organs.
Metabolic disorders can also occur due to the growth retardation and thus lead to various complications in adulthood. In most cases, the symptoms of this disease can not be completely controlled, resulting in reduced life expectancy and increased susceptibility to infection after birth.
In some cases, the patient's mental development is also limited or severely slowed by this disease. This can also lead to malformations in the heart. After birth, the growth retardation can no longer be treated causally. Should the symptoms be detected before birth, the expectant mother should refrain from using drugs and follow a healthy lifestyle.
This can be used to limit further damage. If the growth retardation has been caused by another illness, premature birth may have to be initiated. This can lead to various complications.
An expectant mother should in principle participate in all preventive and check-up examinations during pregnancy. With these examinations, delays in the development of the embryo can already be detected and diagnosed in imaging procedures several months before the calculated date of birth by the physician.
If the expectant mother has a vague feeling that something is wrong with the fetus or the general development during pregnancy, she should consult a doctor. If the pregnancy belly grows unusually little or if the weight gain of the pregnant women is very low, these abnormalities should be discussed with a doctor. If the expectant mother identifies a peculiarity of the metabolism, the consultation of a doctor is necessary. In case of heart rhythm disorders, changes in blood pressure or palpitations, a doctor should be consulted. If there are problems with sleep, fears or uncertainties, it is advisable to consult a doctor. If genetic disorders are found in the family, they should be discussed with a doctor and clarified.
The therapy depends on the cause. Alcohol and nicotine consumption must be stopped immediately. One goal of the therapy is to improve placental blood flow. Pregnant women often need to keep bed rest after diagnosis. Eventually a stationary recording is required. In severe cases, the birth is initiated before the 37th week of pregnancy.
Although intrauterine growth retardation has no consequences for the mother's health, it has serious consequences for the health of the unborn child. First, changes occur in the metabolism of the fetus, which ensure that physical functions can not express themselves according to age. As a result, the child with physical and mental development disorders come on the world. At best, the baby is underweight at birth and can be supported by appropriate nutrition after birth in its development, so that it no longer suffers in later life, the intrauterine growth retardation.
In the worst case, the consequences are an increased risk of certain chronic diseases that only occur in the course of life. For example, the risk of affected children later becoming ill with coronary heart disease is increased by intrauterine growth retardation.
If the problem arose from a basic disease of the fetus, the prognosis for the further life of the baby depends strongly on this underlying disease. Because it is likely to be underweight and very small in the world, it has little energy reserve to cope well with the burden of its underlying disease. Affected babies must be cared for and examined early in life after birth, because only then physical and mental damage can be detected early and be dammed in its consequences for health in a timely manner.
Intrauterine growth retardation requires intensive medical attention during and after pregnancy. Immediate treatment and subsequent follow-up will help to reduce the physical harm done to the baby. This is very important for the health of the child. It is important for the affected women to strictly follow the doctor's recommendations after diagnosis.
Here is the consistent bed rest in the foreground. The expectant mother needs a lot of sleep and rest. This protection has a positive effect on the course of the disease and affects both the mother and the unborn child. The stress level should be lowered as much as possible. At the same time, physical effort is a taboo for the women affected.
Depending on the situation, only short walks are allowed. The fresh air and the light movement stabilize the physical condition and also improve the mood. This has a positive effect on the psyche and the entire condition. Diet also plays a role.
Together with the doctor, the patient should make an adjustment to the diet in order to supply the body with sufficient nutrients. With balanced meals, lots of vegetables and fresh fruit, the organism gets the necessary strength. On the other hand, too few calories can have a detrimental effect on the further course of pregnancy.
In everyday life there are some methods that people can use for self-help. Most importantly, note that bed rest should be respected. This specifically applies to cases where it has been prescribed by the doctor. During bed rest, attention should be paid to sleep quality and quantity. Sufficient sleep is essential even without prescribed bed rest for the protection of the patients and the unborn child.
The general lifestyle also plays a role. If there is any stress level, it should be kept to a minimum as much as possible. Thus, the greatest possible protection of the patients can be achieved. Those affected should minimize any effort and avoid strenuous physical activity. However, this does not apply to short walks in the fresh air. These can have a positive effect on the psyche and the body and thus contribute to an improvement of the condition.
Furthermore, the diet of the patients to control. If this is too one-sided, the diet should be changed. A suitable meal plan contains as balanced a diet as possible, lots of fresh fruits and vegetables. Even too low a calorie intake can be harmful. Therefore, it is important to ensure sufficient nutrient intake. Any nicotine or alcohol consumption should be stopped immediately after diagnosis.