Iugr

1. INTRAUTERINE GROWTH RESTRICTION FAHAD ZAKWAN

2. What factors affect fetal weight?

3. Toxoplasmosis Rubella

4. Trisomy 18 Turner syndrome

5. Trisomy 13

6. SYMMETRICAL IUGR ASYMMETRICAL IUGR EARLY ONSET. SEEN IN 20% CASES LATE ONSET. SEEN IN 80% CASES ETIOLOGY : GENETIC DISEASE/ INFECTION (INTRINSIC TO FETUS) ETIOLOGY: CHRONIC PLACENTAL INSUFFICIENCY(EXTRINSIC TO FETUS) TOTAL CELL NUMBER : LESS, CELL SIZE : NORMAL TOTAL CELL NUMBER : NORMAL, CELL SIZE : SMALLER USG : ALL PARAMETERS (HC, BPD, AC, FL) SMALLER THAN EXPECTED USG : HEAD SPARING EFFECT, BUT ABDOMEN IS SMALL NEONATAL COURSE : COMPLICATED WITH POOR Px USUALLY UNCOMPLICATED HAVING GOOD Px

7. BIOPHYSICAL TEST : THE FIRST EXAM SHOULD CONFIRM THE CLINICAL ESTIMATION OF THE GESTATIONAL AGE

8. Fetal distress / death. Asphyxia & RDS. Hypoglycemia. Meconium aspiration syndrome. Hypothermia. Pulmonary hemorrhage. May have retarded growth . May have cardiac disease, diabetes, in adulthood, if survives. Long term complications Lower IQ, learning & behavior problems, major neurological handicap seizures, cerebral palsy, mental retardation

9. Increased meconium aspiration Decreased surfactant deficiency

10. Severe degree of IUGR – termination is to be done if lung maturation is achieved. - If lung maturation has not been achieved corticosteroid therapy (betnasol 12 mg i.m. 24 hrs apart – 2 doses given to reduce the risk of neonatal RDS) 9. CS – to be done in the case of preterm delivery & unfavorable cervix. 10. Baby should be shifted to intensive neonatal care unit.