● Problems with breathing and feeding
● Trouble keeping a steady body temperature
● Abnormal blood cell counts
● Low blood sugar level (hypoglycemia)
● Problems fighting off infections
● Neurological problems
What causes FGR?
It may happen because the baby doesn't get enough nutrients and nourishment. This can happen if there is a problem with the placenta or blood flow in the umbilical cord, which connects the baby to the placenta. Rarely, birth defects and genetic disorders can also be the cause.
Intrauterine growth restriction also can happen if a pregnant person:
● Has an infection
● Has high blood pressure
● Has kidney or heart disease
● Has diabetes prior to pregnancy
● Smokes, drinks alcohol or use drugs
● Takes some types of medicines, such as some seizure treatments
● Has a medical condition such as lupus, anaemia, or clotting problems
● Is carrying a baby that has a genetic disorder or birth defect
● Is pregnant with multiples (such as twins or triplets)
How is this diagnosed?
Before your baby is born, your LMC or specialist will check their growth by measuring your belly from the top of the pubic bone to the top of the uterus. This is called the fundal height. (And the size of your bump definitely isn't a good indicator, for that matter.)
They also can do an ultrasound, which is how FGR is often diagnosed. The ultrasound scan helps specialists estimate the baby's size and weight. These estimates aren't exact, but they do help health care providers track your baby's growth and see if there's a problem.
They will also be able to see the amount of amniotic fluid in your uterus - in some babies who have FGR, the amount of amniotic fluid is low. They will check the blood flow to the placenta and through the umbilical cord.
If they think a baby has FGR, they may also suggest such tests as:
● Fetal monitoring to track the baby's heart rate and movements
● Screening you for infections that could affect the baby
● Amniocentesis to look for genetic causes of FGR (and sometimes to help them see how mature the baby's lungs are)
What is the treatment pathway?
Treatment for FGR depends on how far along your pregnancy is and how your baby is doing. Your LMC and specialists will monitor you and your baby closely during visits. You will be booked in for added ultrasounds, keep track of the baby's growth, and watch for other problems.
If you have a health condition, this will be managed. This might include making sure you eat a healthy and nutritious diet and gain the right amount of weight during your pregnancy. Some women might need to go on bed rest to try to improve blood flow to their baby.
Try to get eight hours of sleep (or more) each night. An hour or two of rest in the afternoon is also good for you. Rest will not only help you feel better, it may even help your baby grow.
Sometimes, it will be recommended to induce labour and delivery early. They might do this if your baby seems to have stopped growing, or if there's a problem with the placenta or the blood flow in the umbilical cord. Sometimes, babies with FGR appear to be small but healthy.
If there are no signs of problems with your baby during labour, a vaginal delivery is okay. A caesarean section may be suggested if the stress of vaginal delivery is considered too risky for your baby.
Babies born with FGR usually need to stay in the hospital longer after birth. This is especially true for babies born early. They need to breathe and feed normally, as well as gain weight before they can go home.
Babies born with FGR often catch up in size and have a normal height and weight by about two years of age.
■ Bellies to Babies Antenatal & Postnatal Classes, baby massage courses and baby and infant first aid courses, 2087 Pakowhai Rd, Hawke's Bay, 022 637 0624. https://www.hbantenatal-classes.co.nz/
Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice. The information is not intended to replace medical advice offered by physicians.
