The term retardation does not imply the possibility of mental handicap. It only signifies a lower weight of the fetus than expected.

PREDISPOSING FACTORS

• Multiple pregnancy
• Malformation
• Infection
• Maternal smoking
• Maternal illnesses like diabetes, hypertension (eg pre-eclampsia), severe anemia, heart and kidney disease.

ANTENATAL DIAGNOSIS

As high as 50% are NOT detected before birth and many babies suspected of IUGR do not have it. If growth retardation is suspected, growth in utero can be monitored by serial ultrasound examinations of head circumference and abdominal circumference. Modern investigations like biophysical profile monitoring and antenatal cardiotocography are used to try to detect those babies who are at higher risk and would benefit from delivery. Mothers who smoke should be advised to stop smoking, to use a fetal kick chart and to take plenty of rest.

DELIVERY AND AFTER CARE

Growth retarded fetus are more susceptible to hypoxia, so monitoring in labor is a must. Hb at birth is high, so jaundice is more common. They are also more susceptible to infection.

EFFECTS OF IUGR IN ADULT LIFE

Many studies have confirmed risk from:

• Hypertension
• Non-insulin-dependent diabetes mellitus
• Coronary artery disease.
• Autoimmune thyroid disease.