II. Epidemiology

  1. Represents 90% of Intrauterine Growth Retardation
  2. Occurs in third trimester

III. Pathophysiology

  1. Results from placental insufficiency
  2. Intrauterine Growth Retardation with head sparing
  3. Severe Asymmetric IUGR may become Symmetric IUGR
  4. Chronic Fetal Hypoxia

IV. Causes: Utero-Placental Insufficiency

  1. Maternal Preeclampsia or Chronic Hypertension
  2. Gestational Diabetes (Second most common cause IUGR)
  3. Maternal Collagen Vascular Disease
  4. Maternal Tobacco abuse
    1. Most common preventable cause of IUGR
    2. Birth weight reduced 200 grams if mother smokes
  5. Maternal Infection

V. Complications

  1. Fewer neurologic complications than Symmetric IUGR
  2. Perinatal complications
    1. Polycythemia (hyperviscosity)
    2. Hypoglycemia

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