II. Definitions

  1. Intrauterine Growth Retardation (IUGR)
    1. Estimated fetal weight < 10% per Gestational age
    2. Some suggest cutoff of 5% to reduce false positives
  2. Small for Gestational Age (SGA)
    1. Normal small infants without adverse risks

III. Evaluation

  1. Indicators of IUGR
    1. Poor Maternal Weight gain
      1. Most sensitive indicator for IUGR
    2. Fundal Height less than expected for Gestational age
  2. Consider environmental and comorbid factors
    1. Tobacco abuse (most significant individual risk)
    2. Poor Nutrition
    3. Illicit Drug Use
    4. Alcohol Abuse
    5. Minimal to no Prenatal Care
    6. Traumatic stress
  3. Fetal Assessment
    1. Follow Fetal Movement Counts (kick) counts
    2. Follow Non-Stress Test
    3. Serial Obstetric Ultrasounds for growth
    4. Biophysical Profile

IV. Diagnosis

  1. Detection rate in-utero: 70%
  2. Indications for Obstetric Ultrasound
    1. Low risk fetus smaller than expected size
    2. High risk monitoring
  3. Ultrasound interpretation
    1. Head Circumference to Abdominal Circumference ratio
      1. Most useful in assessing Asymmetric IUGR

V. Management

  1. Address risk factors
    1. Tobacco Cessation
    2. Eliminate other negative habits
    3. Ensure adequate maternal weight gain
    4. Maximize Prenatal Care
    5. Reduce environmental stressors
  2. Perinatology Consultation Indications
    1. Poor Nonstress Test
    2. Decreasing Biparietal diameter
    3. Oligohydramnios
    4. Abdominal circumference 4 weeks less than BPD
  3. Early Delivery Indications
    1. Doppler diastolic flow 0 mmHg in umbilical artery

VI. Complications: Peripartum Risks of IUGR

  1. Meconium Aspiration
  2. Intrauterine Asphyxia
  3. Polycythemia
  4. Hypoglycemia

VII. Causes: Intrauterine Growth Retardation (IUGR)

  1. Symmetric IUGR (Head and body growth retarded)
  2. Asymmetric IUGR (head growth spared)

VIII. References

  1. Gabbe (1996) Obstetrics, Churchill, p. 863-886
  2. Ahluwalia (2001) Obstet Gynecol 97:649-56 [PubMed]

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Ontology: Fetal Growth Retardation (C0015934)

Definition (NCI_CTCAE) A disorder characterized by inhibition of fetal growth resulting in the inability of the fetus to achieve its potential weight.
Definition (NCI) A fetus that does not grow beyond the 10th percentile of conventionally accepted weight for gestational age.(NICHD)
Definition (CSP) abnormal fetal physical growth or growth potential at any gestational stage.
Definition (MSH) The failure of a FETUS to attain its expected FETAL GROWTH at any GESTATIONAL AGE.
Concepts Pathologic Function (T046)
MSH D005317
ICD9 764.90, 764.9
ICD10 P05.9
SnomedCT 22033007, 206166000, 156185006, 267337006, 268815007
English Growth Retardation, Fetal, Growth Retardation, Intrauterine, Intrauterine Growth Retardation, IUGR, Retardation, Fetal Growth, Retardation, Intrauterine Growth, Fetal growth retardation NOS, IUGR - Intraut growth retardat, Intrauterine growth retardatn., Slow fetal growth, unspecified, prenatal growth disorder, Fetal growth retardation, Fetal growth restriction, Intrauterine growth retardation (IUGR), intrauterine growth retardation, intrauterine growth retardation (diagnosis), Intrauterine growth restriction, Fet growth retard wtNOS, Fetal Growth Retardation [Disease/Finding], Foetal growth retardation, unspecified, Foetal growth restriction, Intrauterine growth retard, Fetal growth retardation, unspecified {weight}, Growth intrauterine retard, Fetal growth retardation, unspecified, Foetal growth retardation, Foetal growth retardation, unspecified {weight}, fetal growth retardation, growth intrauterine retardation, iugr, microsomia, intrauterine growth retard, poor fetal growth, iugrs, growth intrauterine restriction, intrauterine growth restriction, Intrauterine Growth Restriction, Fetal growth retardation, unspecified, unspecified [weight], Fetal growth retardation, unspecified [weight], Poor prenatal growth, (Fetal growth retardation NOS) or (intrauterine growth retardation), Insufficiency - placental, (Fetal growth retardation NOS) or (intrauterine growth retardation) (disorder), Fetal growth retardation NOS (disorder), Fetal Growth Restriction, Poor fetal growth state, Intrauterine growth retardation, Microsomia, Microsomic baby, IUGR - Intrauterine growth retardation, Poor fetal growth, FGR - Fetal growth retardation, Fetal growth retardation (disorder), fetal; growth retardation, fetal; poor growth, fetal; slow growth, poor; fetal growth, slow; fetal growth, Fetal growth retardation, NOS, Intrauterine growth retardation, NOS, Foetal growth retardation, NOS, Fetal Growth Retardation, Fetal growth retardation, unspecified weight, Intrauterine growth retardatio, intrauterine growth retardatio
Swedish Hämmad fostertillväxt
Finnish Sikiön kasvun hidastuminen
Russian RAZVITIIA PLODA ZADERZHKA VNUTRIMATOCHNAIA, PLODA RAZVITIIA ZADERZHKA, VNUTRIMATOCHNOGO RAZVITIIA PLODA ZADERZHKA, ВНУТРИМАТОЧНОГО РАЗВИТИЯ ПЛОДА ЗАДЕРЖКА, ПЛОДА РАЗВИТИЯ ЗАДЕРЖКА, РАЗВИТИЯ ПЛОДА ЗАДЕРЖКА ВНУТРИМАТОЧНАЯ
German Intrauterine Mangelentwicklung, nicht naeher bezeichnet, fetale Wachstumsverzoegerung, Wachstum, intraunterin, verzoegert, fetale Wachstumsverzoegerung, unspezifisch, fetale Wachstumsverzoegerung, unspezifisch {Gewicht}, intrauterine Wachstumsverzoegerung, intrauterines Wachstum verzoegert, Wachstumseinschraenkung des Foetus, Mikrosomie, Fetale Wachstumsretardierung, IUGR, Intrauteriner Wachstumsrückstand, Wachstumsrückstand, intrauteriner
Italian IUGR, Ritardo di crescita intrauterina, Ritardo di crescita fetale, non specificato, Ritardo di crescita fetale, non specificato {peso}, Restrizione della crescita fetale, Ritardo della crescita fetale, senza specificazione del peso, Distrofia fetale non specificata, Microsomia, Ritardo di crescita fetale
Korean 상세불명의 태아 성장 지연
Croatian FETUSNI RAST, RETARDACIJA
Dutch niet-gespecificeerde foetale groeivertraging {gewicht}, groei intra-uterien vertraagd, niet-gespecificeerde foetale groeivertraging, achterblijven van foetale groei, foetale groeivertraging, intra-uteriene groeivertraging, foetale groeibeperking, foetale groeivertraging, niet-gespecificeerd, {gewicht}, foetale groeivertraging, niet-gespecificeerd, microsomie, foetaal; groei-achterstand, foetaal; slechte groei, foetaal; trage groei, slecht; foetale groei, traag; foetale groei, Trage foetale groei, niet gespecificeerd, Foetale groeistoornis, Groeistoornis, foetale, Groeivertraging, intra-uteriene, Intra-uteriene groeivertraging
Spanish Crecimiento intrauterino retardado, Retraso en el crecimiento intrauterino, Retraso en el crecimiento fetal, no especificado (peso), Retardo del crecimiento fetal (con peso) no especificado, Retraso del crecimiento fetal, Restricción del crecimiento fetal, Retraso en el crecimiento fetal, Retraso en el crecimiento fetal, no especificado, Retardo del crecimiento fetal no especificado, Microsomía, retardo de crecimiento fetal, SAI (trastorno), retardo de crecimiento fetal, SAI, RCIU, retardo del crecimiento fetal (trastorno), retardo del crecimiento fetal, retardo del crecimiento intrauterino, retraso de crecimiento fetal, bebé microsómico, estado de crecimiento fetal pobre, microsomía, Retardo del Crecimiento Fetal, Retardo del Crecimiento Intrauterino
Portuguese Atraso do crescimento fetal, Atraso do crescimento fetal NE, Atraso de crescimento intra-uterino, Atraso do crescimento fetal NE (peso), Restrição do crescimento fetal, Microsomia, Retardo do Crescimento Intrauterino, RCIU, Retardo do Crescimento Fetal
French Retard de croissance foetale, non précisé {poids}, Retard de croissance foetale, non précisé, Retard de croissance foetale, poids non précisé, Retard de croissance intra-utérine, Restriction de croissance foetale, Microsomie, Hypotrophie foetale, Retard de croissance foetale, Retard de croissance intra-utérin, Retard du développement foetal, RCIU, Retard de croissance intra-utérin (RCIU)
Japanese タイジハツイクチエン, 胎児発育遅延、体重詳細不明, 胎児発育遅延、詳細不明, 胎児発育遅延, シキュウナイタイジハツイクチエン, タイジハツイクチエンタイジュウショウサイフメイ, タイジハツイクチエンショウサイフメイ, ショウタイショウ, 小体症, 子宮内成長遅滞, 胎児成長遅滞, 子宮内胎児発育遅延, 成長遅滞-子宮内
Czech Intrauterinní růstová retardace, Růstová retardace plodu, blíže neurčená (váha), Růstová retardace plodu, Retardace intrauterinního růstu, Opoždění vývoje plodu, Retardace růstu plodu, blíže neurčená (váha), Retardace růstu plodu, Opožděný vývoj plodu, Růstová retardace plodu, blíže neurčená, Zpomalení intrauterinního růstu, Retardace růstu plodu, blíže neurčená, Mikrosomie, nitroděložní růstová retardace, fetální růstová retardace, IUGR, intrauterinní růstová restrikce plodu, fétus - růstová retardace, intrauterinní růstová retardace
Polish Hipotrofia płodu wewnątrzmaciczna, Opóźnienie rozwoju płodu
Hungarian Intrauterin növekedési retardatio, Intrauterin növekedési visszamaradás, Magzati növekedés retardatiója, Magzati növekedés korlátozása, Magzati növekedés retardatiója, nem meghatározott, Magzati növekedési retardatio, nem meghatározott {súly}, Microsomia, Növekedési intrauterin visszamaradás, Magzat növekedés korlátozása, Magzati növekedés retardatiója, nem meghatározott {súly}, Magzati növekedési retardatio, Magzati növekedési retardatio, nem meghatározott
Norwegian Føtal vekstretardasjon, Intrauterin veksthemming, Hemmet fostervekst, Hemmet føtal vekst, Veksthemming, intrauterin