fetal growth retardation
Introduction
Introduction Intrauterine growth retardation (IUGR): Traditionally, the fetal weight is less than the 10th percentile of the average body weight of the gestational age or 2 standard deviations below the average body weight. However, it is not exactly the same as small for gestational age (SGA). SGA is a normal structure without malnutrition. Perinatal children have no adverse outcomes. IUGR is caused by pathological causes, which not only affects fetal development, but also affects physical development during childhood and adolescence. The incidence is 2.75%-15.53%, and the perinatal mortality is 4-6 times that of normal fetuses.
Cause
Cause
Pregnant women factors:
1. The difference in fetal weight 40% comes from the genetic factors of the parents, and is influenced by the genetic factors of the pregnant women, which is related to the pre-pregnancy weight, the age at the time of pregnancy and the parity of the fetus. If the body weight is less than 54kg before pregnancy and the body weight is too small or too large during pregnancy, the chance of intrauterine growth retardation increases.
2. Malnutrition in pregnant women, especially insufficient supply of protein and energy, chronic hypoxemia or low oxygen transport capacity, pregnancy with kidney disease, severe anemia, severe heart disease, pregnancy-induced hypertension syndrome, chronic hypertension, etc. Vascular disease, affecting the blood flow and function of the uterus and placenta, leading to fetal malnutrition, immune diseases, endocrine diseases, infectious diseases can affect fetal growth and development.
In addition, when pregnant women smoke, alcohol, drug abuse and other bad habits, as well as social conditions and poor economic conditions, the chances of intrauterine growth retardation also increase.
Fetal factor
1. The fetus has a history of hereditary diseases or chromosomal diseases. The intrauterine growth retardation occurs earlier, such as chromosome number and structural abnormalities. It is more common with 21, 18, or 13 trisomy syndrome and Turner syndrome.
2. Infection of pathogenic microorganisms such as bacteria or viruses, such as fetal rubella virus, cytomegalovirus, herpes simplex virus, Toxoplasma gondii, and Treponema pallidum can cause intrauterine growth retardation.
3. Twin pregnancy can also cause intrauterine growth retardation.
Examine
an examination
Related inspection
Fetal biophysical phase score interventional intrauterine material examination cysteineuria screening fetal heart rate obstetrics B-ultrasound
Clinical monitoring:
(1) Defining the gestational age: For the suspicious IUGR, the gestational age should be checked first. The gestational age is calculated from the first day of the last menstrual period. If the menstruation is not accurate, the fetal head or hip length or the double top diameter measured by the early pregnancy. determine. Therefore, when considering IUGR, fetal growth rate and size must first be assessed and monitored after gestational age according to the last menstrual and early fetal ultrasound.
(2) Measurement of uterine fundus height: Prenatal examination measures the height of the uterus every week after 28 weeks of gestation, which is less than the normal 10th percentile for 2 consecutive times, and the intrauterine growth retardation should be suspected.
The method of measuring the height of the uterus is measured by measuring the distance between the midpoint of the upper edge of the pubic symphysis and the highest point of the uterus. Fetal growth and development index = height of the fundus (cm) - 3 × (pregnancy month + 1). If the growth and development index is less than -3, it indicates that there may be fetal dysplasia; if it is between -3 and +3, it means normal growth; if it is greater than 3, it may be considered as a huge child or twin pregnancy, and amniotic fluid.
Diagnosis
Differential diagnosis
1. Early detection of high-risk pregnant women, early detection of pregnancy-induced hypertension and other diseases affecting fetal growth and development, so as to have sufficient time to treat before the fetus is damaged.
2. Eliminate all factors that may cause IUGR: smoking, drug addiction, malnutrition or partial eclipse.
3. Increase uterine blood flow, such as the left lateral position.
4. Perform fetal system monitoring, such as fetal heart monitoring or ultrasound on a regular or weekly basis.
5. Finding problems that require early induction of labor should go to hospitals with better medical conditions.
