intrauterine growth retardation
Introduction
Introduction Intrauterine growth retardation, also known as intrauterine dysplasia, refers to the birth weight of newborns below the 1st percentile of normal weight of the same gestational age, or 2 standard deviations below the mean. There are many factors that cause intrauterine growth retardation. There are maternal factors such as maternal malnutrition, chronic diseases, insufficient placental blood perfusion caused by uteroplacental disease, smoking, drinking, exposure to chemicals or radiation, and multiple pregnancies. Fetal factors. Such as intrauterine infection, fetal cell division is disordered. Placental factors include placental infarction, small placenta, and chorionic placentalitis. The incidence rate is about 3-1% of pregnancy, and the perinatal mortality rate is 4-6 times that of normal developmental fetus. The short-term or long-term prognosis is not yet confirmed, so it is included in the category of high-risk pregnancy.
Cause
Cause
Intrauterine growth retardation refers to the tenth percentile or two standard deviations of the birth weight of the fetus than the average body weight of the same gestational age. If the gestational age has reached 37 weeks, the newborn's weight is less than 2.5 kg, also known as intrauterine growth retardation. The reasons for this are:
1 maternal factors, such as malnutrition in pregnant women, partial eclipse, hyperemesis in pregnancy, lack of protein and vitamins, smoking, drug use, mental stress, pregnancy-induced hypertension syndrome, pregnancy and medical diseases.
2 fetal factors, such as chromosomal abnormalities and fetal malformations, intrauterine viral infections, multiple pregnancy.
3 placental factors, such as placental dysplasia, decreased placental function, umbilical cord is too long or twisted knotted. In addition, pregnant women are exposed to harmful chemicals during pregnancy, X-ray exposure, living and environmental pollution around the work, etc., also have a certain impact. Some of the reasons are obvious, some are not clear, such as "I" fetal intrauterine growth retardation, is due to pregnancy with lupus erythematosus.
Examine
an examination
Related inspection
Placental maturity, infants, body length, anticardiolipin antibody, fetal globulin test, amniotic fluid osmotic pressure
1. In the medical history, there may be malnutrition during pregnancy, including pregnancy-induced hypertension, multiple births, polyhydramnios, pregnancy bleeding, kidney disease, cardiopulmonary disease, diabetes or infection. In the past, there was a congenital malformation or a history of intrauterine growth retardation.
2. Prenatal examination After the 28th week of pregnancy, the height of the palace is measured every week. If the number is less than the normal 10th percentile for 2 consecutive times, or the weight of the pregnant woman does not increase for three consecutive times, the intrauterine growth retardation should be suspected.
3. B-ultrasound detection of fetal biparietal diameter, chest circumference, abdominal circumference, femur length and other indicators.
4. NST and OCT detection can occur fetal heart abnormalities, such as late deceleration and variability deceleration, suggesting fetal intrauterine growth retardation.
5. Ultrasound Doppler fetal blood flow spectrogram determination of fetal umbilical artery blood flow rate, S / D ratio >3 is abnormal in late pregnancy.
6. Urinary estriol (E3 or E/C ratio and placental prolactin (hPL) determination.
7. Check the blood sugar of pregnant women, if necessary, test for glucose tolerance.
8. Amniotic fluid to check creatinine, fat cell count, lecithin / sphingomyelin (L / S) ratio and foam test combined with genetic counseling, if necessary, amniocentesis chromosome culture and karyotype analysis.
Diagnosis
Differential diagnosis
Fetal growth retardation: After 37 weeks of gestation, if the fetal weight is less than 10% of the normal weight of the fetus in the gestational week, and there is a maternal or placental problem, for example, oligohydramnios or early calcification of the placenta, it may be a fetus. Growth retardation.
Fetal distress: The fetus has signs of hypoxia in the uterus that endanger the health and life of the fetus, known as fetal distress.
Paper-like fetus: A paper-like fetus refers to a fetus with twin-fetal or multiple-pregnancy, which is caused by fetal growth restriction and early death is sliced by other fetuses. This kind of paper-like fetus occurs mostly in twin-child transfusion syndrome. Therefore, prenatal monitoring of early system is a necessary condition for the diagnosis of twin-child transfusion syndrome. Correct diagnosis and reasonable intervention can reduce fetal perinatal mortality.
