Analysis of fetal growth restriction in pregnancy in subjects attending in an obstetric clinic of a tertiary care teaching hospital

Abstract

Background: Intrauterine growth restriction (IUGR) is defined as fetal growth less than the normal growth potential of a specific infant because of genetic or environmental factors. Fetal growth restriction or intrauterine growth restriction is one of the leading causes of perinatal mortality and morbidity in newborns. Fetal growth restriction is a complex multifactorial condition resulting from several fetal and maternal disorders. Objective of present study was to find out incidence of IUGR and assessment and evaluation of different important changes in IUGR.Methods: Women who attended the Obstetric OPD in their 1st trimester of pregnancy and those who were thought would be able to visit the antenatal clinic for their fortnightly check-up regularly were screened for intrauterine foetal growth retardation. Women with irregular and uncertain menstrual history and where the 1st trimester USG foetal crown rump length did not corroborate with the menstrual gestational age were excluded from this study.Results: Incidence of IUGR was 18.2% and 84% were found to be asymmetrical. IUGR was found to be double among primigravids and women above 30 years. It had been observed that IUGR was associated with certain conditions like short stature (52%), pregnancy induced hypertension (24%) and anaemia (12%).Conclusions: Thus, early USG screening along with robust screening for maternal BMI, nutritional status, and anaemia can assist the obstetric team in providing early diagnosis, prompt intervention, and better outcome in pregnancy with fetal growth restriction.

Maternal risk factors and perinatal outcomes in fetal growth restriction using obstetric Doppler in South Kerala, India

“…20 Referrals with FGR were 26.8% similar to that in Singh A et al 15 Hypertensive disorders of Pregnancy (24.39%), thyroid dysfunction (21.95%), anaemia (19.51%) and Gestational diabetes (14.63%) were noted in FGR mothers similar to Satyavrathan V et al and Sharma et al 16,21 Motghare DD et al, Bassetty KC and Jamal M et al described gestational hypertension and anaemia as maternal determinants of FGR. 19,20,22 Caesarean delivery was 75.60% and 67% of them were electives in present study similar to Seal A et al 17 with 68% lower segment caesareans and 54% electives. 24% of women delivered vaginally compared to 32% as in Seal A et al 17 Impending Eclampsia, HELLP syndrome and Eclampsia, accounted for 9.75% of terminations.…”

“…19,20,22 Caesarean delivery was 75.60% and 67% of them were electives in present study similar to Seal A et al 17 with 68% lower segment caesareans and 54% electives. 24% of women delivered vaginally compared to 32% as in Seal A et al 17 Impending Eclampsia, HELLP syndrome and Eclampsia, accounted for 9.75% of terminations. The most common indication for LSCS in Sinha et al was found to be abnormal Doppler findings (23.72%) followed by severe oligohydramnios (22.03%) and fetal distress (18.64 %) which is observed in Raja Rajeswari et al and in present study.…”

“…28 There was significance in EBW and original birthweights (p value:0.004) in this study. Female babies were more likely to be growth restricted compared to male babies consistent with the study by Seal A et al 17 Gestational age at delivery and NICU stay were compared and it was found that neonates born at term had shorter NICU stays than very preterm neonates. Also, FGR with normal Doppler had shorter NICU stays than FGR neonates with Doppler abnormalities (p value-0.003) similar to Rekha BR et al (P value-0.003).…”

“…23,24 As with Seal et al, majority (64%) of FGR were diagnosed between 32-34 weeks in this study. 17 In Lekshmi et al, 60% of the FGR were born to mothers <37 weeks and 29% <32 weeks, while in ours, 52% were born term and 32% were born 34-36.6 weeks. 25 .8% in present study.…”

“…14 Majority of mothers were in 25-34 age group (90.2%) similar to Singh A et al and Satyavrathan V et al 15,16 57% were multipara in Satyavrathan V et al similar to ours (58%). 16 Infertility treated subjects were 29.3% as in Seal A et al 17 Ghazi et al also in his study noted the increased incidence of infertility in FGR. 18 Those women with past history of spontaneous abortion were 2.21 times more likely to have an IUGR baby compared to women without such history in Motghare DD et al 19 30% in ours.…”