Study of obstetric outcome in pregnancies with intrauterine growth retardation

Abstract

Background: The prevalence of low birth weight affects approximately 3-10% of live-born newborns in developed countries and 15-20% of newborns.in developing countries. The most common cause of low birth weight is considered to be intrauterine foetal growth restriction. IUGR being an outcome of multiple etiologies and as indicated by the literature survey varies upon population statistics in terms of economic status as well as maternal health conditions.Methods: This study includes 100 patients with foetal growth restriction in a tertiary health care centre in Mumbai over a period of 11/2 year (Jan 2015 to July2016) and the relevant data of these patients such as indoor registration number, maternal age, parity, antenatal registration and referral details, medical, obstetric, social risk factors and feto-maternal outcome were collected using a predesigned proforma.Results: Incidence of IUGR in our study population was found to be 2.13% of which maximum number of cases (48%) were seen in the age group of 21-25 years. Low socio-economic group, maternal high-risk factors like Pre-eclampsia and eclampsia were associated with low Mean Birth weights of babies. Symphysio-fundal height was found to be a sensitive predictor of IUGR and the ratio HC/AC was associated with prediction of type of IUGR (p=0.000). 83% cases were found to have asymmetric IUGR while 17% cases had symmetric IUGR. The Perinatal Mortality Rate was found to be 1.92 per 1000 live births with 5% still births and 8% neonatal deaths, the most common causes of neonatal death being sepsis (44.4%) and respiratory distress syndrome (44.4%).Conclusions: Accurate dating, provision of early registration with regular antenatal checkup, clinico- sonographic evaluation and correlation for fetal growth in high risk patients and strict antepartum surveillance after IUGR has been identified are recommended. Integration of foetal anatomy assessment, amniotic fluid dynamics, uterine, umbilical, and foetal middle cerebral artery Doppler is the most effective approach to differentiate potentially manageable placenta-based Fetal Growth Restriction(FGR) from IUGR due to aneuploidy, non- aneuploid syndromes, and viral infection.

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

“…In a study by Sinha et al, the mean birth weight was found maximum (1958 g) in the group with normal Doppler findings (33% cases) and minimum (1519 gm) in those with abnormal Doppler which similar to present study. 23 This is also in accordance with who demonstrated that foetuses with lower birth weight had associated Doppler abnormality. 28 There was significance in EBW and original birthweights (p value:0.004) in this study.…”

“…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. 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.…”

Risk Factors Associated With Intrauterine Growth Restriction: A Case-Control Study

“…According to research by Ashwani et al [ 11 ], Sinha and Kurude [ 9 ], and Singh and Ambujam [ 12 ], a higher prevalence of IUGR has been associated with low socioeconomic status. Maternal health and nutrition are impacted by socioeconomic factors such as housing quality, employment, education level, and water supply source.…”

Stage-based FGR (Barcelona Protocol): Perinatal Outcome in SGA and FGR

“…However, the mean gestational age of diagnosis for FGR in Heera et al was 34-35 weeks, Malhorta et al was 27 weeks for FGR (Doppler abnormal) and 37 weeks for SGA group (Doppler normal). 25 Advanced maternal age did not appear to be a risk factor in comparison with Nihal et al 19 It is generally accepted that nulliparity increases the risk of SGA infants when compared with multiparity, [19][20][21] In this study, no association was observed between the number of previous deliveries and an increase in the frequency of SGA & FGR fetuses in comparison with Teixeira et al 22 In the SGA group, the rate of hypertensive disorders (8%) was higher compared to other medical disorders in comparison 30 The preterm birth rate in our study was around 35% in SGA and FGR stage I group compared to 100% in FGR stages II & III group, this result is also statistically significant.…”