What causes fgr?

Intrauterine growth restriction is based on having an accurate gestational age or determining your due date. This is found by identifying the first day of your last menstrual period and by performing a first-trimester ultrasound. Having this date gives your healthcare provider a baseline for diagnosing IUGR.

Once your provider determines gestational age (or weeks in pregnancy), they can can diagnose IUGR using a few different methods.

Fundal height is the size of your belly from the top of your pubic bone to the top of your uterus or the size of your "baby bump." Your healthcare provider measures your fundal height using measuring tape (usually made of paper). They place one end on your pubic bone and the other end at the top of your uterus.

Fundal height is measured in centimeters (cm) and should be about the same number you are in weeks of pregnancy (after 20 weeks). For example, if you are 32 weeks pregnant, your fundal height should be around 32 cm. Your healthcare provider may suspect IUGR if you measure at least 4 cm less than what your fundal height should be. So, in this example, your provider may suspect IUGR if your fundal height is 28 cm or lower.

Your provider can also use their hands to feel certain areas of your belly (called palpation) and estimate the size of the fetus.

Your healthcare provider measures your weight at every prenatal appointment. Poor weight gain could indicate that the fetus is also not gaining enough weight.

If you are diagnosed with IUGR, you will have additional ultrasounds to monitor fetal growth throughout your pregnancy.

During a fetal ultrasound, your healthcare provider moves a wand or probe across your belly. Sound waves from the ultrasound create a picture of the fetus. Your healthcare provider uses the picture to take measurements and estimate the size and weight of the fetus. They can also use ultrasound to check the blood flow from the placenta through the umbilical cord or through the blood vessels (this is called Doppler flow). Poor circulation of blood can suggest IUGR.

Ultrasound can also measure the amount of amniotic fluid surrounding the fetus. Too little amniotic fluid could indicate IUGR.

Your healthcare provider straps a monitoring device across your uterus. You lie down wearing this device for about 30 minutes while it tracks the fetal heart rate. Your healthcare provider checks these results for any signs of growth issues.

Fetal growth restriction (FGR) is a condition in which an unborn baby (fetus) is smaller than expected for the number of weeks of pregnancy (gestational age). It's often described as an estimated weight less than the 10th percentile. This means that the baby weighs less than 9 out of 10 babies of the same gestational age. Newborn babies with FGR may be called “small for gestational age.”

FGR can begin at any time during pregnancy. With FGR, the baby doesn't grow well. FGR may affect the overall size of the baby and the growth of organs, tissues, and cells. This can cause many problems. But many newborns who are small may just be small. They may not have any problems.

Many things increase the risk for FGR. These include problems with the placenta or umbilical cord. The placenta may not attach well. Or the blood flow through the umbilical cord may be limited. Factors in both the mother and the baby may cause FGR.

Factors in the mother that can cause FGR include:

Factors in the baby that can cause FGR include:

A pregnant woman doesn’t have symptoms of FGR. But a baby with FGR may have certain signs after birth, such as:

One of the main reasons for regular prenatal exams is to make sure your baby is growing well. During pregnancy, the size of your baby is estimated in different ways, including:

If your healthcare provider thinks you have FGR, you'll have other tests. These include:

You may have repeat ultrasound exams, Doppler studies, and other tests.

Management depends on how serious the FGR is. This is based on the ultrasound (estimated fetal weight) and Doppler ultrasound (blood flow to the baby), as well as risk factors and the number of weeks gestation.

Treatment may include:

FGR can cause many serious complications. Your baby may need to be delivered early and stay in the hospital. Your baby may have trouble breathing, infections, and other problems. Stillbirths and death may occur. As your child grows, they'll be at higher risk for heart and blood vessel problems.

FGR can happen in any pregnancy. But some factors, like cigarette smoking or alcohol or medicine use, increase the risk for FGR. Regular and early prenatal care and a healthy diet and steady weight gain help to prevent FGR and other problems.

Make sure your healthcare provider knows your health history. If you're counting fetal movements and find that the number has decreased, let your healthcare provider know. And if you notice other changes or if you have concerns about your pregnancy, call your healthcare provider.

The most common cause of FGR is a problem before birth in the placenta (the tissue that carries oxygen, food, and blood to the baby). Birth defects and genetic disorders can also cause FGR. A baby also may develop FGR if the mother: Has an infection.

• High blood pressure or other heart and blood vessel disease.
• Diabetes.
• Too few red blood cells (anemia)
• Long-term lung or kidney conditions.
• Autoimmune conditions such as lupus.
• Very low weight.
• A large amount of excess weight (obese)
• Poor nutrition or weight gain.