Sound of reason. Fetal growth retardation: causes and consequences

26.07.2019

A new little man is growing inside a pregnant woman, and it is quite natural that she wants to protect, protect him from all the misfortunes of the outside world. One of the most feared diagnoses for expectant mothers is intrauterine growth retardation of the fetus. Let's look at how dangerous this diagnosis is and how to deal with it? What are the deviations in the development of the fetus from the norm? When should you start worrying, and when is fear not justified?

Fetal growth retardation: main causes

All nutrients and oxygen enter the fetus through the placenta, therefore, any violation of it leads to a delay in the development of the child, characterized by a low weight of the fetus compared to generally accepted norms. There are a lot of reasons leading to placental insufficiency (a condition when the placenta does not cope with its duties of saturating the child with nutrition and oxygen). The main ones are late preeclampsia, increased uterine tone, Rh conflict, past infectious diseases, various anomalies in the development of the uterus, placenta (premature aging, detachment, improper attachment, etc.) and umbilical cord, chronic diseases of the mother, for example, diabetes mellitus , heart disease, hypertension, etc. The correct development of the placenta also depends on the age of the woman. Young girls are not yet quite ready for the stresses ahead of their body, and women over 30 often have various chronic diseases that also have an impact on the development of the placenta. In addition to diseases, risk factors include smoking, alcohol abuse, and drug addiction. All these bad habits cause vasoconstriction, therefore, uteroplacental blood flow decreases. Also, deviations in the development of the fetus can be in a healthy woman. This usually happens if a woman has multiple pregnancies. The delay in the development of the fetus in this case is caused by the fact that the nutrients go not to one baby, but to two or more.
As for diets, the issue is quite controversial. Recent studies have shown that women who, for one reason or another, adhere to a low-calorie diet, can give birth to a completely healthy baby with normal weight, that is, dietary nutrition should not necessarily cause delayed fetal development.

How to determine?

Most often, the first signs of a delay in the development of the fetus are found at 24-26 weeks, less often at 32 weeks. Distinguish between symmetrical delay and asymmetric delay. The first is characterized by a decrease in all the baby's organs evenly, and the second is a decrease in the size of the internal organs, while the brain and skeleton are normal.

In order to determine the delayed development of the fetus, the following methods are used:

1. Measurement of the height of the fundus of the uterus and the circumference of the abdomen at the level of the navel at each visit to the obstetrician-gynecologist and comparing them with the norms.
This is one of the simplest and most accessible methods that allows the doctor to judge the size of the fetus, but the indicators may not always be objective, since the measurement is affected by the physique, the size of the abdominal wall, and the amount of amniotic fluid. But it is this method that contributes to the first detection of the slow development of the baby.
2. A study on the content of placental hormones (lactogen, alkaline phosphatase, etc.) in the mother's blood. If the hormones are normal, therefore, the placenta is functioning normally, then the baby is getting everything he needs in sufficient quantities.
3 . CTG (cardiotocography) of the fetal heart, which can be used to determine whether the fetus is receiving enough oxygen. Since lack of air (hypoxia) can lead not only to malnutrition, but also to asphyxia (suffocation) of the fetus.
4. Ultrasound (ultrasound examination) of the fetus, in which the head, femur and tummy of the baby are measured. With the help of ultrasound, not only the possible smallness of the fetus is revealed, but also the proportionality of the development of the baby's organs, it is determined whether the placenta and umbilical cord are functioning normally. In case of any deviations from the norm, a dopplerometric study (a type of ultrasound) is mandatory, with the help of which the doctor finds out the direction and speed of blood through the vessels of the umbilical cord and arteries of the fetus.

Treatment

The identified abnormal development of the fetus requires immediate treatment, since placental insufficiency can lead not only to a developmental delay, but also to fetal death due to a violation in the mother-placenta-fetus circulatory system.

Basically, medications are used to treat malnutrition:
- tocolytic, designed to relax the uterus;
- vasodilators to increase blood flow to the placenta;
- solutions-blood substitutes, aimed at reducing the viscosity of blood, so that it passes through the vessels and capillaries faster and easier;
- vitamins and amino acids that compensate for the lack of substances necessary for the tissues and organs of the fetus.

Hyperbaric oxygen therapy (breathing oxygen-enriched air), medical ozone, sleep, and other non-drug treatments are also considered very helpful if abnormal fetal development associated with a lack of nutrients and oxygen is identified.
Naturally, during treatment, monitoring with ultrasound and CTG is mandatory. In principle, with timely diagnosis, it is possible not only to increase the size of the fetus, but also to bring them to normal. The main thing to remember is that the goal is to normalize metabolic processes, and not to “feed” the baby.

Advanced fetal development

It often happens that the fetus develops too quickly. This phenomenon is characterized by too rapid maturation of the placenta, which can also cause hypoxia and nutritional deficiencies in the fetus. With such a diagnosis, a Doppler study is mandatory and appropriate treatment is prescribed, since the advanced development of the fetus can lead to premature birth due to placental abruption.

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In every tenth case of pregnancy, a diagnosis is made - intrauterine growth retardation (the pathology is also known under the abbreviation IUGR). The doctor determines the deviations, which are characterized by a discrepancy between the size of the child and the normal indicators for a particular week of pregnancy. How dangerous this pathology is and what exactly is to be afraid of, it is useful for every future mother to know, because no one is immune from such a phenomenon.

Causes of the disease

Intrauterine growth retardation of the fetus is diagnosed at various stages of pregnancy. This happens if the baby does not receive enough nutrients and oxygen, which are actively involved in the formation of a small organism. The reasons for this can be very different:

placental pathology: incorrect presentation or detachment;
chronic diseases of the mother: high blood pressure, problems with the cardiovascular system, anemia, improper functioning of the respiratory tract;
deviations in the chromosome set: Down syndrome;
pathologies of intrauterine development: malformation of the abdominal wall or kidneys;
mother's bad habits;
infectious diseases suffered by a woman during pregnancy: rubella, toxoplasmosis, syphilis, cytomegalovirus;
inadequate or malnutrition;
constant stress;
gynecological diseases;
self-administration of medications during pregnancy without a doctor's prescription;
multiple pregnancy;
climatic conditions: living in an area that is located high above sea level.

Smoking and alcoholism while carrying a baby can lead to such a phenomenon as asymmetric fetal growth retardation, when, according to ultrasound, the child's skeleton and brain correspond to the term, but the internal organs remain undeveloped. It is especially important to supply the fetus with everything necessary in the last weeks of pregnancy so that it successfully adapts to the new environment.

Symptoms of IUGR

The first signs of the IUGR syndrome are detected already in the early stages of pregnancy (at 24–26 weeks), but the woman is not able to determine them on her own. This can only be done by a doctor. Symptoms are considered non-compliance with the norm of the following indicators:

abdominal circumference at a certain level, the height of the fundus of the uterus (palpable by hand by a gynecologist);
the size of the head, femur, belly of the baby;
growth with constant monitoring;
the amount of amniotic fluid;
violations of the functioning of the placenta (the size or structure may change);
blood flow velocity in the placenta and umbilical cord;
baby's heart rate.

Even doctors are often mistaken in the diagnosis, because sometimes the discrepancy between these parameters is nothing more than a genetic or hereditary predisposition. To avoid misdiagnosis, a survey of parents is conducted, with what weight they were born. Whereas a delay in fetal development for 2 weeks or more already gives serious reasons to believe that the diagnosis is accurate.

Treatment Methods

Treatment largely depends on the degree of observed abnormalities:

intrauterine growth retardation of the 1st degree - a lag of 2 weeks (therapy can be quite successful and negate the negative consequences for the further development of the baby);
2 degrees - a delay of 3-4 weeks (strong treatment will be required, and the results can be completely unpredictable);
3 degrees - a lag of more than a month (even the most intensive therapy will not be able to equalize such a large lag, and the child may be born with serious deviations from the norm).

Treatment includes:

therapy for maternal diseases;
treatment of pregnancy complications;
increasing the resistance of a small organism to hypoxia;
normalization of placental insufficiency (as a rule, drugs are prescribed to expand blood vessels to improve the blood supply to the fetus and uterus, as well as means to relax the muscles of the uterus).

The treatment is carried out on a stationary basis so that the mother and child are constantly under medical supervision. The timing and methods of delivery depend on the well-being of the mother and the condition of the fetus.

The consequences that the syndrome of fetal growth retardation entails can be very different. Children with this diagnosis after birth can have serious health problems.

In infancy:

obstetric complications during childbirth: hypoxia, asphyxia, neurological disorders;
poor adaptation to new living conditions;
hyperexcitability;
increased or decreased muscle tone;
poor appetite;
small weight gain;
psychomotor retardation in development;
inability to maintain body temperature constant within the normal range;
insufficient degree of development of internal organs;
high susceptibility to infectious diseases.

At older age:

diabetes;
tendency to corpulence;
high blood pressure.

In adulthood:

cardiovascular diseases;
obesity;
non-insulin dependent diabetes mellitus;
elevated blood lipid levels.

However, many babies diagnosed with intrauterine growth retardation over time may not differ at all from their peers, catching up with them in terms of both height and weight, without any consequences for their health at any age.

Doctors diagnose "FGR" to all children who at birth are underweight relative to their gestational age. Many women learn about this pathology during pregnancy. From the materials of this article, you will learn what symptoms accompany the syndrome of fetal growth retardation, why it occurs.

SZRP - what is it?

Fetal growth retardation syndrome (FGR) is a pathology characterized by a lag in the size of the baby from the average values recorded as the norm for a certain period of pregnancy. In Russia, the prevalence of this disorder ranges from 5 to 18%. The small size of the child does not always indicate this syndrome. Approximately 70% of children diagnosed with this diagnosis are naturally small. Their father or mother may be small in stature. In addition, gender should be taken into account (girls are usually 5% smaller than boys, which is approximately 200 g) and nationality.

As a rule, the condition of the baby is compensated during the first year of life. He is gradually gaining weight and gaining height, approaching the normative indicators. If the diagnosis confirmed by the doctor becomes the main cause of the developmental delay in the child, affects his health and quality of life, a special treatment complex is considered.

There are two forms of SZRP: symmetrical and asymmetric. Each type of pathology has its own characteristics. We will talk about them later in this article.

Asymmetric form of FGR

Pathology usually occurs in the second trimester and is characterized by a lack of fetal weight with normal growth. The child has a lag in the development of the tissues of the abdomen and chest. Asymmetric FGR is sometimes characterized by uneven formation of internal organ systems. In the absence of timely treatment, there is a decrease in the size of the child's head and a lag in the development of the brain, which can provoke his death.

Symmetrical shape of the SZRP

Pathology is characterized by a proportional decrease in the size of the child's body relative to the average values for a particular gestational age. It is usually diagnosed in the second trimester. The symmetrical form of the syndrome in most cases is due to intrauterine infection of the fetus, chromosomal abnormalities. Children with this diagnosis are born with inferior development of the central nervous system.

The main causes of pathology

A baby can be born small for several reasons. We should not exclude the fact that this is its physiological feature. The short stature of the baby can be inherited from the parents. However, even in this case, the doctor will diagnose "fetal growth retardation syndrome." If, after birth, the child's body is fully functioning, and his reflexes correspond to the norms, specific treatment is not required.

Doctors identify certain causes of sdfd, which can lead to hypoxia and even fading of pregnancy. Developmental delay is observed if the baby inside the womb does not receive oxygen and the necessary nutrients. Without them, it is impossible to imagine the full life of the body.

The reduction in the amount of incoming substances can be caused by many factors:

placental problems. This organ is responsible for transporting oxygen to the fetus in the womb. If the placenta is deformed, it cannot function fully.
Pathologies in the work of the systems of internal organs in a future woman in labor (high blood pressure, anemia, heart and respiratory diseases, diabetes mellitus).
In the development of the fetus, a special role belongs to the chromosome set, which he receives from his parents.
Bad habits. Many of the fair sex smoke and drink alcohol. Bad habits, even if a woman abandoned them shortly before conception, can cause FGR during pregnancy.
Doctors constantly say that a woman in position should literally eat for two. It really is. Dieting or a sharp reduction in calorie intake can adversely affect the child. If the fetus does not have enough nutrients, it begins to take them from the mother's body. Eating for two doesn't mean you have to eat everything. The diet should be balanced and consist exclusively of healthy foods. During pregnancy, you should not be afraid to get better, it is strictly forbidden to sit on strict diets.
Taking medications. From medicines during the bearing of the baby should be discarded. You can take drugs only on the advice of a doctor when nothing else can help.
Infectious diseases transferred during pregnancy (rubella, toxoplasmosis, syphilis) can stop the development of the fetus. That is why doctors strongly advise to be vaccinated long before the conception of the baby.
FGR 2 degrees are often given to women who live in areas high above sea level. In such regions, the pressure is increased, and this often leads to hypoxia in the fetus and its slow development.

Timely determination of the cause of the syndrome and its subsequent elimination allow the doctor to choose an effective treatment.

What are the symptoms of fetal growth retardation syndrome?

The clinical picture of this pathology is usually erased. It is unlikely that a pregnant woman will be able to suspect such a diagnosis on her own. Only regular observation by a gynecologist for nine months allows you to identify the problem in a timely manner.

There is an opinion that if a woman gains little weight during pregnancy, most likely the fetus is small. This is partly true, but it is rarely true. When a future woman in labor limits her daily diet to 1500 kcal, she is fond of diets, the likelihood of fetal sdfd is quite high. On the other hand, the occurrence of pathology should not be excluded in those women who have an excessively large weight gain.

Rare and sluggish fetal movements are considered a clear sign of the syndrome. Such a symptom should alert and become a reason for an emergency visit to a specialist.

Examination for fetal growth retardation

If the pathological development of the baby is suspected, the doctor may be alerted by the discrepancy between the height of the fundus of the uterus and the normative indicators that are characteristic of this particular period of pregnancy. The most reliable diagnostic option is an ultrasound examination of the fetus, during which a specialist evaluates its size and weight. In addition, with the help of ultrasound, you can determine the state of the systems of the internal organs of the child.

Dopplerometry is also prescribed for suspected sdfd. What it is? This examination is carried out to assess the blood flow in the vessels of the baby and the placenta. Fetal cardiotocography (heartbeat study) is considered an important diagnostic method. Normal heart rate ranges from 120 to about 160 beats per minute. When a baby in the womb experiences a lack of oxygen, his heartbeat gradually increases.

Based on the results of the examination, the doctor can confirm the diagnosis and determine the severity of the disease.

FGR of the 1st degree is considered the easiest, characterized by a two-week developmental delay from the average anthropometric data.
SZRP 2 degrees differs in deviation from the normative indicators within two to four weeks.
The most severe is the 3rd degree of sdfd. The size and weight of the baby in the womb are not within the norm for more than four weeks. In most cases, grade 3 FGR leads to fetal freezing.

Treatment Methods

To treat this syndrome in obstetrics, a large arsenal of drugs is used that are aimed at normalizing uteroplacental blood flow.

Tocolytic means for relaxing the uterus ("Ginipral", "Papaverine").
Preparations for the normalization of metabolism in tissues ("Kurantil", "Actovegin").
Infusion therapy using glucose and blood substitute solutions.
Vitamin therapy.

All drugs are prescribed for a long time with constant monitoring of the condition of the fetus.

Particular attention in the treatment of FGR during pregnancy is given to nutrition. The diet should be as balanced as possible. It is not recommended to lean on certain products. You can eat absolutely everything. Meat and dairy products should not be excluded, as they contain a large amount of animal protein. It is in it that by the end of pregnancy the need increases by about 50%. It is important not to forget that the main goal of therapy is not to fatten the child, but to provide him with full growth and harmonious development.

Pregnancy management with SZRP

After confirming the final diagnosis, the future woman in labor requires constant monitoring by specialists. Ultrasound is prescribed at least twice a month. A detailed study is necessary to identify the anatomy of the child and structural defects that may be the cause of delays. Also, future women in labor are prescribed an amniocentesis procedure to assess chromosomal abnormalities if pathologies were detected on ultrasound.

Regardless of what factors influenced the occurrence of FGR, the consequences for the child may be irreversible. To prevent them, a woman should undergo an ultrasound examination every two weeks. It is necessary to assess the size of the fetus and its growth rate.

When a woman is in her 37th week, doctors usually decide to induce labor. Until this period, pregnancy management depends on the condition of the crumbs inside the womb. If a woman develops symptoms of preeclampsia, doctors decide to have a premature birth.

Possible complications and consequences

In children with this syndrome, serious complications are often recorded not only during intrauterine life, but also after birth. The degree of risk directly depends on the causes of the pathological process, its severity and time of onset. According to statistics, the presence of complications is most likely in those children whose birth weight does not exceed 1 kg.

Due to the fact that the fetus with this syndrome does not receive enough oxygen and nutrients, such children may be born already dead. Often they are not able to withstand the stress of labor pains, so doctors usually decide to perform a caesarean section.

In children born with sdfd, the consequences of this diagnosis are directly reflected in the work of the main systems of internal organs. They usually have hypoglycemia, poor resistance to infections. They are prone to jaundice and meconium aspiration, that is, inhalation of the original feces.

If doctors diagnose grade 2 FGR, the consequences of the pathology are almost impossible to predict. The quality of life of the child primarily depends on the underlying causes of the syndrome. Some babies gradually catch up with their peers in development. Others have serious health problems. They are diagnosed with obesity early, which subsequently leads to disruption of the heart, diabetes mellitus and hypertension.

Preventive actions

SZRP should not be ignored. What is it, we have already told. Is it possible to prevent its occurrence?

The best prevention of FGR is early pregnancy planning. Before the direct conception of a child, future parents must pass a number of tests, treat chronic diseases. Diseases of the genital area and caries should not be ignored.

Regular visits to the gynecologist after registration for pregnancy play an important role in the prevention of FGR. The sooner the doctor detects the pathology, the higher the likelihood of eliminating dangerous complications in the development of the baby during gestation and after it is born.

A pregnant woman should take care of the mode of work and rest. Full sleep should be at least 10 hours at night and 2 hours during the day. If you can’t sleep after dinner, you can allow yourself to lie down in a horizontal position for a while. Daytime sleep helps to normalize blood circulation between the child and mother, improve the transfer of nutrients.

Walking in the fresh air, a balanced diet and moderate exercise are excellent prevention of FGR. What does it mean? A woman should eat exclusively healthy food, rich in vitamins and minerals. For some women, doctors recommend a diet high in carbohydrates, as these substances improve the mood of the pregnant woman and the well-being of the fetus inside the womb. As for the issue of physical activity, yoga classes, swimming in the pool are an excellent solution.

Fetal growth retardation syndrome is not a sentence for future parents who are looking forward to the birth of a baby. A huge role in the treatment of this pathology belongs to the timeliness of the diagnosis. However, its seriousness is not a reason to abandon the child. There are no obstacles that loving parents cannot overcome. Especially when it comes to true maternal happiness.

Approximately every tenth woman in position, the doctor diagnoses "fetal growth retardation" (IUGR). The specialist determines the presence of deviations, characterized by a discrepancy between the size of the baby and the normative indicators for a particular week of development. How dangerous this pathology is in reality and how it threatens the child, it is important for every mother to know, because absolutely no one is immune from such a phenomenon.

What is a ZVUR?

Retardation of intrauterine development of the fetus is usually diagnosed on the basis of an ultrasound examination. Pathology is determined if the weight of the baby is less than the normative indicators characteristic of this period of development. In medical practice, specially designed tables are used that indicate the weight of the fetus in accordance with its gestational age, that is, the time since fertilization. This indicator is usually determined in weeks. In other words, there are certain norms for each stage of pregnancy. The basic unit of measure in such tables is the percentile. If the fetus is less than 10 percentiles on this table, the doctor confirms the presence of pathology.

Fetal growth retardation: causes

Sometimes, when diagnosed with IUGR, parents do not need to worry. It happens that a baby is born small in size, since his father and mother are not very tall. This physiological feature does not affect the activity of the child, his mental and physical development. During pregnancy and after birth, such a baby does not need narrowly targeted therapy.

In all other situations, special attention should be paid to the diagnosis. This condition can lead to deviations in the development of the child or even death of the fetus. IUGR may indicate that the baby in the womb is not eating well. This means that it does not receive sufficient nutrients and oxygen. Nutritional deficiencies are usually attributed to the following reasons:

Wrong chromosome set.
Bad habits of the mother (smoking, drinking alcohol and drugs).
Pathogenic diseases (hypertension, anemia, diseases of the cardiovascular system).
Incorrect location and subsequent formation of the placenta.

In addition, doctors call a number of other reasons that can also provoke intrauterine growth retardation syndrome:

Multiple pregnancy.
The use of drugs without a doctor's prescription.
Childbirth after 42 weeks.
Irrational nutrition. Many women do not want to get better during pregnancy, so they exhaust themselves with diets. By this they provoke the exhaustion of the body, which leads to the development of pathology.
Diseases of an infectious nature (toxoplasmosis, rubella, syphilis).

Clinical picture

What are the symptoms of intrauterine growth retardation? Signs of pathology appear most often in the early stages (approximately 24-26 weeks). A woman is not able to determine them on her own, this can only be done by a doctor. IUGR syndrome is diagnosed when the following indicators do not meet the standards:

The size of the head and femur of the baby.
Abdominal circumference at a certain level, the height of the fundus of the uterus.
Volume of amniotic fluid.
Violation of the functioning of the placenta (its structure and size change).
Fetal heart rate.
Blood flow velocity in the placenta and umbilical cord.

In some cases, the pathology develops quite quickly and progresses without any special disturbances, that is, it is asymptomatic.

Severity

I degree. Degree 1 intrauterine growth retardation is considered relatively mild, since the developmental delay from anthropometric data corresponding to a certain gestational age is only two weeks. Timely prescribed therapy can be effective and minimize the likelihood of negative consequences for the baby.
II degree. The delay in development is approximately 3-4 weeks, serious treatment is required.
III degree. It is considered the most severe form due to the delay in fetal parameters by one month or more. This condition is usually accompanied by so-called organic changes. Delayed intrauterine development of the fetus of the 3rd degree often ends in death.

Asymmetric form of pathology

In this case, there is a significant decrease in the weight of the fetus with its normal growth. The child is diagnosed with a lag in the formation of soft tissues of the chest and abdomen, and an abnormal development of the trunk. Uneven growth of internal organ systems is possible. In the absence of adequate therapy, a gradual decrease in the size of the head and a lag in the development of the brain begin, which almost always leads to the death of the fetus. The asymmetric variant of the IUGR syndrome occurs mainly in the third trimester against the background of general placental insufficiency.

Symmetrical form of pathology

With a symmetrical form, a uniform decrease in the mass, size of organs and growth of the fetus is observed. This pathology most often develops in the early stages of pregnancy due to fetal diseases (infection, chromosomal abnormalities). Symmetrical intrauterine growth retardation increases the likelihood of having a child with an imperfectly formed CNS.

Diagnostic measures

If this pathology is suspected, a woman is recommended to undergo a complete diagnostic examination. First of all, the doctor collects the patient's medical history, clarifies the previous gynecological diseases, the features of the course of the previous pregnancy. Then a physical examination is carried out with the obligatory measurement of the circumference of the abdomen, the fundus of the uterus, the height and weight of the woman.

Additionally, ultrasound, dopplerometry (assessment of blood flow in the arteries and veins) and cardiotocography (continuous recording of the fetal heart rate, its activity and directly uterine contractions) may be required. Based on the results of the tests, the specialist can confirm the diagnosis or refute it.

What treatment is required?

To determine the subsequent management of pregnancy after confirming the diagnosis of intrauterine growth retardation, the causes of the pathology, the form and degree of the disease should be taken into account. The main principles of therapy should be focused on improving blood flow in the uterus-placenta-fetus system. All therapeutic measures are carried out in stationary conditions. First of all, a woman needs to ensure peace, rational nutrition and a good long sleep. An important element of therapy is the control of the current state of the fetus. For these purposes, ultrasound is used every 7-14 days, cardiotocography and blood flow dopplerometry.

Drug treatment includes the use of angioprotectors to protect blood vessels, tocolytics against uterine muscle tension (Papaverine, No-shpa), general tonic. In addition, all women, without exception, are prescribed drugs that reduce neuropsychic excitation (tincture of motherwort, valerian) and improve blood flow in the placenta (Actovegin, Curantil).

Depending on the severity of the pathology, the results of treatment may vary. Delayed intrauterine development of the fetus of the 1st degree usually responds well to therapy, the likelihood of further negative consequences is minimized. With more serious pathologies, a different approach to treatment is needed, while its results are quite difficult to predict.

Abortion

Early delivery, regardless of the gestational age, is recommended in the following cases:

Lack of fetal growth for 14 days.
A noticeable deterioration in the condition of the baby inside the womb (for example, a slowdown in blood flow in the vessels).

Pregnancy is maintained up to a maximum of 37 weeks if, due to drug therapy, there is an improvement in performance, when it is not necessary to talk about the diagnosis of intrauterine growth retardation.

Consequences and possible complications

Babies with such a pathology after birth may have deviations of varying severity, their subsequent compatibility with ordinary life will largely depend on their parents.

The first consequences appear already during delivery (hypoxia, neurological disorders). The intrauterine growth retardation of the fetus inhibits the maturation of the central nervous system and its functions, which affects all systems. In such children, the body's defenses are usually weakened; at a more mature age, there is an increased likelihood of ailments of the cardiovascular system.

In children under five years old, slow weight gain, psychomotor retardation in development, improper formation of internal organ systems, and hyperexcitability are often diagnosed. Teenagers are at high risk of developing diabetes. Such children are usually overweight, they have problems with blood pressure. This does not mean that their daily existence will be reduced to taking medications and living in hospitals. They just need to pay a little more attention to their own nutrition and daily physical activity.

Some children who have been diagnosed with grade 2 intrauterine growth retardation and treated appropriately do not differ from their peers. They lead a normal life, go in for sports, communicate with friends and get an education.

How can IUGR be prevented?

The best prevention of this pathology is the planning of an upcoming pregnancy. In about six months, future parents must undergo a comprehensive examination and treat all existing chronic diseases. Refusal of addictions, proper lifestyle, rational nutrition and daily dosed physical activity is the best option for preventing IUGR.

Visiting the antenatal clinic on a regular basis after registration plays an important role in the diagnosis of intrauterine growth retardation. Treatment of a timely detected pathology minimizes the risk of negative consequences.

Pregnant women should have a well-organized work and sleep schedule. Proper and proper rest means 10 hours of sleep at night and 2 hours during the day. This mode allows you to improve blood circulation and transport of nutrients between mother and child.

Daily walks in the fresh air, dosed physical activity not only improve the general well-being of the pregnant woman, but also normalize the condition of the fetus inside the womb.

Conclusion

Do not ignore such a pathology as intrauterine growth retardation, the consequences of which can be the most sad. On the other hand, parents should not take this diagnosis as a sentence. If it is delivered in a timely manner, the future woman in labor will take all necessary measures to eliminate its cause and will follow all the doctor's recommendations, the prognosis may be favorable. There are no obstacles in the world that cannot be overcome. It is important to remember that the happiness of motherhood is incomparable!

Sometimes pregnancy is overshadowed by diagnoses that scare parents. One of these is "syndrome of intrauterine growth retardation". Retardation of intrauterine development of the fetus is diagnosed only on the basis of ultrasound. It is determined if the fetus has a lower weight compared to the norms characteristic of its age. In medical practice, special tables are used that describe the norms for the size of the fetus according to its gestational age (gestational age is the age from the moment of fertilization, which is measured in weeks). Roughly speaking, there are norms for each week of pregnancy. The unit of measure for such tables is percentile. And so, if the baby is less than 10 percentiles according to the table, then intrauterine fetal retention is diagnosed.

Causes of fetal growth retardation

A baby can be born small for several reasons. The fact that such is his physiological feature. Perhaps mom or dad is short and the baby inherited this from their parents. But even in this case, at the doctor's appointment, a diagnosis of intrauterine growth retardation will be made. This fact after childbirth is confirmed by the normal state of the child and the correspondence of all reflexes of the newborn to the period at which the baby was born. Then the doctors state that the diagnosis of intrauterine growth retardation was associated with inherited genetics and this condition does not require treatment. But there are reasons for intrauterine development of the fetus, which can lead to fetal hypoxia, the negative consequences of the development of the child after birth, and even the fading of pregnancy. Fetal growth retardation occurs when the baby does not receive the proper amount of oxygen and nutrients which play a major role in his life.
A decrease in the amount of substances and oxygen entering the fetus can be caused by the following factors:

malformation of the placenta or umbilical cord. The placenta may not be located there (diagnosis "abnormal placenta previa"), be very small or exfoliate (diagnosis "placental abruption");
maternal diseases, which can interfere with the intake of the necessary substances for the normal development of the fetus. These diseases include chronic high blood pressure, diseases of the cardiovascular system, anemia, chronic respiratory diseases;
plays an important role in fetal development chromosome set, which he receives from his parents at the time of conception. Sometimes it happens that there is a failure or deviation in the chromosome set. So, for example, there is a disease - Down's syndrome. Also, developmental pathologies such as kidney or abdominal wall defects can affect the overall development of the baby in the womb;
doctors all over the world talk about the negative impact bad habits on the human body. Particular attention is paid to the body of a woman who, at least once, has to bear a child. Bad habits in a woman (even if she gets rid of them shortly before conception) can cause a delay in intrauterine development of the fetus;

transfer during pregnancy infectious diseases like rubella, syphilis, toxoplasmosis, cytomegalovirus can stop or slow down the development of the fetus. That is why it is so important to get vaccinated against infectious diseases even before conception (especially for women who work in hospitals, clinics and with children, because rubella is a childhood disease) and be careful in choosing a sexual partner during pregnancy, if there is no permanent one;
at every step, the pregnant woman is told that she must eat for two. And indeed it is. If the baby does not have enough nutrients, then he draws them from the mother's body, thereby worsening her general well-being. But eating for two doesn't mean you have to eat everything. Nutrition should be healthy and balanced. During pregnancy, you do not need to be afraid that you will get better, you cannot go on diets. Only if you are diagnosed with a large fetus and the doctor himself prescribes the correct and useful diet in this case. Malnutrition leads to a child's weight loss and developmental delay;
medications during pregnancy are reduced to nothing with any kind of disease. Their use is prescribed only in special cases, when nothing else can help. Self-administration of medications can lead not only to the development of pathologies in the fetus, but also to intrauterine growth retardation;
multiple pregnancy can cause a delay in the development of one fetus or several at once. This happens due to the fact that there are not enough nutrients for two or more fruits;
intrauterine growth retardation syndrome is often posed to women who live high above sea level. In such areas, increased pressure is observed, and the fetus may suffer from hypoxia (lack of oxygen) for a long time, which also slows down development in the womb.
babies are often born with low birth weight if childbirth occurs after 42 weeks pregnancy.

Consequences of intrauterine growth retardation

For 9 months, it is common for a future mother to worry about the health of her unborn baby. Scheduled examinations in the antenatal clinic are carried out so that the expectant mother and the doctor have the opportunity to realistically assess the situation and draw a conclusion about the health of the child. The fear of abnormalities in the fetus most often causes these abnormalities. Stress is the first cause of developmental disorders. The child feels everything. And there is such an expression "thoughts materialize." You only need to think positively, and if someone told you that intrauterine growth retardation is a horror, then do not believe it. Every woman has an individual pregnancy and childbirth. One recalls with horror 6 hours after the birth of the baby, and the other half an hour after the birth tells her husband that she wants another child. Similarly, with a diagnosis of "Delayed fetal development." Yes, some difficulties and violations can occur during pregnancy and after the birth of the baby. But there are quite a few unsolvable problems with the level of today's medicine. The degree of risk with such a diagnosis, first of all, depends on the cause of the phenomenon. So, if it is hereditary (parents of small stature), then the baby may be tiny, but with the normal development of all vital organs. There is also a difference in the risk of problems depending on the degree of developmental disorder, the timing of pregnancy when this diagnosis is made and the period at which the baby is born. The highest risk indicator is reached by children who are born prematurely with a diagnosis of intrauterine growth retardation. Children born after such a diagnosis are more likely to develop diabetes, they are more sensitive than other children to infectious diseases, and it is difficult for them to maintain body temperature. That is why they are usually placed in special chambers after birth. This is a necessary measure to preserve the vital activity of the baby's organs, since developmental delay speaks not only of low weight, but also of an insufficient degree of development of vital organs. Many children who are diagnosed with developmental delay in the womb, after a while, do not differ at all from their peers who were born with normal weight. Children with this diagnosis tend to obesity and high blood pressure. But this does not mean that their existence will be reduced to a life on medicines and in hospitals. This only suggests that it will be necessary to pay a little more attention to their nutrition and physical activity. But what's wrong with a healthy lifestyle, proper nutrition and regular moderate physical activity?

Fetal growth retardation: how to prevent?

The best prevention for fetal growth retardation is pregnancy planning. When planning a pregnancy for six months, the couple must undergo a complete examination of the body and treat all chronic diseases. Treatment of caries and the urogenital area should also not fall out of attention. Giving up bad habits for at least six months is the best option to prevent this diagnosis. Regular visits to the antenatal clinic after being registered for pregnancy (and this must be done no later than 12 weeks), plays an important role in preventing negative consequences in the diagnosis of fetal growth retardation in the womb. The earlier the disease is detected and treated, the more likely it is to avoid negative consequences in the development of the fetus during gestation and after birth. A pregnant woman must have a properly built work and sleep mode. Good sleep during pregnancy (10 hours at night and 2 hours during the day) is a good prevention of intrauterine growth retardation. If you can’t sleep during the day, then rest in a horizontal position and with your eyes closed for 2 hours should be present in any case. Day rest helps to improve blood circulation between mother and child, gas exchange and transport of nutrients to the baby. being outdoors, moderate exercise in the form of gymnastics for pregnant women, complete and proper nutrition with a full range of vitamins and minerals (a frequent recommendation by a doctor when making such a diagnosis is eating food with a high content of carbohydrates) not only improves the mood of the pregnant woman, but also improves the well-being of the fetus in the womb. Read more about how to eat a future mother → The diagnosis of intrauterine growth retardation should not be a sentence for future parents. The reason for such a violation plays an important role, but the severity of the reason is not a reason to refuse the birth of a baby. There are no barriers that cannot be overcome. Believe me, the happiness of motherhood is incomparable with anything. We recommend reading: Delicate Pregnancy Issues: Urinary Incontinence

Every pregnant woman worries: is her baby developing correctly? Does it meet its deadlines? Sometimes you can hear a strange abbreviation from doctors: ZVPR, which stands for intrauterine growth retardation. How dangerous is this for a child, is it possible to compensate for this delay, and why does it occur at all?

According to statistics, such a complication as ZVPR occurs in every tenth pregnancy. A delay in the development of the fetus is called its lag in size and weight. A logical question - how do doctors determine this? After all, one child can be large, and the other - very small, but this does not affect their health.

There are special tables of fruit sizes for each period. They are called percentile tables. The average value - 50 percentiles - is the norm for the weight of the child. All values above this indicator mean that the fetus is large. All values below 50 - that its size and weight are less than average. The diagnosis of IUGR is made if the baby's weight is below the 10th percentile at the corresponding gestational age table.

There are three forms of fetal growth retardation: symmetrical, asymmetric and mixed. With a symmetrical form, a proportional decrease in all sizes of the fetus is observed. With asymmetric - a decrease in the volume of the abdomen of the fetus. With mixed - a decrease in the size of the abdomen (a discrepancy in its size for more than two weeks) and a slight decrease in other body sizes.

According to the degree of retardation in the development of the ZVPR is divided into three stages:

1 degree - sizes differ from the norm by 2 weeks;
Grade 2 - sizes differ by 3-4 weeks;
Grade 3 - the fetus is more than 4 weeks behind the norm.

At what time can it be assumed that the fetus has a small mass and size?

Symptoms of intrauterine growth retardation

There are three periods of fetal development. The first two are implantation and embryonic (up to 12 weeks). The third period is called fetal and ends directly with the birth of a child. Therefore, the syndrome of fetal growth retardation is detected precisely in this period: in the second or third trimesters of pregnancy. It is worth noting that in many cases, IUGR is asymptomatic, and is detected only at the next examination by a doctor. However, a number of symptoms may indicate abnormalities. For example, if a pregnant woman has a small weight gain, if the abdominal circumference does not correspond to the norm, if the fetus is small, or vice versa, it moves too much.

To confirm or refute the diagnosis, a number of studies are prescribed - first of all, ultrasound of the fetus, then CTG (cardiotocography), which allows assessing the cardiac activity of the fetus and determining whether it is experiencing hypoxia. The normal fetal heart rate is 120-160 beats per minute. With a lack of oxygen, the heart rate increases or, conversely, slows down.

To determine the syndrome of fetal retention, a number of other tests are also used - for example, a study of the content of placental hormones in the mother's blood.

Why does the IUGR occur?

Of course, not always the small weight and size of the child means that he has any pathology. Sometimes this is just an individual feature - for example, if the parents themselves do not differ in large sizes. Sometimes the size discrepancy is due to an error in calculating the gestational age - for example, if a woman does not remember the date of her last menstruation.

IUGR is always preceded by the so-called fetoplacental insufficiency (FPI). This is a condition in which the placenta does not adequately provide the fetus with oxygen and essential nutrients. Therefore, the fetus begins to lag behind in development. Another name for intrauterine growth retardation is fetal malnutrition.

There are many risk factors in which fetal hypotrophy is possible. Of course, this is the use of alcohol, drugs and nicotine. Insufficient nutrition of the mother during pregnancy, work in hazardous industries, excessive workload and stress can also affect the functioning of the placenta.

A number of chronic diseases in a woman have a direct effect on the blood circulation system in the placenta. These primarily include endocrine diseases, diseases of the heart, blood vessels and kidneys, infections and a burdened gynecological history.

Often, fetal growth retardation occurs with multiple pregnancies, preeclampsia and Rhesus conflict.

Treatment of fetal growth retardation syndrome

Treatment tactics depend on the cause of fetal malnutrition and the degree and form of the disease. A woman will need to regularly undergo ultrasound and CTG, as well as Doppler blood flow. Treatment is carried out permanently. It will be aimed at restoring blood flow in the "womb-placenta-fetus" system. 4.9 out of 5 (23 votes)

It happens that expectant mothers hear at the appointment with the attending physician or in the ultrasound room a frighteningly incomprehensible abbreviation - IUGR. Its decoding is even more frightening - "delayed intrauterine development of the fetus." A pregnant woman faced with a similar diagnosis is tormented by many questions. How dangerous is this condition? How will it affect the health of the baby? Will he be able to catch up?

What is FPI and IUGR?

Nutrition and respiration of the fetus is provided by a temporary ("provisional") organ - the placenta, which supplies the fetus with the substances necessary for life, receiving them from the mother's circulating blood. A condition in which the placenta does not adequately cope with its duties is called (FPN). Fetoplacental insufficiency over time leads to the fact that the fetus, not receiving the required amount of nutrients, weighs less than normal. This condition is called intrauterine growth retardation (IUGR), or intrauterine growth retardation (IUGR), or fetal malnutrition.

The causes of FPI are manifold. These include: late (nephropathy) - increased blood pressure, the appearance of protein in the urine, edema, long-term increased with the threat of premature birth, anomalies in the development of the uterus, anomalies in the development of the placenta and umbilical cord (for example, a short umbilical cord), general maternal diseases (heart defects, hypertension), common infections (from to influenza), . Factors predisposing to the development of FPI are rightly considered bad habits - smoking, addiction to alcohol and any drugs. Quite often, one or both fetuses with twins are affected by developmental delay.

Sick or just small?

Of course, not always a child is born small due to FPI. There is the concept of "constitutionally small fetus." It is logical when a small child is born to parents of short stature. In this case, the child is born with a low body weight, but absolutely healthy, not experiencing additional difficulties in the period of adaptation to extrauterine life, like children prone to true IUGR. Hypotrophic children differ from low-weight children in insufficient functioning of organs. It is important to understand that IUGR is not just underweight, but an important symptom of advanced FPI. And most importantly, FPI can cause intrauterine death of the fetus, since in case of circulatory disorders in the "mother-placenta-fetus" system, in extreme cases, the delivery of oxygen and nutrients to the fetus can be stopped.

Diagnosis of FPI

The simplest method of monitoring the growth of the fetus is to measure the height of the uterine fundus above the womb and compare the results with the standards for a given period. Along with this, newer methods are also used - determining the content of placental hormones in the mother's blood - placental lactogen, alkaline phosphatase, and some others. Obviously, a healthy placenta produces hormones in sufficient quantities, and the affected by a pathological process, on the contrary. These parameters are determined as part of a maternal blood test. An important role in the diagnosis of FPI is also played by cardiotocography (CTG), during which the cardiac activity of the fetus is recorded on a special tape and on the screen. During this study, a special sensor is attached to the belly of the expectant mother, with the help of which the vibrations created by the baby's heartbeat are transmitted to the device, where the signal is transformed into a certain curve, which reflects the number of heartbeats of the fetus. The purpose of this study is to make sure that the fetus does not lack oxygen. If the normal number of fetal heartbeats is 120-160 beats per minute, then with a lack of oxygen, it decreases or increases. Other indicators also change - the reaction to movements, etc.

The most common and accurate method for diagnosing intrauterine growth retardation is ultrasound. With the help of ultrasound, it is possible to accurately establish not only the discrepancy between the fetal weight and normal for a given period of pregnancy, but also find out how the development of the fetus is proportional and harmonious, how the internal organs of the fetus function, whether the placenta and umbilical cord have a normal structure. With the help of a variety of ultrasound - Doppler study - you can get information about the speed and direction of blood flow through the vessels of the umbilical cord and large arteries of the fetus.

Treat or feed?

Fetal growth retardation detected by ultrasound should be treated. The goal of treatment in this case is not to “fatten the baby”, but to normalize metabolic processes and support the vital functions of the fetus.

A large arsenal of medicines is used to treat fetal hypotrophy. Treatment should be individualized, taking into account the cause that caused FPI in this particular case. The success of treatment largely depends on how timely it is started.

In the treatment of FPI, tocolytic (i.e., relaxing the uterus) and vasodilators are widely used. Their use allows you to expand small vessels and increase the volume of uteroplacental blood flow. A similar goal is pursued by the appointment of infusion therapy - intravenous drip of blood substitute solutions that reduce blood viscosity and facilitate its passage through the capillaries. Of great importance in the treatment of placental insufficiency is also the use of vitamins (especially vitamin C and E) and amino acids, which allows you to normalize the composition of circulating blood and enrich it with substances necessary for the construction of organs and tissues of the fetus, as well as the synthesis of its enzymes and hormones.

Currently, for the treatment of intrauterine growth retardation, many non-drug remedies are also used, such as medical ozone, hyperbaric oxygenation (a medical procedure is breathing oxygen-enriched air under conditions of high barometric pressure) and some others. It is highly desirable to comply with the regime, which in English-speaking countries is called "bed rest" - during the day it is necessary to spend in bed in the side position for at least 6 hours. Well, the original Russian "quiet hour" - daytime sleep in the afternoon.

For expectant mothers who are carrying a small child, it is very important to have a good diet rich in vitamins and animal proteins, as well as a regimen with limited physical activity. Although you should not overeat, remembering that excesses in the diet do not at all lead to a proportional increase in the amount of nutrients taken by the placenta for the fetus. It is a historical fact that even during the blockade, mostly full-weight children were born to Leningrad women.

The effect of therapeutic measures must be constantly monitored using ultrasound and CTG, which are usually prescribed at intervals of 2 weeks (CTG - if necessary and more often). Treatment of IUGR almost always gives good results, although only in 10-20% of cases, the weight of the fetus can be brought to normal. In most cases, it is possible to observe adequate fetal growth, for example, in 7-10 days, the size of the fetus increases accordingly, but does not lag behind even more, which is considered a completely satisfactory result of treatment. In rare cases, when the efforts of doctors are in vain, the ultrasound shows a lack of fetal growth, accession, Doppler indicators worsen, and CTG shows signs of oxygen deficiency. In this case, you need to think about emergency delivery. The choice of method of delivery (delivery or caesarean section) depends on the readiness of the body and the cervix for childbirth and the severity of the fetal condition. If there is no certainty that a weakened child will endure birth stress, a caesarean section is preferred.

Prevention of FPI

It is necessary to think about the well-being of the unborn child even before pregnancy. It must be remembered that abortions, injuring the uterus, can later lead to violations of the uteroplacental circulation. During pregnancy, it is better to strongly refrain from smoking and drinking alcohol, contact with toxic substances and radiation sources - especially in the early stages of pregnancy, when the placenta is forming. It is necessary to timely (and better - in advance) treat infectious diseases and possible foci of infection, such as carious teeth or chronic tonsillitis. All expectant mothers, without exception, are advised to take multivitamin preparations for pregnant women.

Sometimes high-risk pregnant women (too young; women over 30 expecting their first child; suffering from chronic diseases; who have given birth to small children in the past; with long intervals between pregnancies) are recommended courses of drug prevention of FPI for up to 12 weeks, 20-23 weeks and 30-32 weeks, which include vasodilators and vitamins.

Detached consequences

As a rule, children who have had IUGR in utero require more careful care after birth. In height and weight, such children usually catch up with their peers by one and a half to two years, although due to reduced immunity, they get sick more often than other children. In addition, these children sometimes have problems with concentration and perseverance. However, medical rehabilitation helps young children overcome all difficulties and have good health in adulthood.

Discussion

Very informative. They did CTG for me, but we were told the scores (from 0 to 10), and not the heart rate of the child.
Also: there are rare cases when the cycle lasts not the "usual" 28-36 days, but more, then you have to prove that you are "not a camel". My two babies were given IUGR 2 weeks behind. And according to ultrasound in dynamics and according to CTG, everything was also in dynamics, but ultrasound showed a delay just for my two weeks and for some reason the doctor did not want to hear about my native even 43 day cycle. In general, the babies were born on their due date, and not set for a 28-day cycle (I don’t remember what this lag is called, but in general, this is an imaginary lag). And although the babies were born with a weight of exactly 3.0 kg each, there was no IUGR. But, my case is an exception :).

Comment on the article "Intrauterine growth retardation"

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Discussion

While the violations are minimal, Actovegin and a mixture of vitamins can be dripped. Do 10 droppers and see if there is an effect or not. You shouldn't joke about it. Consult with your doctor and do not be nervous, especially since nothing will change in 3 days and you can calmly relax and live. According to Doppler, these are not strong violations)

I don't quite understand why you were given FPN?
according to your figures, you have a slight degree of impaired uteroplacental blood flow (yes, this is degree 1a) in the left uterine artery (0.63 for you, the norm is 0.59, for me, by the way, this figure is worse - 0.77) . As 2 ultrasound specialists have already explained to me, the child does not suffer with such indicators.
The rest of the indicators - the umbilical artery and the fetal aorta - are normal.
What they told me on the last doppler: track. Do it every 2-3 weeks (after 30 weeks - CTG), such indicators can persist throughout B., the main thing is not to worsen. But what to do if it gets worse - they didn’t tell me, I’m worried myself ... :(

Retardation of intrauterine development of the fetus. With the help of a variety of ultrasound - Doppler study - you can get information about the speed and direction of blood flow through the vessels of the umbilical cord and large arteries of the fetus.

Discussion

a friend's daughter had a 100% healthy girl

my second daughter had one artery. my daughter is almost 3 months old, I gave birth myself, this was not an indication for a cop. voevodin on ultrasound was the first to see this and said that I should not think about it at all. I gave birth in the PMC, they also didn’t care at all about this one artery, they cut it off and forgot about it. I was also very worried about this during pregnancy, now I think what a fool I was, I just shook my nerves.

Discussion

I canceled at 16-18 weeks

Canceled after 14 weeks. The medicine is needed to support pregnancy from the 8th to the 12th week, this is a critical period (there are only 3 such terms for pregnancy, IVF women for these periods are generally kept for preservation, regardless of well-being) - if there is not enough own progesterone, then it is during this period that the probability of miscarriage is high or frozen. After 12 weeks, there is no such threat, so they slowly begin to reduce the dose, and at 14 weeks they cancel it altogether. The placenta still continues to form until 14 weeks, and then it is completely ready to take care of the baby.
My own hormones fail, the third pregnancy in the morning in the first trimester - after the abolition, no problems.

Retardation of intrauterine development of the fetus. During pregnancy, it is better to strongly refrain from smoking and drinking alcohol, contact with toxic substances and radiation sources - especially in the early stages of pregnancy ...

True, the ultrasound showed placental hypertrophy and IUGR of the 1st degree, and a small fetus. The local doctors took me to the day hospital. Retardation of intrauterine development of the fetus.

malnutrition is ... there is no such diagnosis of hypertrophy ... malnutrition (intrauterine growth retardation) is put on a combination of signs, one of which is a low indicator of abdominal volume compared to other ultrasound measurements ... malnutrition ...

Discussion

malnutrition is ... there is no such diagnosis of hypertrophy ... malnutrition (intrauterine growth retardation) is put on a combination of signs, one of which is a low abdominal volume compared to other ultrasound measurements ... malnutrition is a consequence of problems with the placenta (premature aging, placental insufficiency, etc.) or (less often) with the umbilical cord (impaired blood flow). In this case, it doesn't matter how much and what you eat, what matters is how much and what reaches the fetus.
We need to do a Doppler (measure the blood flow), and once again see if everything is in order with the placenta ... But in general - in my opinion, the baby is normal by the due date ... think the belly is smaller ... not everyone can be short-legged and pot-bellied ...

Hypoxia inhibits intrauterine development of the fetus and can even cause its death. Retardation of intrauterine development of the fetus. A large arsenal of medicines is used to treat fetal hypotrophy.

Discussion

All links to English sites. I could translate some articles, but I need to know which ones are important to you.
And I also gave emails to Russian doctors. They work in the US with adapted children and invite doctors from Russia and Ukraine. I thought that maybe they would advise you on a FAS specialist in Russia. I do not want to give their emails openly, if you need, I will send you in private.

articles for parents of children with FAS
http://www.faslink.org/katoc.htm#PArenting

strategy of behavior with a child with FAS
http://www.come-over.to/FAS/BEAM.htm

Features of infants with FAS
http://come-over.to/FASCRC/ 24.11.2016 01:26:49, Anna1988

Retardation of intrauterine development of the fetus. Nutrition and respiration of the fetus is provided by a temporary ("provisional") organ - the placenta, which supplies the fetus with the necessary pregnancies) ...

Discussion

Yesterday I wrote to you, today I will write more: for a period of 32-33 weeks, the 2nd degree of maturity of the placenta is normal. 3 degree of maturity of the placenta from 35 weeks. If there is a suspicion that the child does not receive the required amount of substances, CTG and Doppler should be done, where everything will become clear. If blood circulation is disturbed, then it really makes sense to go into pathology, they will feed the child.
At 32 weeks, my placenta was 38-40 thick, the doctor in the LC gave me a referral to pathology and after some time persuaded me, I went to the hospital, where I was going to give birth later, I lay there for a week exactly, they didn’t do ANYTHING to me there - someone was put on a dropper or fed with pills, but I just lay there and regretted that I had gone for it.

placental pathology: incorrect presentation or detachment;
chronic diseases of the mother: high blood pressure, problems with the cardiovascular system, anemia, improper functioning of the respiratory tract;
deviations in the chromosome set: Down syndrome;
pathologies of intrauterine development: malformation of the abdominal wall or kidneys;
mother's bad habits;
infectious diseases suffered by a woman during pregnancy: toxoplasmosis, syphilis, cytomegalovirus;
inadequate or malnutrition;
constant stress;
gynecological diseases;
self-administration of medications during pregnancy without a doctor's prescription;
multiple pregnancy;
climatic conditions: living in an area that is located high above sea level.

Symptoms of IUGR

abdominal circumference at a certain level, the height of the fundus of the uterus (palpable by hand by a gynecologist);
the size of the head, femur, belly of the baby;
growth with constant monitoring;
the amount of amniotic fluid;
violations of the functioning of the placenta (the size or structure may change);
blood flow velocity in the placenta and umbilical cord;
baby's heart rate.

Treatment Methods

Treatment largely depends on the degree of observed abnormalities:

intrauterine growth retardation of the 1st degree - a lag of 2 weeks (therapy can be quite successful and negate the negative consequences for the further development of the baby);
2 degrees - a delay of 3-4 weeks (strong treatment will be required, and the results can be completely unpredictable);
3 degrees - a lag of more than a month (even the most intensive therapy will not be able to equalize such a large lag, and the child may be born with serious deviations from the norm).

Treatment includes:

therapy for maternal diseases;
treatment of pregnancy complications;
increasing the resistance of a small organism to;
normalization of placental insufficiency (as a rule, drugs are prescribed to expand blood vessels to improve the blood supply to the fetus and uterus, as well as means to relax the muscles of the uterus).

The consequences that the syndrome of fetal growth retardation entails can be very different. Children with this diagnosis after birth can have serious health problems.

In infancy:

obstetric complications during childbirth: hypoxia, neurological disorders;
poor adaptation to new living conditions;
hyperexcitability;
increased or decreased muscle tone;
poor appetite;
small weight gain;
psychomotor retardation in development;
inability to maintain body temperature constant within the normal range;
insufficient degree of development of internal organs;
high susceptibility to infectious diseases.

At older age:

diabetes;
tendency to corpulence;
high blood pressure.

In adulthood:

cardiovascular diseases;
obesity;
non-insulin dependent diabetes mellitus;
elevated blood lipid levels.