Study of fetomaternal implications in intrauterine growth restriction pregnancies
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240783Keywords:
FGR, IUGR, Perinatal morbidity, Lower segment caesarean sectionAbstract
Background: Fetal growth restriction (FGR) is a pathological condition in which a fetus has not achieved its genetic growth potential. FGR incidence is 6 times higher in underdeveloped and developing countries as compared to the developed world.
Methods: This is a retrospective study done in the department of obstetrics and gynaecology, civil hospital and B. J. Medical college, Ahmedabad over the period of 6 months from December 2022 to May 2023. A total of 30 cases of intrauterine growth restriction (IUGR) pregnancies were studied.
Results: Majority of the study population, 60% belonged to younger age group of 20-30 years. Multiparity was associated with IUGR babies. Majority of patients i.e. 76.66%. Presented at gestational age of ≥37 weeks and 23.33% at <37 weeks. Most IUGR babies (73.33%) had a birth weight between 2 to 2.5 kg. One third of babies required NICU admission while the perinatal mortality was 10%. Doppler changes in umbilical artery were noted in 27% of cases of IUGR. Among risk factors anemia, preeclampsia and oligohydramnios had equal contributions at 10% each. Previous history for SGA baby is a significant association in 16% of cases. Induction of labor was done in 60% cases, 63% were delivered vaginally and rest via lower segment caesarean section (LSCS), the most common indication of LSCS was fetal distress.
Conclusions: The study concluded that IUGR continues to be one of the major etiological factors for fetal morbidity and mortality and increase in rates of LSCS contributing maternal morbidity. IUGR was commonly observed in multigravida patients lacking antenatal care. Anemia and hypertensive disorders of pregnancy as well as oligohydramnios are the potential risk factors for IUGR.
References
Cunningham FG, Leveno KJ, Dashe JS, Hoffman BL, Spong CY, Casey BM. Williams Obstetrics, 26e. 26th edi, McGraw Hill / Medical publications. 2022.
Bhide A, Arulkumaran S, Damania KR, Daftary SN. Arias’ Practical Guide to High-Risk Pregnancy and Delivery: A South Asian Perspective. 5th edi, Elsevier India publications, 2019.
Sharma D, Shastri S, Sharma P. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clin Med Insights Pediatr. 2016;10:67-83.
Kiserud T, Piaggio G, Carroli G, Mariana W, José C, Lisa NJ, et al. The World Health Organization fetal growth charts: a multinational longitudinal study of ultrasound biometric measurements and estimated fetal weight. PLoS Med. 2017;14(1):e1002220.
Kiserud T, Benachi A, Hecher K, Rogelio GP, José C, Gilda P, et al. The World Health Organisation fetal growth charts: concept, findings, interpretation, and application. Am J Obstet Gynecol. 2018;218(2S):S619-29.
WHO. Fetal growth calculator. Available at: https://srhr.org/fetalgrowthcalculator/#/. Accessed on 25 January, 2024.
Dapkekar P, Bhalerao A, Kawathalkar A. Risk Factors Associated with Intrauterine Growth Restriction: A Case-Control Study. Cureus. 2023;15(6):e40178.
Ashwani N, Neela AR, Babu SM, Kumar CS, Pratap OT. Maternal risk factors associated with intrauterine growth restriction: hospital based study. Int J Med Res Rev. 2016;4:2125-9.
Sinha S, Kurude VN. Study of obstetric outcome in pregnancies with intrauterine growth retardation. Int J Reprod Contracept Obstet Gynecol. 2018;7(5):1858-63.
Singh A, Ambujam K. Maternal socio-demographic determinants and fetal outcome of intrauterine growth restriction. Int J Reprod Contracept Obstet Gynecol. 2018;7(9):3843-7.
Radhakrishnan T, Thankappan KR, Vasan RS, Sarma PS. Socioeconomic and demographic factors associated with birth weight. A community-based study in Kerala. Indian Pediatr. 2000;37(8):872-6.
Aghamolaei T, Eftekhar H, Aghamolaei SZT. Risk Factors Associated with Intrauterine growth Retardation (IUGR) in Bandar Abbas. J Medical Sci. 2007;7(4):665-9.
