Study of obstetric outcome in pregnancies with intrauterine growth retardation
Keywords:Asymmetrical IUGR, Intrauterine growth Restriction (IUGR), Small for gestational age (SGA), Symmetrical IUGR
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.
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