1178 Immediate Management of Growth Restricted Infant

Abstract

Background and aims: Intrauterine growth restriction (IUGR) is characterized by fetal growth less than normal for the population and growth potential of a given infant. The decreased fetal growth rate in IUGR is an adaptation to an unfavourable intrauterine environment and may result in permanent alterations in metabolism, growth, and development. The acute neonatal consequences of IUGR are perinatal asphyxia and neonatal adaptive problems. Methods: During the period of 3 years, immediate management of 160 infants from fetal growth restricted pregnancies were studied. We used SPSS 1.1 and Statgraf for Win 2.1 statistical programs. Results were compared by Person Chi-Square (< 0.05) and logistic regression analyses. Results: Compared with normally grown infants, those who were growth restricted had increased risk for fetal distress (OR 16.47; 95%CI 6.86- 39.55), operative way of delivery (OR 4.25; 95%CI 2.72-6.64), perinatal asphyxia (OR 3.26; 95%CI 1.96-5.43), need for resuscitation (OR 2.81; 95%CI 1.83-4.32) and transfer to NICU (OR 2.38; 95%CI 1.56-3.65). Conclusions: Perinatal asphyxia is the initial concern in the IUGR fetus. Careful obstetric surveillance and timely delivery can prevent perinatal asphyxia and its clinical consequences. A neonatal resuscitative team should be available at delivery to improve neonatal outcome. Immediate management in delivery room should focus on the anticipation of a depressed infant, adequate resuscitation and insuring a normal physiologic transition.