English

Abstract

IUGR is one of the most serious challenges in both developed and developing contraries. It is the single most important factor that determines in chances of child survival. In our country PGRF remain one of the commonest cause of neonates morbidity and mortality 30% of neonatal death are done to IUGR. Despite of all efforts by government 100% antenatal care is poor but women are seeking health facility for delivery at time ever more important to identify such high risk pregnancy and manage for better met and fetal examination (one step) in 3 rd trimester can be used as a screening procedure for detection of IUGR babies. MATERIAL AND METHODS: all pregnant women coming to the facility diagnosed to have IUGR by clinical method (SFH, AG, clinical assessment of liquor) were included in the study for duration of one year. Maternal and fetal outcome was noted in terms of mode of delivery and neonatal death, still birth, SGA, AGA. Apgar score of all the babies was noted to assess morbidity. OBSERVATION: Of the total antenatal women 200 were identify as IUGR by clinical method out of which most of were from age group 21-25 years comprising 72.4% of total cases. Maternal weight and height influence weight of the babies 75% IUGR babies were noted in height less than 145 cm. 78.5% were unbooked and 64 belong to rural population. various risk maternal factors like hypertensive disorder 26%, anemia 16.5%, previous history of IUGR 9%, antepartum haemorrhage 6%, diabetes 1%, rh negative 4.5%, heart disease 1%, recurrent abortion 5% in 17% no identified risk factors were found, 80% were delivered vaginal, 67.5% babies were SGA after birth as assessed by clinical method, 68%, had Apgar score less than 7. Perinatal mortality constituted 27.3% of the babies. DISCUSSION: Intrauterine growth restriction is one of the common abnormality encountered by the obstetrician, when present it increases perinatal morbidity and mortality. it is a multifactorial disease with varying degree of severity as in our study the noted 68% of babies with Apgar less than 7 and only 32 had Apgar more than 7 with perinatal mortality of 27.3%. IUGR per se is a major problem in India, nearly million low birth weight babies are born annually in India and it account for more than half of neonatal death. This is evidenced in our study that we were able to screen and detect 67.5% of babies who were SGA out of total screen as IUGR. This study also emphasizes the fact that IUGR as cause of neonatal morbidity and mortality can be reduced if proper antenatal care prompting early detection of high risk factor and IUGR is done. One step method of clinical assessment of IUGR can be included in maternal health programs focusing on early detection of IUGR and associated maternal risk during antenatal period and early referral to more complete health care centres where they can be benefited by more sophisticated diagnostic and therapeutic methodology such as colour doppler and ultrasound.