Management of intrauterine growth restriction

Abstract

Intrauterine growth restriction (IUGR) is a condition where the fetus does not attain its biologically determined growth potential due to a pathological process. The main tools for antenatal surveillance in a growth-restricted fetus include amniotic fluid volume, Doppler studies, and biophysical profile. The frequency of surveillance depends on the severity of the growth restriction and the findings on previous ultrasound studies. The decision to deliver the fetus is dependent on factors such as gestational age, severity of growth restriction, and findings on the Doppler studies. If there is severe abnormality in the Doppler studies, lower segment cesarean section is recommended as the mode of delivery. Vaginal delivery may be attempted after induction of labor if Doppler parameters are normal, in a center with adequate facilities for monitoring facilities and when there are personnel with expertise. This review provides an overview of antenatal monitoring in a pregnancy with IUGR and decision-making during the time of delivery.