Frequency Of Intrauterine Growth Retardation Research Articles

Prevalence of Intrauterine Growth Retardation on Antenatal Ultrasound Scan in Lahore, Pakistan

Fetal growth retardation is described as infants whose weights are much less than expected. Population based norms are used to categorize abnormal growths. The objective of the study was to determine the frequency of intrauterine growth retardation on antenatal ultrasound scan. It was an observational descriptive study conducted at the Radiology Department of Fatima Memorial Hospital, Shadman Lahore. Patients visited the Ultrasound Department for Obstetric scan. The study was conducted in 6 months from January to June in 2022. The sample size of 87 was calculated for study with expected rate of 9% of pregnancies resulted in intrauterine growth retardation at 5% level of significance at 5% margin of error. The study included pregnant females in third trimesters of pregnancy. The data was analyzed using SPSS version 20. A total of 87 obstetric ultrasounds were performed during the study period. The mean age of the patients was 28.69 ±4.46 years with age range 20-42. The 87 included patients showed mean gestational age 35.29 ±2.50 weeks. The mean biparietal diameter was 8.69±0.57 cm and abdominal circumference was 29.72±3.03 cm. The mean fetal body weight is 2.52±0.59 kg. The frequency of intrauterine growth retardation was 10.3%. Fetal biometry, biophysical profile and Doppler studies were helpful in the diagnosis of intrauterine growth retardation and evaluation of ultrasound parameters in third trimester.

Fetal growth retardation as a complication of post-COVID endotheliitis: causes, consequences, ways of prevention

The risk of fetal intrauterine growth retardation (IUGR) is increased in women who have experienced acute infections, as well as in pregnant women with gynecological pathology and endocrine diseases. A woman’s lack of nutrition also makes a negative contribution to the development of IUGR. The frequency of IUGR in the population is very variable and depends on a number of reasons. In practically healthy pregnant women, IUGR is registered in 3–5% of cases, in case of complicated obstetric and gynecological diagnosis and complicated pregnancy – in 10–25%. Morphofunctional disorders in the chorion/placenta in pregnant women with COVID-19 on the background of post-covid endotheliitis are the main pathogenetic factor in the development of preeclampsia, ectopic pregnancy, antenatal fetal death, and impaired condition of the fetus and newborns. Sufficient saturation of the pregnant woman’s body with the nitric oxide donor L-arginine and L-carnitine (main cofactor of fatty acid metabolism in cells) with the improvement of microcirculation and the correction of hypovolemic disorders in the fetoplacental complex can be considered one of the real ways to prevent IUGR in women in the post-covid period.A review of the scientific literature on pathogenesis, diagnosis, impact on the life and health of a newborn with IUGR in women after COVID-19, as well as the possibilities of medical correction of placental dysfunction during pregnancy was performed.This analysis and our own clinical experience allow us to state the fact that after a coronavirus infection during pregnancy, one of the frequent and threatening for the further development of the child is the formation of placental dysfunction and IUGR. One of the ways to prevent these conditions is to saturate the woman’s body with the nitric oxide donor L-arginine from the stage of pre-gravid preparation, which will provide the opportunity for adequate angiogenesis and development of the embryo/fetus. In the case of additional risk factors, such as coronavirus disease, complex therapy blood (Rheosorbilact), in combination with a nitric oxide donor and L-carnitine as an endothelium-protective agent (Tivor-L).

АНАЛИЗ СОСТОЯНИЯ НОВОРОЖДЕННЫХ ДЕТЕЙ ПАЦИЕНТОК, ПЕРЕНЕСШИХ КОРОНОВИРУСНУЮ ИНФЕКЦИЮ

Abstract. One of the urgent problems of modern obstetrics is the diagnosis, treatment and prevention of intrauterine growth retardation. This pathology ranks second after prematurity among the causes of the birth of children with low body weight. The frequency of intrauterine growth retardation varies in different countries of the world from 6.5-30.0% of all newborns, of which about 23% are found among children with very low body weight and about 38% with extremely low body weight. Currently, an outbreak of a new coronavirus infection continues, caused by the viral pathogen SARS-CoV-2, which contributes to the formation of thrombotic microangiopathy in combination with hypercoagulability syndrome. It is known that during physiological pregnancy, the risk of complications associated with both bleeding and thrombus formation increases, which is affected by changes in fibrinolytic activity and the state of hypercoagulability, endothelial dysfunction, and changes in the rheological properties of blood. This virus can significantly increase the risk of developing pregnancy complications such as preeclampsia, placental insufficiency, fetal hypoxia and, as a result, leads to intrauterine growth retardation. The study analyzes the condition of newborns and the incidence of intrauterine growth retardation in women who have recovered from coronovirus infection. The study included two groups of women: the first group consisted of patients whose pregnancy occurred 3-6 months after a new coronavirus infection, and the second group was a control group. As a result of the study, it was found that women of the first group more often suffered from preeclampsia, and their children were more often diagnosed with intrauterine growth retardation.

Contribution of L-Arginine supplementation during gestation on sow productive performance and on sow microbial faecal profile

Arginine plays an important role during reproduction, however, the amount of supplementation in sow diet is still uncertain. The aim of the study was to verify the efficacy of a gestating diet enriched or not with a low dose of L-arginine (Arg) on sow productive performance in terms of numbers and weight of piglets at birth and at weaning, frequency of intrauterine growth retardation (IUGR) and piglets’ mortality, sow placenta weight and salivary humoral immunity and intestinal microbial balance of the sows. 205 sows (Landrace x Large White) were divided into two experimental groups: a control group (CON) (102 sows) and a group supplemented with 0.25% of Arg (ARG) for the whole pregnancy period. Saliva and faecal samples were collected two days before farrowing and used for immunoglobulins and microbial analysis, respectively. Arg improved the number of total born piglets (p = .043) and tended to improve the number of total born alive (p = .086) and to reduce IUGR % (p = .090) and dead piglets at d0–d3 (p = .088). The weight of placenta and humoral immunity were not influenced by Arg. Arg did not modify the faecal microbial structure (alpha and beta indices) but increased the relative abundance of Bacteroidaceae family and Bacteroides genera (p = .0001). The results support the knowledge that Arg plays a key role in nutrition and physiology of pregnant sows without compromising gut eubiosis. Highlight Arg supplementation of sows’ gestation diet increased the number of total borns Arg supplementation of sows’ gestation diet did not negatively affect the sows’ gut eubiosis Arg plays a significant role in the nutrition of pregnant sows.

Experience in using dipyridamole in the group of pregnant women with a high risk of perinatal pathology

This article provides the evaluation results of the efficacy of low-dose dipyridamole (CurantylO) [1, 2] taken to prevent placental insufficiency in women in the group with a high risk of perinatal pathology and feto-maternal disease in past medical history. The early use of low-dose dipyridamole in high-risk groups contributes to a significant reduction in the frequency of intrauterine growth retardation, premature labour and birth of low birth-weight babies.

Pregnancy diet and associated outcomes in the Avon Longitudinal Study of Parents and Children.

All publications covering diet during pregnancy that stemmed from the Avon Longitudinal Study of Parents and Children were reviewed. Diet was assessed using a food frequency questionnaire. Socioeconomic background, maternal mental health, and the health and development of the offspring were assessed using a variety of methods, such as direct measurement, self-completion questionnaires, and assays of biological samples. Differences in diet, including specific food and nutrient intakes and dietary patterns, were associated with maternal educational attainment, smoking habits, and financial difficulty. There were marginal intakes, compared with recommendations, of the key nutrients iron, magnesium, potassium, and folate. Maternal diet during pregnancy was predictive of offspring diet during childhood. There were independent associations between prenatal fish consumption and lower frequency of maternal depressive and anxiety symptoms, as well as lower frequency of intrauterine growth retardation. Consistent evidence that fish consumption during pregnancy benefited the neurocognitive development of the child was also found. Two constituents of fish, n-3 polyunsaturated fatty acids and iodine, were associated with these benefits in children. The findings from the Avon Longitudinal Study of Parents and Children strengthen the recommendation to eat fish regularly during pregnancy.

Paramètres anthropométriques, fréquence et facteurs de risque du retard de croissance intra-utérin chez le nouveau-né à terme dans la région du Nord-Togo

Objective. – To establish fullterm newborn anthropometric parameters to determine the frequency of intrauterine growth retardation and to study mother's and socio-economic risk factors associated with the intrauterine growth retardation in the population in North-Togo. Methods. – Twelve month prospective study in the savana area in North-Togo. One thousand and six alive newborns born after normal single pregnancy, and without severe neonatal diseases were included. Results. – The mean birth-weight ± SD was 2938 ± 421 g. The incidence of low birth-weight was 11,7%. Among mother's and socio-economic risk factors, teenage mothers, mothers with a weight lower than 50 kg or with body mass index lower than 20 kg/m 2 had a significantly high risk of having a child with intrauterine growth retardation (Odds ratio = 2,71; 2,57; 1,57 respectively). Father's job also affected the mother's and newborn's weight. Conclusion. – The recognition of these easy to identify risk factors should allow specific recommendations for this population.

MATERNAL AND NEONATAL OUTCOME OF PREECLAMPTIC PREGNANCIES: THE POTENTIAL ROLES OF FACTOR V LEIDEN MUTATION AND 5,10 METHYLENETETRAHYDROFOLATE REDUCTASE

ObjectiveTo investigate the potential perinatal effects of Factor V Leiden mutation and 5,10 methylenetetrahydrofolate reductase C677T polymorphism in preeclamptic women.Study DesignOne hundred twenty preeclamptic women (N = 120) and 101 healthy pregnant controls (N = 101) were recruited and evaluated for frequency of Leiden and 5,10 methylenetetrahydrofolate reductase (MTHFR) mutations using polymerase chain reaction (PCR). Perinatal outcomes were then recorded and analyzed for all study participants and their neonates.ResultsLaboratory analysis yielded 22 (18.33%) heterozygous carriers of Factor V Leiden mutation among preeclamptic women and 3 (2.97%) heterozygous carriers among the healthy controls; differences between the two groups were found to be statistically significant [p < 0.001, the relative risk (RR) = 6.17, 95% confidence interval (95% CI) = 1.90–20.02]. Homozygous MTHFR mutations were found in 8 of 120 (6.67%) preeclamptic women and in 6 of the 101 (5.94%) healthy controls evaluated. Among preeclamptic women, episodes of hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome were reported in 7 of 22 (31.81%) of those with Factor V Leiden mutation and in 11 of 98 (11.22%) of those who were negative for the mutation. Group differences were determined to be statistically significant (p < 0.015, RR = 2.83, 95% CI = 1.24–6.48). Perinatal indicators collected from the two groups included frequency of intrauterine growth retardation, birth weight, and gestational age. No statistically different perinatal outcomes were found between Factor V Leiden positive and negative preeclamptic women. In addition, MTHFR gene polymorphism did not appear to be correlated with the development of preeclampsia.ConclusionAlthough the frequency of Factor V Leiden mutation appears to be significantly higher among preeclamptic women, the mechanism of pathogenesis and potential influence on perinatal outcomes is not yet well understood. Relatively high rates of HELLP syndrome among those with Factor V Leiden mutation suggest that this thrombogene mutation may play a significant role in hemostatic system activation. Our results suggest that the role of MTHFR polymorphism and other factors such as folic acid supplementation will require more extensive analysis in controlling worldwide morbidity and mortality associated with this important maternal condition.

When children "have children"--reproduction biological problems in girls between 11 and 15 years of age

The aim of the present study was to evaluate the obstetric risk in pregnant adolescents under 16 years of age. From July 1, 1970 to June 30, 1993, 188 girls aged 11-15 years were delivered at the 2nd Department of Obstetrics and Gynaecology, Vienna; 4569 primiparous women between 20 and 24 years with singleton pregnancies served as a control group. No significant differences between the two groups were found for the frequency of pregnancy-induced hypertension (2.1% vs. 3.5%), premature delivery rates (24.4% vs. 29.8%), percentage of babies weighing less than 2500 g (10.1% vs. 9.1%), mean birthweight (3082 g vs. 3117 g), frequency of intrauterine growth retardation (2.1% vs. 2.4%) and malformations (1.6% vs. 3.1%) and perinatal mortality to the end of the first week (1.1% vs. 0.5%). Adolescent mothers were found to have more spontaneous deliveries (85.1% vs. 74.9% in the control group, p < 0.005), lower Caesarean section rates (6.4% vs. 11.3%, p < 0.05) and fewer babies with a birthweight exceeding 4000 g (1.1% vs. 4.3%, p < 0.05). For the first time, the pregnancy outcome of European adolescents was studied over a period of 23 years. We conclude on the basis of our results that maternal and neonatal risk in mothers under 16 years of age does not exceed the obstetric risk in adult mothers.

Postnatal Growth in Infants Born Between 700 and 1,500 g

Our purpose was to examine postnatal growth in very low birth weight (VLBW) infants (n = 54). A high frequency of intrauterine growth retardation was noted that was corrected by plotting birth weight against crown-heel length and not gestational age. No differences in postnatal growth were noted between infants whose size was appropriate for gestational age (n = 37) and those small for gestational age (n = 17). Overall, growth tended to exceed that previously published. Weight but not length or head gain was less in the smaller (< or = 1,000 g) when compared to the larger (> 1,000 g) VLBW infant. Poorer weight gain could not be related to more "illness" or less nutrient intake in the smaller infants.

Postnatal Growth in Infants Born Between 700 and 1,500 g

SummaryOur purpose was to examine postnatal growth in very low birth weight (VLBW) infants (n = 54). A high frequency of intrauterine growth retardation was noted that was corrected by plotting birth weight against crown‐heel length and not gestational age. No differences in postnatal growth were noted between infants whose size was appropriate for gestational age (n = 37) and those small for gestational age (n = 17). Overall, growth tended to exceed that previously published. Weight but not length or head gain was less in the smaller (≤ 1,000 g) when compared to the larger (&gt; 1,000 g) VLBW infant. Poorer weight gain could not be related to more “illness” or less nutrient intake in the smaller infants.

Long term predictive value of Doppler studies in high risk fetuses.

To determine whether the predictive value of Doppler ultrasonography extends beyond the perinatal period. Descriptive follow-up study. Specially designated paediatric clinic in Royal Maternity Hospital. 40 children who as high risk fetuses had had assessment of umbilical artery flow velocity waveforms. Parental history, physical examination, anthropometry, Denver developmental screening test. Weight, height, head circumference, neurological impairment, Denver development screening test Abnormal waveforms were an accurate predictor of neonatal outcome, with significant differences in birthweight, gestational age, need for nursery admission, and frequency of intrauterine growth retardation between normal and abnormal waveform groups. However, abnormal Doppler studies were not predictive of long-term adverse sequelae. There were no significant differences in height, head circumference, proportion with neurological impairment, or results of Denver developmental screening test at a median age of five years. The predictive value of Doppler ultrasonography is less for long-term growth and neurodevelopment than for perinatal outcome in the high risk fetus.

Congenital Malformations and Intrauterine Growth Retardation: A Population Study

The relationship between congenital malformations and intrauterine growth retardation was investigated using data from the population-based Metropolitan Atlanta Congenital Defects Program. Between 1970 and 1984, the system ascertained 13,074 infants with major structural malformations diagnosed in the first year of life and born to metropolitan Atlanta residents. These infants were classified as having intrauterine growth retardation if their birth weight was below the race-, sex-, and gestational age-specific tenth percentile limits for all Atlanta births. Overall, the frequency of intrauterine growth retardation among malformed infants was 22.3% (relative risk 2.6). Of 48 defect categories evaluated, 46 were associated with excess intrauterine growth retardation, most notably chromosomal anomalies (eg, 83.7% for infants with trisomy 18, relative risk 46) and anencephaly (73.3%, relative risk 25). Only a few isolated defects (such as isolated polydactyly, pyloric stenosis, and congenital hip dislocation) were not associated with excess intrauterine growth retardation. Among infants with multiple malformations, the frequency of intrauterine growth retardation increased markedly with increasing number of defects--from 20% for infants with two defects to 60% for infants with nine or more defects. The relationship between malformations and intrauterine growth retardation can be explained by one or more of three mechanisms: (1) intrauterine growth retardation can be a secondary disturbance to the presence of malformations; (2) intrauterine growth retardation can predispose the fetus to malformations; and (3) intrauterine growth retardation can coexist with malformations because of common etiologic factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Placental pathology at term associated with elevated midtrimester maternal serum α-fetoprotein concentration

Reports have supported an association between elevated midtrimester maternal serum α-fetoprotein concentrations (unexplained by fetal anomalies) and intrauterine growth retardation. Our observations show an association between such elevations of maternal serum α-fetoprotein levels and two types of placental pathology at delivery, chronic villitis and placental vascular lesions of infarction or intervillous thrombosis. If chronic villitis was present, the frequency of intrauterine growth retardation was significantly increased, whereas no increase in intrauterine growth retardation was found in the absence of placental pathology.

Hemodynamic changes after chronic pindolol administration in pregnant renal hypertensive rats.

The aim of the present study on pregnant renal hypertensive rats was to investigate the effects on central hemodynamics and uteroplacental blood flow after chronic administration of pindolol, a nonspecific beta-adrenergic receptor blocking agent with intrinsic beta-stimulatory effect. Renal hypertension was induced by partial clamping of both renal arteries four weeks before pregnancy. Pindolol was administered with the food during the entire pregnancy period. Two to four days before expected delivery mean arterial pressure, heart rate, cardiac output, (dye-dilution technique) and utero-placental blood supply (microsphere technique) were determined. The chronic pindolol treatment reduced heart rate by 25 per cent while both mean arterial pressure and cardiac output remained unchanged. However, blood flow to uterus and placentae was reduced by 43 and 64 per cent, respectively, after pindolol treatment. Clinical as well as experimental studies (15, 16) demonstrate a reduced utero-placental blood supply when pregnancies are complicated by hypertension. As pregnancies with severe hypertension are associated with an increased frequency of intrauterine growth retardation and intrauterine asphyxia the present results indicate that the combination of hypertension and long-term treatment with beta-blockers might reduce utero-placental blood flow enough as to seriously interfere with fetal oxygen supply thereby increasing the risk of intra- and extra-uterine asphyxia.

The human materno-foetal relationship in malaria. II. Histological, ultrastructural and immunopathological studies of the placenta

Histological and ultrastructural studies of four placentae heavily infected with Plasmodium falciparum revealed large intervillous accumulations of erythrocytes containing parasites together with monocytes which had ingested pigment. These appearances were associated with focal syncytial necrosis, loss of syncytial microvilli and proliferation of cytotrophoblastic cells. In addition, marked irregular thickening of trophoblastic basement membranes and protrusion of tongue-like projections of syncytiotrophoblast into the basement membrane were observed. In six other placentae which contained scanty amounts of pigment but no parasites, representing past or inactive infection, no large collections of monocytes or abnormalities of trophoblast were apparent but basement membrane thickening was evident. Immunohistological studies revealed no significant differences between placentae positive for parasites and those containing pigment only, although the amount of certain immunoproteins and clotting factors was clearly increased above normal. These findings establish that P. falciparum infection in the placenta may result in substantial damage although lesions within the villus are rare. Furthermore, previous infection, although adequately controlled, may leave a heritage of pigment deposition, basement membrane thickening and immunopathological lesions. These results may thus account for both the high frequency of intra-uterine growth retardation and the rarity of congenital malaria in the presence of P. falciparum malaria.

Influence of blood pressure changes with and without proteinuria upon outcome of pregnancy

A prospective study of 10,074 white gravidas and 2,880 black gravidas carried out during the years 1959 to 1967 has been analyzed with respect to the impact of elevated blood pressures and/or proteinuria upon pregnancy outcome. Edema was not considered because no evidence is available to indicate that its occurrence increases risk. The mean arterial pressure exhibited during the fifth and sixth months of pregnancy was found to be of significance, as well as the absolute levels of blood pressure attained prior to labor and delivery. The degree of rise in blood pressure was not of importance in itself. However, categories with significant proteinuria had greater increases in mean arterial pressure than did comparable categories without it. Significant proteinuria alone but especially with hypertension was also detrimental to pregnancy outcome. Eight categories incorporating early and late hypertension with and without proteinuria were created, and these were given descriptive diagnostic labels. Only “gestational hypertension”, as defined, proved to be essentially devoid of risk to the fetus. In all other non-normotensive categories there was an increase in the stillbirth rate, the perinatal mortality rate, the frequency of intrauterine growth retardation, and neonatal morbidity. In every category, each of these untoward events was greater in black than in white gravidas, and a higher percentage of blacks was noted in each of the hypertensive categories. It is believed that hypertension, significant proteinuria, or both are associated with decreased uteroplacental blood flow which is the common denominator for all of these deleterious effects. The study suggests that “gestational hypertension” occurring late but without proteinuria may or may not represent an early stage of “pre-eclampsia” but does not, at least, place the infant at any substantially increased risk.