Neonatal management of the growth-restricted infant.
Close collaboration between obstetricians and neonatologists is essential for proper care of the growth-restricted fetus. A joint decision on the appropriate timing of delivery is made, based on the risk of fetal compromise compared with that of neonatal morbidity. A neonatal resuscitative team should be available at delivery. Gestational assessment, anthropological measurements and physical examination are necessary to confirm the diagnosis of intra-uterine growth retardation and establish the symmetric, asymmetric, combined or dysmorphic classification. Neonatal management requires special attention to a number of significant morbidities that growth-restricted infants are more prone to develop compared with normally grown infants, including asphyxia, meconium aspiration syndrome, respiratory distress syndrome, massive pulmonary haemorrhage, chronic lung disease, hypothermia, hypoglycaemia, hypocalcaemia, polycythaemia-hyperviscosity, intraventricular haemorrhage, sepsis, necrotizing enterocolitis, coagulation abnormalities, and congenital anatomical and genetic abnormalities. Intra-uterine growth retardation is associated with a higher stillbirth rate and infant mortality rate in preterm, term and post-term infants.
Yu
Victor Y H
VY
Department of Paediatrics and Ritchie Centre for Baby Health Research, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia. victor.yu@med.monash.edu.au
Upadhyay
Amit
A
D036861:Delivery, Obstetric; D005260:Female; D005315:Fetal Diseases / Q000209:etiology; D005317:Fetal Growth Retardation / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006801:Humans; D011247:Pregnancy