Intrauterine restriction (IUGR).
Perinatal mortality and morbidity is markedly increased in intrauterine growth restricted (IUGR) fetuses. Prenatal identification of IUGR is the first step in clinical management. For that purpose a uniform definition and criteria are required. The etiology of IUGR is multifactorial and whenever possible it should be assessed. When the cause is of placental origin, it is possible to identify the affected fetuses. The major complication is chronic fetal hypoxemia. By monitoring the changes of fetal vital functions it is thus possible to improve both management and outcome. The timing of delivery is crucial but the optimal management scheme has not yet been identified. When IUGR is identified at very early gestational ages, serial assessments of the risk of continuing the in utero fetal life under adverse conditions versus the risks of the prematurity should be performed. Delivery of IUGR fetuses should take place in centers where appropriate neonatal assistance can be provided. Careful monitoring of the IUGR fetus during labor is crucial as the IUGR fetus can quickly decompensate once uterine contractions have started.
Mandruzzato
Giampaolo
G
Department of Obstetrics and Gynecology, Istituto per l'Infanzia, Burlo Garofolo, Trieste, Italy. mandruzzatogiampaolo@tin.it
Antsaklis
Aris
A
Botet
Francesc
F
Chervenak
Frank A
FA
Figueras
Francisc
F
Grunebaum
Amos
A
Puerto
Bienve
B
Skupski
Daniel
D
Stanojevic
Milan
M
D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D017408:Guidelines as Topic; D006801:Humans; D007231:Infant, Newborn; D018743:Perinatal Care / Q000379:methods / Q000592:standards; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods / Q000592:standards; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*