ANTENATAL THERAPY FOR INTRAUTERINE GROWTH-RETARDATION

Currently, there is no effective antenatal therapy for intrauterine gr owth retardation (IUGR). Although the IUGR fetus is undernourished in utero and there have been many attempts to treat IUGR with nutritional supplements, most studies have been poorly controlled, and there is n o evidence to date that nutrient supplements can reverse the process o f IUGR once it is established. Nutrient supplementation is also potent ially risky and a combination of nutrients is likely to be needed. Alt ernative approaches to antenatal therapy for IUGR that show promise in clude fetal growth hormone and insulin-like growth factor I treatment to improve fetal growth. Fetal and maternal hormone supplements may al so prove useful in IUGR by improving placental function and thus fetal substrate supply. Fetal enteral supplementation by the administration of growth factors and/or nutrients into the amniotic fluid may also p rove effective and clinically feasible. It seems likely that combinati ons of these approaches will be required before effective therapy can be devised for the IUGR fetus in utero.