INTRAUTERINE GROWTH RESTRICTION - IDENTIFICATION AND MANAGEMENT

Intrauterine growth restriction (IUGR) is a common diagnosis in obstet rics and carries an increased risk of perinatal mortality and morbidit y. Identification of IUGR is crucial because proper evaluation and man agement can result in a favorable outcome. Certain pregnancies are at high risk for growth restriction, although a substantial percentage of cases occur in the general obstetric population. Accurate dating earl y in pregnancy is essential for a diagnosis of IUGR. Ultrasound biomet ry is the gold standard for assessment of fetal size and the amount of amniotic fluid. Growth restriction is classified as symmetric and asy mmetric. A lag in fundal height of 4 cm or more suggests IUGR. Serial ultrasonograms are important for monitoring growth restriction, and ma nagement must be individualized. General management measures include t reatment of maternal disease, good nutrition and institution of bed re st. Preterm delivery is indicated if the fetus shows evidence of abnor mal function on biophysical profile testing. The fetus should be monit ored continuously during labor to minimize fetal hypoxia.