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.