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Understanding Fetal Growth Restriction: Causes And Management

Fetal growth restriction, where a developing baby does not reach its expected size in the womb, brings complications for both the baby and the mother. This article explores fetal growth restriction and its potential causes and risks. It also discusses how doctors manage this condition to ensure a healthy outcome.

This can pose significant risks to the baby’s health, potentially resulting in complications during birth, increased susceptibility to infections, and developmental challenges later in life. Understanding the underlying causes of FGR, such as placental insufficiency and maternal health, is important for doctors to develop treatments to optimize fetal growth. This article looks into fetal growth restriction, explaining its causes and diagnostic procedures. It also outlines treatment options to support healthy fetal development and a successful pregnancy.

1. Defining Fetal Growth Restriction

Fetal growth restriction (FGR), or intrauterine growth restriction (IUGR), refers to a situation where the baby’s growth is limited. This leads to a lower birth weight than expected for their gestational age. This condition can arise from various factors influencing the baby’s development in the womb.

a. Importance of Early Detection


Early detection of this is essential for timely treatment. This can also manage the condition, improve the baby’s chances of a healthy outcome, and minimize potential risks to the mother.

2. Causes of Fetal Growth Restriction

Understanding the underlying causes of fetal growth restriction is crucial for identifying risk factors and providing effective prenatal care.

a. Placental Issues
  • Placental Insufficiency: When the placenta fails to provide adequate nutrients and oxygen to the baby, it can hinder their growth.
  • Placental Abruption: A sudden separation of the placenta from the uterine wall can lead to reduced blood flow, affecting the baby’s growth.
b. Maternal Factors

Woman stressed due to pregnancy

  • Hypertension: Chronic high blood pressure can restrict blood flow to the placenta, potentially leading to FGR.
  • Infections and Chronic Illnesses: Maternal infections or underlying health conditions may interfere with fetal development, restricting growth.

3. Risks and Complications

It carries many risks and potential complications, both for the baby and the mother.

a. Risks to the Baby
  • Preterm Birth: FGR often leads to premature birth, increasing the risk of health issues for the baby.
  • Low Birth Weight: Babies affected by FGR are often born with low birth weight, which can lead to developmental problems.
b. Risks to the Mother

Surgeons performing C-Section in operating room

  • Preeclampsia: Mothers carrying a baby with FGR are at an increased risk of developing preeclampsia, a pregnancy-related severe condition.
  • Cesarean Section: FGR may necessitate a cesarean section to ensure the baby’s safe delivery, which carries risks and recovery challenges.

4. Diagnosis and Monitoring

Diagnosing fetal growth restriction involves a combination of physical assessments and specialized tests during prenatal care.

a. Physical Assessment
  • Fundal Height Measurement: Doctors monitor the growth of the mother’s uterus to track potential fetal growth issues.
  • Ultrasound: Regular ultrasounds help measure the baby’s size and assess blood flow through the umbilical cord.
b. Specialized Tests

blood tests

  • Doppler Blood Flow Studies: These studies assess blood flow in the umbilical cord and fetal vessels, providing insights into the baby’s well-being.
  • Biophysical Profile (BPP): BPP combines assessments like fetal movement, heart rate, and amniotic fluid levels to gauge the baby’s overall health.

5. Management and Interventions

When doctors diagnose fetal growth restriction, they implement strategies to safeguard the baby’s well-being.

a. Close Monitoring
  • Increased Prenatal Visits: Mothers with FGR require more frequent prenatal check-ups to monitor the baby’s growth and overall health.
  • Non-Stress Tests (NST): NSTs measure the baby’s heart rate and movement to assess their well-being.
b. Lifestyle and Medical Interventions


  • Nutritional Counseling: Mothers with FGR may receive guidance on dietary adjustments to support the baby’s growth.
  • Early Delivery: In severe cases, early delivery may be necessary to mitigate potential risks associated with FGR.

6. Prognosis and Outlook

The prognosis for babies affected by fetal growth restriction varies based on the underlying causes and the severity of the condition.

a. Mild Fetal Growth Restriction
  • Positive Outlook: With timely detection and appropriate management, many babies with mild FGR can experience healthy development.
  • Post-Delivery Monitoring: Babies born with mild FGR may require close monitoring post-birth to ensure their well-being.
b. Severe Fetal Growth Restriction


  • Challenges: Severe cases of FGR may lead to long-term health challenges for the baby, necessitating specialized care.
  • Long-Term Follow-Up: Babies with severe FGR may need ongoing medical attention and intervention to address potential developmental issues.

Fetal growth restriction is a complex and potentially serious condition that impacts both the baby and the mother. It is important for expectant parents and doctors to understand its causes, risks, and management options. Early detection, regular monitoring, and appropriate interventions can significantly improve the prognosis for babies affected by FGR. If you suspect fetal growth restriction or have concerns about pregnancy, consult your doctor to ensure the best result for both you and your baby.

This article is approved by Dr. M. V. Jyothsna, Consultant Obstetrician & Gynaecologist, Yashoda Hospitals.

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