Is your baby not growing properly in the womb? Is this IUGR (Intrauterine Growth Restriction)? Let's find out!

If you are a mother-to-be, you may have heard the words `IUGR`. Perhaps your doctor or midwife has also mentioned this. So it is very important for you and your family to know exactly what this is. Today, let's talk about what `IUGR` is, why it happens, and what can be done about it. Don't worry, let's understand this simply.

Can we explain a little more about what IUGR is?

`IUGR` stands for Intrauterine Growth Restriction. Simply put, this means that your little one is not growing as expected, for the week they are in, or for their gestational age. This means that the baby is smaller than doctors expect. For example, if you are 30 weeks pregnant, you should have a normal weight and length for that 30-week pregnancy. In the case of `IUGR`, the baby can be significantly smaller than that.

There are two main types of `IUGR`. Doctors will tell you about these two types.

• The first type is called `(Symmetrical IUGR)`. In this, the baby's entire body, that is, the head, limbs, stomach, everything is the same size. It's as if the entire baby has been crushed. This condition can start from the very early stages of pregnancy.
• The second type is called `(Asymmetrical IUGR)`. This is a little different. The baby's head and brain have grown normally, to the expected size. But the rest of the body, especially the abdomen, is small. What happens in this case is that the baby's body tries to preserve the nutrients and oxygen needed by the brain, thereby restricting the growth of other organs. This condition is most often seen in the latter part of pregnancy.

Why does IUGR occur? What are the causes?

Now you may be thinking, 'Why is this happening to my baby? Is this my fault?' Don't think so. There are many reasons why `IUGR` can occur. The main reason is that the baby in the womb is not getting the nutrients and oxygen it needs. Just like a plant cannot grow properly if it lacks water and nutrients. There are several main factors that contribute to this lack of nutrition:

• Placenta Problems: As you know, the placenta is like a bridge that carries oxygen and nutrients from the mother to the baby. So if the placenta is not properly formed, is small in size, or has some weakness in its functioning, the baby does not get what it needs. Sometimes the placenta may not be properly attached to the uterine wall.
• Umbilical cord blood flow problems: The umbilical cord is the route through which nutrients and oxygen are delivered to the baby from the placenta. If the blood flow in the umbilical cord is reduced, for example, if the umbilical cord becomes tangled, compressed, or if the number of blood vessels in the umbilical cord is reduced, it can also affect the baby's growth.

In addition, some of the mother's health conditions and habits can also affect this. Let's see what they are:

• Smoking, alcohol consumption, and drug use: You probably know that these are very harmful during pregnancy. They directly interfere with the baby's development and reduce blood flow to the placenta.
• Certain infections: Certain infections that the mother contracts during pregnancy, for example, cytomegalovirus, rubella, toxoplasmosis, or syphilis, can affect the baby and reduce growth.
• Certain medications: Certain medications, especially those for epilepsy, can also cause IUGR. Therefore, it is very important to inform your doctor about any medications you are taking. Do not take any medications without your doctor's approval during this time.
• Some chronic medical conditions that the mother has: For example, conditions like lupus, severe anemia, or blood clotting problems, kidney disease, or heart disease can also be causes.
• Hypertension: High blood pressure in the mother during pregnancy (especially conditions like pre-eclampsia) is one of the main causes of IUGR.
• Genetic problems or birth defects in the baby: Sometimes, a baby's own genetic condition (Genetic disorder) or birth defect can also cause growth retardation. Examples include conditions like Down syndrome.
• Multiple pregnancies, such as twins or triplets: When you have more than one baby in the womb, sometimes the nutrients may not be distributed evenly to all of them. Even then, one or more babies may be small.

How do doctors diagnose IUGR?

Okay, now you probably understand what `IUGR` is and why it happens. So how does a doctor diagnose it?

Usually, you go to the clinic every month during your pregnancy. There, the doctor or family health worker will measure the height of your belly. That is, they will measure from the pubic bone in your lower abdomen to the top of your uterus with a tape measure. This is called the ``uterine fundal height'' measurement. This allows doctors to get a rough idea of ​​whether the baby's growth is appropriate for the week. This measurement should increase by a certain amount each week. If it does not, IUGR is suspected.

But the main way to confirm that you have IUGR is with an ultrasound scan. You have had a scan. A gel is applied to your abdomen and a small device called a probe is moved over your abdomen, and images of the baby are displayed on a computer screen. From these images, doctors can measure things like the size of the baby's head, belly circumference, and hip bone length, and calculate the baby's weight. Although these calculations are not 100% accurate, they are very helpful in determining how the baby is developing and whether there are any problems. An anomaly scan, usually done at 20 weeks, also gives an idea of ​​the baby's development. After that, more scans can be done as needed.

An ultrasound scan can also look at other things. For example:

• The location, size, and appearance of the placenta.
• Whether the amount of amniotic fluid around the baby is low or high. A decrease in this fluid can also be a sign of IUGR.
• A special scan called a Doppler ultrasound can also be used to see how the baby's blood is flowing through the placenta and umbilical cord. This can help determine whether the baby is getting enough blood and oxygen.

If there is a suspicion that the baby has `IUGR`, doctors may do several other tests:

• Monitoring the baby's heartbeat and movements (Fetal monitoring): This is also called a ``CTG (Cardiotocography)'' test. This checks whether the baby is doing well in the womb and is not stressed.
• Blood tests to confirm whether the mother has any infections that could affect the baby.
• Amniocentesis: This is not done often, but in some special cases, a small sample of the amniotic fluid surrounding the baby is taken to check for genetic causes of IUGR. Sometimes this can also be used to see how the baby's lungs are developing, especially if the baby is due to be delivered early.

How is IUGR treated?

Imagine that the doctors have just discovered that your baby has `IUGR`. What do you do then? The treatment for this depends on how far along the pregnancy is, the condition of the baby, and the cause of the `IUGR`.

Doctors monitor a baby with IUGR very closely throughout the pregnancy. They do frequent ultrasound scans (perhaps once or twice a week), record the baby's growth, do Doppler scans, do CTG tests, and check for other problems.

If the mother has a health condition that causes IUGR, doctors can help manage the condition. For example:

• If you have high blood pressure, you will be given medication to control it.
• They advise you to eat a good, nutritious diet. They tell you to eat protein-rich foods, vegetables, and fruits.
• It helps you gain the necessary amount of weight during pregnancy.
• Some mothers may also be prescribed bed rest, hoping it will help increase blood flow to the baby. However, this does not work for everyone, so follow your doctor's instructions.
• If you smoke, we provide advice and help to stop.

In some cases, doctors may recommend ``Induce labor and delivery early''.This decision may be made, especially if the baby's growth appears to have stopped completely, or if a Doppler scan or CTG shows that it is dangerous for the baby to remain in the womb, or if there is a serious problem with the placenta or the umbilical cord. Usually, after 37 weeks, the baby's lungs are well developed, so it may be safer to deliver the baby in such a case.

Sometimes, if the baby is too weak to handle the pressure of a vaginal delivery, the doctor may decide to perform a C-section. All of these decisions are made with the safety of you and your baby in mind.

What complications can occur due to IUGR?

Babies with `IUGR`, especially those who weigh very little at birth (less than 2.5 kilograms), are at increased risk of developing certain health problems.

• Premature birth: Babies with `IUGR` can often be born prematurely.
• Hospitalization: You may need to stay in the hospital for a long time after birth. You may also need to receive special care in the neonatal intensive care unit (NICU).
• Breathing difficulties: Respiratory distress syndrome can occur because the lungs are not fully developed.
• Difficulty breastfeeding: Difficulty breastfeeding may occur due to poor sucking ability.
• Difficulty maintaining a stable body temperature (Hypothermia).
• Low blood sugar levels (Hypoglycemia).
• Decreased blood calcium levels.
• Polycythemia: Thickening of the blood due to an increase in the number of blood cells.
• Decreased resistance to infections.
• Perinatal asphyxia: Lack of oxygen at birth.
• Neurological problems and developmental delays: In the long term, there is a small chance of things like learning difficulties.

But not all of these things happen to every IUGR baby. The long-term effects of IUGR on the baby depend on what caused the IUGR in the first place, the severity of the IUGR, and the treatment the baby receives.

What can I do if my baby has IUGR?

If the doctor says that your baby may have `IUGR`, don't panic and stay calm. The most important thing is to follow your doctor's instructions exactly and go to every clinic and every test. Only then will the doctor be able to accurately monitor your baby's development and health and make the right decisions at the right time.

Also, it is very important that you take good care of yourself:

• Eat a balanced, nutritious diet. If your doctor has prescribed extra vitamins and iron tablets, take them exactly and on time.
• Get enough rest and sleep.
• Avoid alcohol, drugs, and smoking completely. These are very harmful to the baby. If you are a smoker, this is the best time to stop.
• Try to stay mentally relaxed. Don't stress yourself out over unnecessary things. Your mental health also affects the baby. Get help from your husband and family.
• Pay attention to your baby's movements (Fetal kick count). Your doctor will advise you on this. You can get some idea of ​​whether your baby is doing well by watching how many times your baby moves in a day.

So, let's summarize what we've talked about. (Take-Home Message)

Okay, so we've talked a lot about `IUGR` today, haven't we? I hope this information has been useful to you. Here are some of the most important things to remember:

• `IUGR` means that the baby in the womb does not grow as well as expected. This can affect the baby's health.
• This can be caused by several factors, including problems with the placenta, the mother's health conditions, and certain conditions in the baby itself.
• Ultrasound scan is the main way to detect and monitor IUGR.
• As treatment, doctors closely monitor the baby, check on the mother's health, and may even deliver the baby early.
• The best thing you can do is follow your doctor's advice, practice good health habits, and stay mentally happy and relaxed.
• Remember, IUGR is not your fault. It can happen to anyone. With proper medical care and your dedication, you can manage this condition and bring a healthy baby into the world. You are not alone, your doctor, your family, and everyone is with you.

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