Fetal Growth Restriction Clinic

Your unborn baby may be growing at a rate less than that expected for the stage of pregnancy. Fetal growth restriction (also known as Intrauterine Growth Restriction) means that your baby’s weight on ultrasound is in the smallest 10%.

Most babies with fetal growth restriction are delivered in a healthy condition in general. However, some babies with fetal growth restriction especially those who are severely affected and those needing very early delivery, might be at high risk for serious complications. Fetal growth restriction is also associated with a maternal condition called preeclampsia, where the mother experiences high blood pressure that could lead to various maternal complications.

Most cases of fetal growth restriction are related to the inability of the placenta to provide enough blood flow and oxygen for the baby’s growth and maintenance of good health, a condition referred to as placental insufficiency. If there is delay in detection, monitoring, and timely management, the baby is at an increased risk of a decreased oxygen supply which can affect the bay’s health inside the womb or directly after birth. Sometimes these problems are serious.

Few cases of fetal growth restriction are related to a chromosomal abnormality, genetic problem, or a fetal infection. In these cases, although diagnosis is made, little can be done to reverse the situation. On the other hand, where the problem is related to placental insufficiency, early diagnosis and management will optimize the health outcomes for the baby and significantly reduces the chance of a serious complication during pregnancy and after delivery.

At our clinic, Dr Abi Nader uses multimodal fetal testing to ensure the health of your fetus when fetal growth restriction is suspected or diagnosed during pregnancy. This includes following-up on fetal measurements, monitoring the fetal movement and heart rate changes, assessing the amount of fluid around your baby, and most importantly measuring the blood flow through the placenta, umbilical cord, fetal brain, and fetal heart vessels using Doppler ultrasound. This kind of close monitoring will let us know when it is the best time to deliver your baby so that complications are minimized. We will also discuss with you the safest mode of delivery (vaginal delivery or cesarean section) depending on your pregnancy details and the baby’s clinical condition. After delivery, your baby will be taken care of by pediatricians with special expertise in the care of small newborns.
It is also important to make sure that the mother’s health is also optimized. When the placenta is not working well, this can also affect the mother by causing a high blood pressure during pregnancy, a condition known as preeclampsia, which can be equally serious for the mother if not evaluated and managed appropriately. In addition, some maternal diseases especially those affecting the vessels like certain rheumatic diseases or diabetes, can increase the risk for both fetal growth restriction and preeclampsia.

Women who have a history for fetal growth restriction or preeclampsia in a previous pregnancy, have advanced maternal age, have certain medical diseases like hypertension or diabetes, had bleeding during their current pregnancy, are pregnant with twins, or are chronic smokers have a higher chance for fetal growth restriction. If you have one of these criteria then, you are a candidate for close monitoring during the second half of your pregnancy. Early screening with uterine artery Doppler will help in the prediction of those who are at highest risk for placental insufficiency. You may also be prescribed low-dose Aspirin for prevention of preeclampsia and fetal growth restriction.

We wish you a healthy pregnancy. Please do not hesitate to contact us for further advice on fetal growth restriction and preeclampsia. Dr Abi Nader will be happy to see you by appointment.