Analytical study of 50 cases of fetal growth restriction
Keywords:
FGR, Diagnosis of FGR, Perinatal mortality and morbidityAbstract
Background: The objective of the study is to earlier diagnose the cases of FGR (Fetal growth restriction) and to identify the possible causes and management option to prevent further damage and to study the fetomaternal outcome and improve fetomaternal outcome in FGR cases.
Methods: This is an analytical study of 50 cases of FGR pregnancies done during the period of 1st April 2013 to 31st March 2014. Data was collected from the OPD books and indoor case papers of patients attending routine antenatal care and emergency services provided by obstetrics and gynaecology department of our institute.
Results: 50 cases of FGR were studied. Various possible etiological factors were studied like presence of anaemia, hypoproteinemia and PIH, maternal pre-pregnancy weight, and average weight gain during pregnancy. Among them, malnutrition (64%) was the commonest aetiology of FGR followed by PIH (44%). Ante partum surveillance was done by serial fundal height measurement, maternal weight gain monitoring and serial ultrasound. 40% patients were having severe oligoamnios and 30% were having altered Doppler waveforms. Operative interference was required in 44% cases. 30 babies out of 50 were admitted to NICU. And perinatal mortality was 13.72%.
Conclusion: Timely diagnosis, proper management at all levels in well-equipped centre can definitely prevent morbidity and mortality from FGR. Improving pre-pregnancy health, ensuring better antenatal care, effective use of contraception, preventing teenage pregnancies, stop smoking are some preventive measures.
References
F. Gary Cunningham. Fetal growth restriction. In: Kenneth J. Leveno, Steven L. Bloom, John C. Hauth, Larry C. Gilstrap III, Katharine D. Wenstrom, eds. Williams Obstetrics. 22nd ed. New York: McGraw-Hill; 2005: 893-910.
William H. Tooley. Intensive care nursery house staff manual. In: William H. Tooley, eds. The Regents of the University of California. California: UCSF Children’s Hospital; 2003: 69-70.
de Onis M, Blossner M, Villar J. Levels and patterns of intrauterine growth retardation in developing countries. Eur J Clin Nutr. 1998;52(Suppl 1):S5-15.
Antonisamy B, Sivaram M, Richard J, Rao PS. Trends in intrauterine growth of single live births in southern India. J Trop Pediatr. 1996; 42(6):339-41.
Scifres C, Odibo A. Oligoamnios as predictor of adverse pregnancy outcomes in preterm IUGR. Suppl Obstet Gynaecol. 2007;109(4):1-2.
Agarwal V. Jain S. Placental grading and its correlation with fetal outcome. J Obstet Gynaecol India. 2000;50(1):59.
Arduini D, Rizzo G, Romanini C, Mancuso S. Fetal blood flow velocity waveforms as predictors of growth restriction. Obstet Gynaecol. 1987;70:7-10.
Divon MY. Umbilical artery Doppler velocimetry; clinical utility in high-risk pregnancies. Am J Obstet Gynaecol. 1996;174:10-4.
Ott WJ. Sonographic diagnosis of intrauterine growth restriction. Clin Obstet Gynaecol. 1997;40:787-95.
