How can IUGR be fully monitored and when should the monitoring start ?

It is most commonly defined as a fetal weight at or below 10% for a given gestational age.

In the postnatal period several other body dimensions can be used. These include Head Circumference, Crown Heel Length, Weight- Height Ratio, Pondering Index (PI), and Skin Fold Thickness. Other consideration include maternal size and race and gender of the neonate.

An early diagnosis of IUGR and close fetal monitoring (BPD,Doppler, and fetal growth evaluation) Is of significant help in managing a pregnancy suspected of IUGR.

There are two basic type of IUGR, Symetric and Asymetric, Symetric growth retardation is characterized by a fetus that is small in all physical parameters (e.g. BPD,HC,AC, AND FL). This is usually the result in the firt trimester. The causes may include low genetic growth potential, intrauterine infection, severe maternal malnutrition, fetal alchool syndrome, chromosomal anomaly.

Asymetric growth restriction is the more common IUGR and is usually caused placenta insufficiency. This maybe the result of maternal desease such as diabetes( classes D-F) or chronic hypertension, cardiac or renal disease, abruption placenta, multiple pregnancy, smoking, poor weight gain, drug usage, or uterine anomaly.

Asymetric IUGR is characterized by an appropriate BPD and HC, with disproportionately small AC. This reinforces the brain-sparing effect, which states that the last organ to be deprived of assential nutrient is the brain. The BPD and HC maybe slightly smaller, but this usually does not happen until late third trimester.

we control the measurment of the fetus.

A recent review found that effective interventions are available for reducing the occurrence of SGA fetuses and preventing related perinatal mortality. Some interventions are effective in all women, while others target specific comorbidities. The most effective interventions to prevent the SGA fetus were anti-platelets before 16 weeks in women at risk of pre-eclampsia and progesterone therapy for prevention of preterm birth. For the prevention of perinatal mortality in high-risk women, anti-platelets and antenatal corticosteroids were found to be effective interventions.