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Fetal growth restriction

Retardatio incrementi intrauterini · Růstová restrikce plodu

female only

What it is

The baby fails to reach its growth potential, usually because the placenta fails; the strongest single link to stillbirth.

Symptoms & signs

  • Often no symptoms
  • bump small for dates
  • reduced movements
  • coexisting pre-eclampsia

🚩 Get help if…

  • call 112 / 911 now Baby moving less, or a change in the pattern of movements
  • call 112 / 911 now Headache, vision changes or sudden swelling
  • see a doctor soon Bump smaller than expected at a check
  • see a doctor soon Missed growth scans when told you are high risk

Where it strikes

Medical treatment

  • Fundal height charts and serial growth scans
  • umbilical-artery Doppler and CTG to time the birth
  • Aspirin 150 mg at night from before 16 weeks for women at high risk of pre-eclampsia — ASPRE: preterm pre-eclampsia cut by 62%; small babies modestly reduced trials support
  • steroids and magnesium sulfate before early birth
  • timed birth, often by caesarean when early

Natural & lifestyle

  • Stop smoking — the largest avoidable cause
  • no alcohol or drugs
  • Balanced protein-energy supplements for undernourished women — heavier babies trials support
  • treat anaemia

Emerging & experimental

  • Sildenafil — STRIDER trials: no benefit; the Dutch trial stopped over lung hypertension and deaths in newborns not confirmed in trials
  • placental gene therapy (VEGF) — animal studies

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Bed rest — no benefit shown not confirmed in trials
  • L-arginine — small trials; not confirmed early / small studies
  • Eating more 'for the baby' — does not fix a failing placenta anecdotal / traditional

ICD codes