Delay in intrauterine fetal development: causes, diagnosis, treatment, consequences

Approximately every tenth woman in the position of a doctor makes a diagnosis of "intrauterine growth retardation" (HNDR). The specialist determines the presence of deviations, characterized by a discrepancy in the size of the baby to the normative indicators in a particular week of development. How much this pathology is really dangerous and how it threatens the child, it is important to know every mother, because of this phenomenon absolutely no one is immune.

What is an EFA?

The delay in fetal development of the fetus, as a rule, is diagnosed on the basis of ultrasound. Pathology is determined in the event that the weight of the baby is less than the normative parameters characteristic for this period of development. In medical practice, specially designed tables are used, in which the mass of the fetus is indicated in accordance with its gestational age, that is, the time from the moment of fertilization. This indicator is usually determined in weeks. In other words, there are certain norms for each term of pregnancy. The basic unit of measure in such tables is the percentile. If the fetus is less than 10 percentile according to this table, the doctor confirms the presence of pathology.

Retardation of intrauterine fetal development: causes

Sometimes, when diagnosing an ARV, parents should not worry. It happens that the baby is born small in size, as his father and mother are not very large. This physiological feature does not affect the child's activity, his mental and physical development. During pregnancy and after birth, such a baby does not need a narrowly targeted therapy.

In all other situations, special attention should be paid to the diagnosis. Such a condition can lead to deviations in the development of the child or even the death of the fetus. ZVUR can testify that the baby in the womb is not eating well. This means that it does not receive sufficient amounts of nutrients and oxygen. The nutritional deficiency is usually explained by the following reasons:

• Incorrect chromosome set.
• Harmful habits of the mother (smoking, drinking alcohol and drugs).
• Pathogenic diseases (hypertension, anemia, ailments of the cardiovascular system).
• Incorrect arrangement and subsequent formation of the placenta.

In addition, doctors call a number of other reasons that can also trigger the syndrome of intrauterine growth retardation:

• Multiple pregnancy.
• Use of medications without prescribing a doctor.
• Childbirth after 42 weeks.
• Irrational nutrition. Many women do not want to get better during pregnancy, so they get fed up with diets. This they provoke the exhaustion of the body, which leads to the development of pathology.
• Diseases of infectious nature (toxoplasmosis, rubella, syphilis).

Clinical picture

What symptoms are accompanied by a delay in fetal development of the fetus? The signs of pathology are most often manifested in the early stages (approximately 24-26 weeks). Identify their own woman is not able to, it can only do a doctor. The syndrome of ZVUR is diagnosed if it does not comply with the following standards:

• Size of the head and thigh bone of the baby.
• Circumference of the abdomen at a certain level, the height of the bottom of the uterus.
• Volume of amniotic fluid.
• Disruption of the functioning of the placenta (its structure and dimensions change).
• Fetal heart rate.
• Blood flow velocity in the placenta and umbilical cord.

In some cases, the pathology quickly develops and progresses without special disorders, that is, it is asymptomatic.

Degrees of gravity

• I degree. The delay in fetal development of the fetus is considered to be relatively easy, since the development gap from anthropometric data corresponding to a certain period of pregnancy is only two weeks. Timely prescribed therapy can be effective and minimize the likelihood of negative consequences for the baby.
• II degree. The delay in development is approximately 3-4 weeks, serious treatment is required.
• III degree. It is considered to be the most severe form due to the lag in the parameters of the fetus for one month or more. This state is usually accompanied by so-called organic changes. The delay of fetal development of the fetus of the third degree often ends in a fatal outcome.

Asymmetric form of pathology

In this case, there is a significant reduction in fetal mass with normal growth. The child is diagnosed with a lag in the formation of soft tissues of the chest and abdomen, improper development of the trunk. Uneven growth of internal organs is possible. In the absence of adequate therapy, a gradual decrease in the size of the head begins and a lag in the development of the brain, which almost always leads to the death of the fetus. Asymmetric variant of the syndrome of ESRD appears mainly in the third trimester against the background of a common placental insufficiency.

Symmetrical form of pathology

In a symmetrical form, a uniform decrease in mass, organ size, and fetal growth is observed. Such pathology most often develops at the initial stages of pregnancy due to fetal diseases (infection, chromosomal abnormalities). Symmetrical retardation of intrauterine fetal development increases the probability of a child with an inferiorly formed CNS.

Diagnostic measures

If this pathology is suspected, a woman should undergo a full diagnostic examination. First of all the doctor collects the patient's anamnesis, specifies the previous gynecological diseases, the features of the previous pregnancy. Then a physical examination is performed with a mandatory measurement of the circumference of the abdomen, the womb, the growth and weight of the woman.

In addition, ultrasound, dopplerometry (assessment of blood flow in the arteries and veins) and cardiotocography (continuous recording of fetal heart rate, its activity and uterine contractions directly) may be required. Based on the results of the tests, a specialist can confirm the diagnosis or disprove it.

What treatment is required?

To determine the subsequent tactics of managing pregnancy after confirming the diagnosis of "retardation of intrauterine development of the fetus," one should take into account the causes of pathology, the form and extent of the disease. The basic principles of therapy should be focused on improving blood flow in the uterus-placenta-fetus system. All therapeutic measures are carried out under stationary conditions. First of all, a woman needs to provide peace, rational nutrition and a full-length long sleep. An important element of therapy is the control over the current state of the fetus. For these purposes, ultrasound is used every 7-14 days, cardiotocography and dopplerometry of the blood flow.

Drug treatment includes the use of angioprotectors for the protection of blood vessels, tocolytics against muscular tension of the uterus (Papaverin, No-shpa), fortifying agents. In addition, all women without exception are prescribed drugs that reduce neuropsychic excitement (tincture of motherwort, valerian) and improve blood flow in the placenta (Actovegin, Kurantil).

Depending on the degree of severity of the pathology, the results of treatment may vary. The delay in the intrauterine development of the fetus of the 1st degree is usually perfectly amenable to therapy, the probability of the appearance of negative consequences in the future is reduced to a minimum. In more serious pathologies, a different approach to treatment is needed, and its results are difficult to predict.

Abortion

Early delivery, regardless of gestational age, is recommended in the following cases:

1. Absence of fetal growth for 14 days.
2. Noticeable deterioration of the baby's condition inside the womb (for example, slowing of blood flow in the vessels).

Pregnancy is saved up to a maximum of 37 weeks in the event that, thanks to drug therapy, there is an improvement in indices, when it is not necessary to talk about the diagnosis of "intrauterine growth retardation".

Consequences and possible complications

Children with this pathology after birth may have deviations of varying severity, their subsequent compatibility with ordinary life will largely depend on the parents.

The first consequences appear even with delivery (hypoxia, neurological disorders). The delay in fetal development inhibits the maturation of the central nervous system and its functions, which affects all systems. These children usually weakened the body's defenses, in a more mature age there is an increased likelihood of the appearance of ailments of the cardiovascular system.

In children under five years of age, a slow set of weight is often diagnosed, a psychomotor lag in development, incorrect formation of internal organs, hyperexcitability. In adolescence, a high risk of diabetes. Such children are usually prone to fatness, they have problems with blood pressure. This does not mean that their daily existence will be reduced to taking medications and living in hospitals. They just need to pay a little more attention to their own diet and daily exercise.

Some children who have been diagnosed with delayed fetal development of the fetus of the 2nd degree and are treated accordingly do not differ from their peers. They lead a habitual way of life, go in for sports, communicate with friends and receive education.

How can I prevent an EFA?

The best prevention of this pathology is planning for the upcoming pregnancy. Approximately six months later, prospective parents must undergo a comprehensive examination and treat all existing chronic diseases. Abandonment of addictions, correct lifestyle, rational nutrition and daily physical exercise are the best option for preventing ZVUR.

A visit to a female consultation on a regular basis after registration is important in the diagnosis of "fetal retardation". Treatment of a timely detected pathology allows to minimize the risk of negative consequences.

Pregnant women should be properly aligned with work and sleep. Correct and high-grade rest means under itself 10 hours of a dream at night and 2 hours during the daytime. This regime allows you to improve blood circulation and transportation of nutrients between mother and child.

Daily walks in the fresh air, metered physical exertions not only improve the overall health of the pregnant woman, but also normalize the fetus in the womb.

Conclusion

It is not necessary to ignore such a pathology as a delay in the intrauterine development of the fetus, the consequences of which can be the most sad. On the other hand, parents should not take this diagnosis as a sentence. If it is delivered in a timely manner, the expectant mother will take all necessary measures to eliminate its cause and will follow all the recommendations of the doctor, the prognosis may be favorable. In the world there are no barriers that can not be overcome. It is important to remember that the happiness of motherhood is incomparable!