Intrauterine growth restriction refers to a baby who is much smaller than average for their gestational age. There are a number of reasons why a baby may have poor growth while in the mother’s womb. It is important for doctors to be aware of growth restrictions in order to prepare for delivery. The child may experience a number of birth complications and needs attentive care to give the child the best chance for success.
What is Intrauterine Growth Retardation?
Intrauterine growth restriction (IUGR) is a medical term for the poor growth of a fetus while in the mother’s womb. Also called intrauterine growth retardation, IUGR has a number of causes, including poor nutrition and poor oxygen supply to the fetus through the umbilical cord and placenta.
Energy and oxygen are vital for the growth of a child and any restrictions, complications, or impairments can delay growth or cause more serious birth injuries. Not all small babies will experience health problems. Some babies are just born small. However, when the baby is small because of delayed development, including underdeveloped organs and tissue, it can cause a number of problems.
Fetal Growth Restriction
Also referred to as fetal growth restriction (FGR), the unborn baby is smaller than expected for the number of weeks of pregnancy, or gestational age. It is sometimes estimated at being in the bottom 10th percentile of other babies of the same gestational age.
FGR or IUGR can occur at any time during pregnancy. Even if a child is having normal growth for the first half of the pregnancy, they may experience a slowdown in development and be considered to have a growth restriction if they fall behind for their gestational age.
Gestational Age and Weight
Gestational age and development are estimated based on what is “appropriate for gestational age,” (AGA). For example, the Fenton Growth Chart measures 3 factors against the gestational age, length, head circumference, and weight.
When the fetus falls below the 10% measure, they may be considered small for gestational age. Alternatively, when the fetus is above the 90% measure, they are considered large for gestational age.
What Causes Intrauterine Growth Retardation?
There are a number of possible causes of IUGR. Some of the most common are oxygen deprivation and energy deprivation. Oxygen deprivation can be caused by problems in the umbilical cord or placenta, or the mother not getting enough oxygen. The mother may not be getting enough oxygen because of:
- Illness
- Pneumonia
- Chronic obstructive pulmonary disease (COPD)
- High altitude
- Carbon monoxide poisoning
Lack of proper nutrition for the mother may also cause problems for the developing fetus. If the mother is not getting enough energy to pass on to the baby, the baby’s organs, tissue, and cells may not develop properly. Some of the reasons the mother may not get proper nutrition include:
- Poor weight gain during pregnancy
- Alcohol abuse
- Malnutrition
- Smoking
- Drug use
- Diabetes
- Anemia
There are also congenital or chromosomal abnormalities that are associated with below-normal weight and size for a developing baby. Some of these problems can include:
- Rubella
- Syphilis
- Toxoplasmosis
- Cytomegalovirus
- Hepatitis B
- HIV
- Erythroblastosis fetalis
- Turner’s syndrome
- Trisomy 13
- Trisomy 18
- Trisomy 21
Diagnosing Intrauterine Growth Retardation
Diagnosing IUGR generally involves showing the fetus is small for their gestational age. Measuring the size of the fetus involves a number of diagnostic and imaging tests. This includes tests of the mother’s weight to ensure the mother is gaining enough weight during pregnancy. Other diagnostic and imaging tests include:
- Ultrasound, to provide an image of the baby for measuring the head, abdomen, and amount of amniotic fluid
- Doppler, to show the blood flow through the fetus and umbilical cord
- Fetal monitoring, to show the rate and pattern of the baby’s heartbeat
- Amniocentesis: to test the amniotic fluid for infection or chromosomal abnormalities
Measurements to diagnose growth includes fundal height. Fundal height is the measurement from the top of the pubic bone to the top of the uterus, measured in centimeters. This should match the weeks of gestation after 20 weeks.
Outcomes of Intrauterine Growth Retardation
When a child is born with a low birth weight, it does not just mean the child is smaller. The baby may not have properly developed in the womb, which may make it difficult to handle the stress of delivery and adapt to life outside the bomb. Some of the birth complications associated with intrauterine growth include:
- Low birth weight
- Decreased oxygen levels
- Hypoglycemia
- Higher risk of infection
- Low Apgar scores
- Meconium aspiration
- Hypothermia
- High levels of red blood cells
- Fetal death
Intrauterine Growth Retardation and Medical Malpractice Claims
A doctor should have a good picture of the mother’s health history, and continually monitor the mother and fetal development during pregnancy. Failure to properly diagnose, treat, or monitor the mother and baby could cause serious injury or birth complications. If a doctor fails to provide the standard level of care, through misdiagnosis, delayed diagnosis, improper treatment, or failure to monitor, the doctor may be liable for birth injuries caused by their negligence.
Filing a Medical Malpractice Claim in Philadelphia
If you are considering taking legal action after the birth of your newborn, it is important to be aware of time restrictions. There is a time limit to filing a personal injury lawsuit, known as the “statute of limitations,” (SOL). If the injury victim waits too long, they may be denied compensation.
In most cases, the statute of limitations for medical malpractice lawsuits in Pennsylvania is 2 years, with some exceptions and time extensions in certain cases. However, there is a separate rule for minors who suffer an injury caused by medical malpractice. Under Pennsylvania law, the statute of limitations for a minor does not begin to toll until the minor has reached the age of 18. A minor who suffered from medical malpractice generally has until they turn 20 to file a malpractice lawsuit.
Philly Birth Injury Attorneys
At Gilman & Bedigian, our aggressive trial lawyers have helped our clients and their families recover millions of dollars in compensation related to birth injuries caused by medical errors. Don’t give up after getting the runaround from the hospital. Contact us online or call our law office at (800) 529-6162 for a free consultation.