Intrauterine Monitoring of the growth-restricted fetus
The fetus with IUGR is at risk from intrauterine hypoxia/intrauterine death and asphyxia during labor and delivery.
The growth-restricted fetus should be monitored closely to determine the optimal time for delivery.
Progressive uteroplacental failure results in:
o Reduced growth in femur length and abdominal circumference (<10th centile)
o Reduced amniotic fluid volume
o Abnormal umbilical artery Doppler waveforms due to increased placental impedance – absent and then reversed end-diastolic flow velocity.
o Redistribution of blood flow in the fetus – increased to the brain, reduced to the gastrointestinal tract, liver, skin and kidneys
o Abnormal ductus venosus Doppler waveform denoting diastolic cardiac dysfunction
o Reduced fetal movements
o Abnormal CTG (cardiotocography)
o Intrauterine death or hypoxic damage to the fetus.
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