People would always get worried whenever their doctors tell them that they have intrauterine pregnancy. This term is a foreign word to many. Some would confuse it as an abnormality in pregnancy while others see it as a taboo.
So, what is intrauterine pregnancy? Intrauterine pregnancy refers to a medical term which means that a trimester-sized baby is seen to be growing inside the uterus. It also consists of a gestational sac in the womb which is usually visible through a transvaginal scan during the fourth or fifth week of gestation.
With this in mind, there is no need to be alarmed whenever you hear this term. You should be worried if your doctor informs you that there is a growth restriction in your intrauterine pregnancy.
What Is Intrauterine Growth Restriction?
Intrauterine growth restriction (IUGR), also known as fetal growth restriction, refers to a pregnancy condition in which the baby inside the womb is not growing at a standard rate. It means that they are smaller than those other babies who are also in the intrauterine pregnancy stage. With IUGR, the organ cells and tissues may not grow in number or size, and at the same time, the overall body and organ development is deficient. According to David Peleg, M.D. and co-authors, “Intrauterine growth restriction (IUGR) is a common diagnosis in obstetrics and carries an increased risk of perinatal mortality and morbidity.”
A fetus experiencing this condition has an initial weight less than the tenth percentile. It indicates that there is a significant tendency that these babies will be born prematurely, that is, before the 37th week.
Newborn babies with IUGR are often characterized as pale and thin and have dry and loose skin. Their umbilical cords are also dull-looking and thin instead of being fat and shiny. Some babies do not exemplify these kinds of extreme malnourished appearance, but they may be small in size overall.
Types Of Fetal Growth Restriction
Fetal growth restriction has two types, namely, symmetric or primary growth and asymmetric or secondary growth.
For symmetric or primary growth restriction, its restriction in size accounts for 20 to 25 percent of all cases of growth restrictions. The central characteristic of this is the reduction in the size of all internal organs. On the other hand, asymmetric or secondary growth refers to the condition where the brain and the head are of normal proportions, but the baby’s abdomen is smaller than the usual. This type of growth restriction is mostly evident only at the start of the third trimester.
Causes Of Intrauterine Growth Restriction
This kind of growth restriction in intrauterine pregnancy results when there is an abnormality in preventing both the tissues and the cells from growing or when there is a decrease in their size. One of the major categories of causes of growth restriction is congenital or genetic. David Miller, MD from Children’s Hospital Los Angeles says that “Some also experience this because of infection or the fetus is not receiving a sufficient amount of oxygen and nutrients needed for the development of its tissues and organs.”
Aside from the causes above, there are other reasons for IUGR. These factors fall into three categories: factors related to the placenta and the uterus, maternal factors, and factors involving the developing baby.
Factors Related To The Placenta
- Placenta attaches low in the uterus (also called placenta previa)
- Placenta detaches from the uterus (also called placental abruption)
- Decreased blood flow in either of these areas
- Infection in the tissues around the placenta
- Low levels of amniotic fluid (oligohydramnios)
- Drug and alcohol substance abuse
- Excessive smoking
- High blood pressure
- Poor nutrition during pregnancy
- Advanced diabetes
- Anemia or malnutrition
- Chronic kidney disease
- Lung disease
Factors Involving The Developing Baby
- Genetics (e.g., chromosomal abnormality)
- Multiple gestations (e.g., the conception of twins or triplets)
- Congenital disabilities
Consequences Of IUGR
IUGR has many negative outcomes because of this delayed growth. These risks are usually felt during pregnancy, while on delivery, and even after birth. Some of these include the following:
- Abnormal measurement of body temperature
- Low resistance to many kinds of infection
- Difficulty in handling the stresses of vaginal delivery
- Abnormal increase in red blood cell count
- Motor and neurological disabilities
- Low blood sugar or hypoglycemia
- Low birth weight
- Decreased blood flow or hyperviscosity
- Attention and performance deficits
- Breathing problems caused by meconium aspiration
- Low Apgar scores
Some severe cases of IUGR also result in stillbirth. Mitchell E. Geffner, MD and co-author advise that “When IUGR is suspected, ensure that the pregnancy is monitored under the guidance of the obstetrician or physician specializing in high-risk pregnancies. Regular ultrasounds should be performed to monitor the growth restriction and assess for any other problems in the pregnancy.” If not treated properly, it can also induce some long-term growth problems to the child.
IUGR Treatments And Prevention Strategies
There are two ways to remedy IUGR: it’s either through prevention strategies or treatment. Prevention is for mothers who can reduce the risk of having this baby growth restriction and improve the prospect of having a healthy pregnancy and baby. Procedures are for those who have received IUGR diagnosis.
- Attend all prenatal appointments. These appointments can be an avenue for you to be able to detect intrauterine pregnancy problems early.
- Make sure to eat healthy food. Measure your calorie intake every day and consult your doctor with the best diet strategy to make sure that your baby is well-nourished.
- Be aware of your baby’s movement inside the womb. Always check if they are often moving. If you notice no motion from your baby, seek the help of your doctor as soon as possible.
- Check your medications. Some medicines cause health problems both to the mother and the child.
- Stop smoking, taking drugs, and drinking alcohol. These healthy lifestyle habits can be of help to the growth of your baby.
- Get plenty of sleep and rest. Feeling relaxed from resting will help your baby steer away from stress and grow properly. As much as possible, get a minimum of eight hours of sleep every night and one hour of rest in the afternoon.
Many studies have explored the most optimal treatment for fetal growth restriction. The procedure will depend on the following factors: medical history, overall health, the extent of the disease, preference, and tolerance from therapies, medications, and procedures. With this in mind, the treatment can range from the following:
- Bed Rest — To help improve the circulation of the fetus, you may opt for bed rest at home or in the hospital. The number of days or weeks of having a bed rest will depend on the severity of the IUGR.
- Nutrition — One of the easiest ways to treat this intrauterine pregnancy complication is to consult a dietician and change your maternal nutrition plan. Increasing the intake of healthy food may also increase gestational weight gain. In return, there will be fetal growth.
- Delivery — If the gestational age is beyond 34 weeks, it is recommended to push through with immediate delivery. It will help avoid any kind of endangerment on the health of the fetus.
According to statistics, one out of every five mothers experiences growth restrictions in their babies during their intrauterine pregnancy phase. With this, all mothers should be wary of their pregnancy conditions to avoid such problems.
Frequently Asked Questions
Is an intrauterine pregnancy normal?
Yes, it is normal to have an intrauterine pregnancy. Intrauterine pregnancy means that there is either a fetal pole or yolk sack inside the gestational sac.
What causes intrauterine pregnancy?
Intrauterine pregnancy is normal and it is how pregnancies are supposed to happen. Intrauterine growth restriction (IUGR), on the other hand, is abnormal. IUGR is caused by different factors such as malnutrition, anemia, infections, diabetes, kidney or lung disease, smoking, drug use, and alcohol intake among others.
What is Twin intrauterine pregnancy?
It means that each of the babies has its own chorionic and amniotic sacs. It usually happens to dizygotic twin pregnancy but may also occur at times to monozygotic twin pregnancy.
What is a failed intrauterine pregnancy?
A failed intrauterine pregnancy means that there is a pregnancy failure. There is no sonographic evidence nor expected viability. It means that there is an irregular intrauterine gestational sac that is less than or equal to 16mm in diameter. Failed intrauterine pregnancy means that there is an abnormal growth over the last 7 days based on the ultrasound. It also means that there is no cardiac activity in the embryo.
What is an intrauterine fetal death?
It means that the baby died in the uterus or commonly known as a stillbirth. This term is usually used for fetal deaths around 20 weeks of gestation. Fetal demise has different terms based on the age and weight of the fetus.
What is a gestational sac?
It the cavity that surrounds the embryo. When the embryo is still unidentifiable, it is used to determine the existence of an intrauterine pregnancy. The sac is more visible around six weeks of pregnancy.
What are the symptoms of fetal death?
There are different symptoms to look out for to know if there is fetal death. The symptoms include spotting or bleeding, when fetal movement stops, no fetal heartbeat on the Doppler or stethoscope, and no fetal movement or heartbeat through the ultrasound.
How will I know if my baby is still alive inside me?
When the baby is continuously kicking or moving inside the womb, it is most likely that the baby is alive. If you are not experiencing symptoms of stillbirth like cramps, bleeding, and spotting, there is no need to worry.