I entered the world of motherhood 13 years ago. You’ll agree with me that becoming a mother is one of the most fulfilling experiences of your life. I vividly remember how I felt when I saw my son for the first time. I held him in my arms, my eyes filled with tears, and my heart beamed with gratitude. I’m sure every new mother feels that way, but my feelings were slightly more intense as I’d only just gotten the chance to hold my 4 day old son for the very first time. He had moderate Intrauterine Growth Restriction (IUGR) and weighed less than 4 pounds (1.8 kilograms) at birth.
The beginning of my pregnancy journey was relatively normal. We were delighted to have a new member joining our family. Then I developed nausea and vomiting with hypersensitivity to fumes, but thought it was normal since my mother had experienced the same problems during her pregnancies. I tried to manage nausea and vomiting by modifying my diet and sleep routine.
The baby growing slowly in the womb?
My baby was growing normally for the 1st 6 months of my pregnancy. It was not until my last trimester that my doctor suspected something wasn’t right during a regular checkup. She noticed that instead of gaining weight as expected, I’d lost a few kilos. My blood pressure was also on the higher side.
After an ultrasound scan and other detailed blood tests, my doctor confirmed that I had placental dysfunction and that my baby wasn’t getting enough nutrition. Since his weight was smaller than expected for the gestational age, he was diagnosed with moderate IUGR.
If you are an expecting or prospective mother or you are going through a difficult pregnancy, you may want to know a little more about IUGR. Let me share a few more facts and experiences about IUGR and surviving this complicated pregnancy.
What does IUGR mean?
Intrauterine growth restriction refers to a clinical condition where the fetus, or baby in the womb, is not growing at an expected rate for the specific gestational period. In simple words, the child is smaller than what’s expected for that particular stage of pregnancy.
IUGR can either be;
- Symmetrical, when the overall growth of your baby is slower than expected.
- Asymmetrical, when the head and brain of your baby develop normally while the rest of the body organs are smaller than the gestational period.
How common is IUGR?
- IUGR affects almost 24% of newborns in the US. Its incidence rate is 6 times higher in low or middle-income countries.
- After premature births, it’s the 2nd most common cause of perinatal deaths of children.
- Out of all children with IUGR, 20–30% have symmetrical IUGR while 70–80% have asymmetrical IUGR.
What causes intrauterine growth restriction?
IUGR can be caused by maternal, placental, and fetal factors or a combination of all 3 risk factors.
- Poor pre-pregnancy health
- Smoking or substance abuse during pregnancy
- Birth spacing issues (less than 6 months or more than 120 months gap)
- Chronic illnesses such as cardiac problems
- Maternal malnutrition
- Pregnancy-induced hypertension
- Moderate to high physical exertion
- Maternal infections
- Placental dysfunction (pregnancy induced hypertension)
- Placental abruption (placental detachment from uterus)
- Chromosomal abnormalities like Down’s syndrome
- Genetic syndromes
- Congenital anomalies such as congenital cardiac problems or metabolic problems
How is the diagnosis of a growth-restricted baby made?
IUGR essentially means your baby is smaller than expected for the gestational period and it becomes evident when your doctor measures the fundal height and performs an ultrasound. The medical practitioner makes the diagnosis of IUGR using these commonly used parameters;
- Fundal height: The uterus’ size is measured through the distance between the pubic bone and the top of your uterus.
- Weight of mother: It indicates if you’re gaining healthy and desirable weight that’s appropriate to the gestational period.
- Ultrasound: A sonogram is a safe way to get a clear picture of your unborn child’s overall growth, including checking for a heartbeat.
A baby is diagnosed with IUGR if his weight is less than the 10th percentile or less than 90% of children at that particular gestational period. It’s further subdivided into moderate IUGR (3rd to 10th percentile) and severe IUGR (below 3rd percentile).
Usually, symmetrical IUGR is diagnosed in the earlier stage because congenital anomalies are often detected during early growth scans in pregnancy. Asymmetrical IUGR usually presents itself during the last trimester or after 6 months of pregnancy because it has more to do with external infections affecting the fetus.
Coping with a difficult pregnancy
The next 12 weeks were my most difficult weeks of pregnancy. I was hospitalized on several occasions and had to keep a close watch on my baby’s movement and heartbeats while at home. It was a period of immense distress. As an expecting mother who had worked with children with special needs for quite some time, I was well aware of the risk factors and potential threats to a fetus’s development. This somehow added to my fears and doubts. As D-Day approached, my stress level was sky-high.
Fortunately, my youngest sister who was pursuing her residency in gynecology at the time was ever-present to provide me with all the emotional support I needed. Even the strongest of women can become very fragile when it comes to their babies. Dear moms, it’s quite normal. We love our kids and have every right to have certain feelings. I went through episodes of fear, doubts, anxiousness, and stress, but I always tried to keep one thing intact: Hope.
If you’re going through a difficult pregnancy, try to be positive. Since mindset greatly influences our bodies, learn to let your inner self heal your physical self. Meditate, relax, listen to music, pray, do whatever makes you feel good.
Don’t miss your regular checkups. My doctor was the biggest support in my journey through this complicated pregnancy. I strictly followed her advice, maintained a proper diet, slept for a good 8-9 hours, and kept full blood pressure recordings. She asked me to chart baby kicks and movements. The good news is that it not only helped to increase my baby’s weight or make IUGR disappear, but to get stronger and ready to welcome my superhero.
When to deliver IUGR baby
Generally, IUGR babies are delivered by 37 to 38 weeks of pregnancy. I delivered my son at 37 weeks. A doctor decides when to deliver depending on the condition of the baby. In some cases, he may consider inducing labor a few weeks earlier. If the doctor thinks that your child might not be able to endure normal delivery stress, he can opt for a Cesarean section.
Possible complications for IUGR baby
Doctors admitted my growth-restricted baby to the Neonatal Intensive Care Unit (NICU) for 4 days to ensure his lungs and other systems functioned well. The next day after getting home, we had to rush him back to the hospital as he was turning yellowish. He had severe jaundice, which meant staying in the nursery for another 4 days of double phototherapy.
Complications may include:
- difficulty in maintaining an average body temperature
- low blood sugar
- feeding difficulties
- weak defense against infections
- associated medical problems if born with congenital or chromosomal anomalies
Remember, an IUGR baby is smaller than other babies. He weighs less and will therefore need specialized care. The first 6 months of his life required lots of care. I had to keep him warm throughout winter. My doctor advised me to restrict social interactions to ensure he wouldn’t get exposed to infections due to his weakened immune system. Thankfully he gradually started gaining weight. At one month, I took him to the pediatrician and he’d doubled his birth weight. By the time he was 5 months old, he was within the normal weight-for-age range.
Going through a difficult pregnancy isn’t easy. There’s a lot of stress and uncertainty, and as a mother who’s gone through this, I suggest you attend your regular medical checkups and strictly follow your doctor’s advice. Your good choices will determine what kind of life your child will have in the future.
I remember the nights I couldn’t get sleep and repeatedly checked if my son was breathing correctly. But I never lost hope. I pushed through for him, maintained a positive outlook, and kept going. I surrounded myself with family and friends whose unwavering support helped me navigate the storm. And as they say, “All’s well that ends well.”
That difficult pregnancy will soon be past. My son grew to be a smart and healthy teenager. So stay strong knowing that you’re getting a bundle of joy at the end, mama. Precious gifts are a high price to pay, and as mothers, we are never short of grit and grace.