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It is natural to feel concerned when informed that your baby is measuring smaller than expected. This condition indicates that your baby is growing at a slower rate within the uterus and will require additional monitoring throughout your pregnancy. With early diagnosis and specialised care, many women experience positive outcomes.
Managing an IUGR pregnancy in Melbourne starts with understanding what IUGR actually is, why it happens, and how specialist care can help protect you and your baby.
This guide explains IUGR in plain words, from diagnosis through to birth, so you feel informed at every step.
If your pregnancy has been identified as high risk because of your baby’s growth, you may also find our guide on high-risk pregnancy helpful for understanding the extra care and monitoring involved.
What Is Intrauterine Growth Restriction?
Intrauterine Growth Restriction (IUGR) means a baby is not growing as fast as expected inside the womb. Doctors usually consider a baby growth-restricted when their measurements fall below the 10th percentile for their gestational age. That means smaller than about 90 out of 100 babies at the same stage. But your obstetrician looks at more than just this number.
It helps to know the difference between an IUGR pregnancy and a baby who is simply small because of family genes. True IUGR involves something actively limiting the baby’s food and oxygen supply, most often a problem with the placenta. These two situations need very different care.
What Causes IUGR?
IUGR can come from several causes. Finding the reason matters, both for this pregnancy and any pregnancies after it.
Common causes include:
– Placental insufficiency. This is the most common cause. It means the placenta is not working as well as it should, so less oxygen and food reach the baby. Doctors often spot this using a Doppler ultrasound, a scan that checks blood flow.
– Blood clotting disorders (thrombophilias). Conditions like antiphospholipid syndrome can cause small clots that block blood flow through the placenta.
– Pre-eclampsia. High blood pressure in pregnancy reduces blood flow to the placenta and is a common cause of growth problems.
– Twins or more. Babies sharing a placenta may compete for resources, raising the risk of growth issues in one or both.
– Health conditions in the mother. Poorly controlled diabetes, kidney disease, and some autoimmune conditions can all affect how well the placenta works. Gestational diabetes can also increase the risk of pregnancy complications and requires careful monitoring.Â
– Infections. Some infections caught during pregnancy, such as cytomegalovirus, are linked to smaller babies.
– Genetic or structural issues. If a baby has a genetic condition or a physical difference, growth restriction may show up very early, even in the first trimester.
Two Types of IUGR
| Type | What Happens | When It Usually Starts | What It May Suggest |
|---|---|---|---|
| Asymmetrical | Tummy growth slows, but head growth is mostly protected. | Second or third trimester. | Placenta not working as well as it should. |
| Symmetrical | All body measurements are smaller together. | Earlier in pregnancy. | May need more tests, such as genetic testing. |
Asymmetrical IUGR
This is the more common type. The baby’s tummy area grows more slowly, while head growth mostly keeps going, because blood flow is sent to the brain first. This is sometimes called the “brain-sparing effect.” It usually comes from placental problems that start in the second or third trimester.
Symmetrical IUGR
Here, all the baby’s measurements are smaller together. It tends to show up earlier and can indicate a genetic condition, an early infection, or a nutritional problem. Doctors often suggest more tests, including genetic testing, when this pattern is found.
How Is IUGR Found and Watched?
IUGR is mostly detected and monitored through ultrasound scans. This is why growth scans are such an important part of good antenatal care in Melbourne for women with known risk factors.
Women experiencing fetal growth restriction are often cared for as part of a complicated pregnancy, where additional scans and specialist monitoring help guide decisions throughout pregnancy.
Monitoring usually includes:
– Growth scans every two to four weeks to track the baby’s size over time
– Doppler scans checking blood flow in the cord and the baby’s brain
– A biophysical profile, which checks the baby’s movement, breathing, muscle tone, and fluid levels
– CTG monitoring to check the baby’s heart rate pattern
– Regular blood pressure and urine checks at each visit
No single test tells the whole story. Your obstetrician uses all of these together to see how your baby is really doing.
Managing an IUGR Pregnancy
No treatment reverses IUGR once it starts. The goal is close watching and choosing the best time for birth. That timing decision is one of the trickiest calls in obstetric care. It means weighing the risks of an early birth against the risks of carrying a pregnancy longer.
If a blood clotting disorder is found, blood-thinning injections like Clexane may be prescribed. Low-dose aspirin is sometimes recommended in a future pregnancy if placenta problems were the likely cause last time.
Getting care from a complex pregnancy specialist in Melbourne with real experience in fetal monitoring makes a genuine difference to outcomes. It also helps families feel more supported through what can be a very stressful time.
The Role of an Experienced Obstetrician
Dr Steven Hatzikostas is an experienced obstetrician and gynaecologist based at Northpark Private Hospital in Bundoora. He also has admitting rights at the Royal Women’s Hospital and the Mercy. Over more than 30 years in practice, he has managed many complex pregnancies, including those affected by growth restriction.
As a dedicated pregnancy complications specialist, Dr Hatzikostas works with fetal-maternal medicine doctors and newborn specialists when needed. He gives all his obstetric patients 24/7 access to a private phone line. This matters when Doppler results change between visits, or when a quick decision about birth is needed.
Practical Steps for Women With IUGR
IUGR cannot be prevented or reversed, but there are things you can do to support your care.
– Go to every growth scan and check-up, even when you feel fine. Blood flow results can change between visits.
– Stop smoking completely. Smoking reduces blood flow to the placenta and can make growth restriction worse.
– Check your baby’s movements each day. Tell your care team straight away if you notice a change.
– Take medicines exactly as prescribed, including Clexane injections or aspirin if these are recommended.
– Ask questions at every visit. Understanding what the numbers mean helps you feel more in control of your own care.
– Report anything unusual right away. Trust your gut feeling.
Conclusion
An IUGR diagnosis changes the shape of a pregnancy, but it does not decide how things will end—finding it early, watching closely, and getting experienced specialist care all help.
Dr Steven Hatzikostas offers experienced, personal obstetric care for women with complex pregnancies in Melbourne, including those affected by growth restriction. If you have been told your baby is not growing as expected, getting specialist help early gives your care team the best chance to act on your and your baby’s behalf.
Frequently Asked Questions
Can IUGR be treated?
There is no direct treatment that reverses growth restriction once it starts. Care focuses on closely monitoring the baby and choosing the right time for birth. If a treatable cause, such as a clotting disorder, is found, treating it may lower the risk in future pregnancies.
Will my baby need to be born early?
Not always, but early birth is sometimes recommended if scans show signs of stress, or if staying pregnant becomes riskier than birth. It depends on how far along you are, how severe the growth restriction is, and what the scans show. Your obstetrician will guide this decision with you.
Does IUGR raise my risk in a future pregnancy?
A past IUGR pregnancy, especially one caused by placenta problems, does raise the risk next time. Seeing a specialist early in a future pregnancy means a watching plan can be in place from the start.
What is the difference between a small baby and an IUGR baby?
A small baby may simply run in the family, with nothing to worry about. An IUGR baby is small because something, usually the placenta, is actively holding back growth. Doctors use Doppler scans and growth trends, not just size alone, to tell the two apart.
Will my baby be okay after birth?
Many babies born after an IUGR pregnancy do well, especially when it is caught early and watched closely. Some babies need care in the special care nursery, depending on how early they arrive and their condition at birth. Outcomes are generally better when IUGR is found and managed by an experienced team.
