Fetal growth restriction (FGR) is a condition in which an unborn baby (fetus) is
smaller than expected for the number of weeks of pregnancy (gestational age). It’s
described as an estimated weight less than the 10th percentile. This means that the
weighs less than 9 out of 10 babies of the same gestational age. Newborn babies with
may be called “small for gestational age.”
can begin at any time during pregnancy. With FGR, the baby doesn’t grow well. FGR
affect the overall size of the baby and the growth of organs, tissues, and cells.
can cause many problems. But many newborns who are small may just be small. They may
have any problems.
Many things increase the risk for FGR. These include problems with the placenta or
umbilical cord. The placenta may not attach well. Or the blood flow through the umbilical
cord may be limited. Factors in both the mother and the baby may cause FGR.
Factors in the mother that can cause FGR include:
- High blood pressure or other heart and blood vessel disease
- Too few red blood cells (anemia)
- Long-term lung or kidney conditions
- Autoimmune conditions such as lupus
- Very low weight
- A large amount of excess weight (obese)
- Poor nutrition or weight gain
- Alcohol or drug use
- Cigarette smoking
Factors in the baby that can cause FGR include:
- Being one of a twin or triplets
- Birth defects, such as heart defects
- Problem with genes or chromosomes
pregnant woman doesn’t have symptoms of FGR. But a baby with FGR may have certain
after birth, such as:
- Low birth weight
- Low blood sugar levels
- Lower body temperature
- High level of red blood cells
- Trouble fighting infections
One of the main reasons for regular prenatal exams is to make sure your baby is growing
well. During pregnancy, the size of your baby is estimated in different ways, including:
Fundal height. To check fundal height, your
healthcare provider measures from the top of your pubic bone to the top of your
uterus (fundus). Fundal height, measured in centimeters (cm), is about the same as
the number of weeks of pregnancy after the 20th week. For example, at 24 weeks
gestation, your fundal height should be close to 24 cm. If the fundal height is less
than expected, it may mean FGR.
your healthcare provider thinks you have FGR, you’ll have other tests. These
Fetal ultrasound. Estimating fetal weight
with ultrasound is the best way to find FGR. Ultrasound uses sound waves to create
images of the baby in the uterus. Sound waves won’t harm you or the baby. Your
healthcare provider or a technician will use the images to measure the baby. A
diagnosis of FGR is based on the difference between actual and expected measurements
at a certain gestational age.
Doppler ultrasound. You may also have this
special type of ultrasound to diagnose FGR. Doppler ultrasound checks the blood flow
to the placenta and through the umbilical cord to the baby. Decreased blood flow may
mean your baby has FGR.
You may have repeat ultrasound exams, Doppler studies, and other tests.
Management depends on how serious the FGR is. This is based on the ultrasound
(estimated fetal weight) and Doppler ultrasound (blood flow to the baby), as well
risk factors and the number of weeks gestation.
Treatment may include:
Frequent monitoring. This means you will have prenatal visits more often, and ultrasound and Doppler ultrasound
exams. You may have other tests.
Your healthcare provider may also ask you to keep track of
fetal movements. If so, they will give you instructions.
- Corticosteroid medicine
- Hospital stay
delivery or emergency cesarean
can cause many serious complications. Your baby may need to be delivered early and
in the hospital. Your baby may have trouble breathing, infections, and other problems.
Stillbirths and death may occur. As your child grows, they’ll be at higher risk for
heart and blood vessel problems.
FGR can happen in any pregnancy. But some factors, like cigarette smoking or alcohol
or medicine use, increase the risk for FGR. Regular and early prenatal care and a
healthy diet and steady weight gain help to prevent FGR and other problems.
sure your healthcare provider knows your health history. If you’re counting fetal
movements and find that the number has decreased, let your healthcare provider know.
if you notice other changes or if you have concerns about your pregnancy, call your
- FGR is a condition in which the baby is smaller than expected for gestational age.
- Many factors increase the risk for FGR. They may be related to the placenta, mother,
- Estimating fetal weight with ultrasound is the best way to identify FGR.
- If FGR is diagnosed, you will need to be closely monitored.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also
know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that
- Know how you can contact your provider if you have questions.