Intra-Uterine Growth Retardation (IUGR)

Small-for-dates Babies: What Do I Need to Know?

Intrauterine growth retardation/restriction (IUGR) is a condition where a baby does not meet the growth expectation during pregnancy and is termed a “small-for-dates baby”. It is generally defined as when the foetal weight falls below the 10th percentile for its gestational age.

Types of intra-uterine growth retardation

1. Symmetric (or primary): All of the foetal parts are proportionally small in size. This accounts for up to 30% of IUGR cases.
2. Asymmetric or secondary): Only the foetus’s abdomen measures small. This accounts for up to 80% of IUGR cases.

Causes of intra-uterine growth retardation

1. Maternal illness

Pre-existing disorders prior to pregnancy such as diabetes, hypertension and kidney disease.
Disorders that develop during pregnancy such as anaemia, preeclampsia, UTI and persistent severe nausea and vomiting that result in serious nutritional imbalances.

2. Pregnancy related illness

Issues with umbilical cord or placenta that limits flow of blood and nutrients to the foetus such as placenta previa and abruptio placenta.
A multiple pregnancy which causes strain on the placenta.
A pre-existing obstetric history suggesting problems in carrying a baby to full term, for example recurrent miscarriages, preterm labour or previous still births.

3. Maternal lifestyle factors

Cigarette smoking, alcohol or drug abuse.
Poor nutrition.
Physical and emotional stress.

Treatment and Management

IUGR affects approximately 10% of all pregnancies. Regular antenatal checks with an ultrasound scan are required to detect these at risk babies. IUGR babies are a concern as they are at risk of being born prematurely or developmental issues such as learning difficulties later in life. Once there is suspicion that the baby is small-for-dates, regular checkup is conducted to monitor the baby’s growth. These include measuring the head circumference, abdominal girth and the blood flow through the umbilical cord.

Management depends on the severity and underlying causes of IUGR. Other than frequent monitoring on the growth of the baby, treatment may also include:

Nutritional support: Ensuring mother has healthy and nutritious diet to support foetal development.
Early delivery: In severe cases, it may be necessary to deliver the baby early to prevent complications before and after birth.

How May Chinese Medicine help?

Acupuncture: In cases where the diagnosis of IUGR has been made, acupuncture can be beneficial by enhancing uterine blood flow. This in turn supports better oxygen and nutrient delivery to the growing baby. It also helps balance pregnancy-related hormones, providing an optimal environment for foetal development. On the other hand, acupuncture may be offered early in pregnancy as a preventative treatment for women with deficiency conditions that are at risk ofIUGR, or to minimise potential risks of placental dysfunction such as in women with high blood pressure (both pregnancy-induced and essential hypertension).
Chinese Herbs: Herbs may also be given to improve gut function and enhance digestion that help to better nourish the mother.
Moxa: Moxibustion, a traditional practice often used in conjunction with acupuncture may be recommended as a home self-treatment for the woman. The method involves the burning of a moxa stick (traditional or smokeless) and applying heat to specific acupuncture points for 5 to 10 minutes daily to at least 5 to 10 consecutive days. It is believed that moxa also promotes blood circulation to the uterus and improves nutrient absorption that are vital for baby’s development in IUGR.

If you are interested in finding out more about our treatment for IUGR or acupuncture to support pregnancy in general, please do not hesitate to contact us or book for an initial consultation today. We look forward to working with you and supporting you through a healthier pregnancy! Make a booking online here.

This Blog is written by Dr. I-Li Ho.