Fetus
Late Onset Growth Restriction
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Late Onset Growth Restriction
, Asymmetric IUGR, Asymmetric Intrauterine Growth Retardation
See Also
Intrauterine Growth Retardation
(
IUGR
)
Symmetric Intrauterine Growth Retardation
(
Symmetric IUGR
)
Large for Gestational Age
Epidemiology
Represents 70-80% of cases of
Intrauterine Growth Restriction
Background
Late onset
Fetal Growth Retardation
has onset >32 weeks gestation
Typically results from utero-placental insufficiency (see causes below)
Previously described as Asymmetric Intrauterine Growth Retardation
However, timing of onset (early or late) is more predictive of complication than asymmetry
Intrauterine Growth Retardation
with head sparing
Severe Asymmetric IUGR may become
Symmetric IUGR
Associated with chronic
Fetal Hypoxia
Less severe than
Early Onset IUGR
Abnormal umbilical artery in <10%
Rare perinatal death
Associated Conditions
Preeclampsia
in 12% of cases (greater association with
Early Onset IUGR
)
Causes
Utero-Placental Insufficiency
See
Intrauterine Growth Retardation
Maternal
Preeclampsia
or Chronic
Hypertension
Gestational Diabetes
(Second most common cause
IUGR
)
Maternal
Collagen
Vascular Disease
Maternal
Tobacco Abuse
Most common preventable cause of
IUGR
Birth weight reduced 200 grams if mother smokes
Maternal Infection
Management
See
Intrauterine Growth Retardation
(
IUGR
)
Complications
Fewer neurologic complications than
Early Onset IUGR
Perinatal complications
Polycythemia (hyperviscosity)
Hypoglycemia
References
Westby (2021) Am Fam Physician 104(5): 486-92 [PubMed]
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