Thursday, June 23, 2011

In fetal growth retardation - Screening and diagnosis

History may IUGR to relevant history of neonatal death and / or risk factors. In these cases it will make a careful analysis of correspondence between the chronology of pregnancy and fetal growth. Definitive diagnosis can not be established until after birth.
Measurement of uterine height (DH) is a method sidmpla. Useful in screening you, provided it is done correctly. A difference (down) 4 cm or more, suggesting fetal growth retardation. Between weeks 18 and 30 on average and normally IU (in cm) coincides number of weeks gestation.
Sonography is a useful tool in monitoring fetal growth. Include routine screening examination in 16-20 weeks to determine pregnancy. Growth rate will be evaluated after the 32nd week. The early signs of IUGR, ultrasound detected appears to be decreased amniotic fluid (which is explained by decreased fetal urine production reduced renal perfusion).
Have been proposed various ultrasound parameters in detecting abnormalities value fetal cresteriii:- Abdominal circumference;- Femur length;- Biparietal diameter;- Report femur length / abdominal circumference;- Report skull circumference / abdominal circumference (this report is normally before the 32nd week, more than 1, between 32 and 34 weeks after 34 weeks is a less than 1, the ratio is asymmetric IUGR large);- Grade 3 placenta, observed in the onset of the third quarter, was correlated with IUGR.Along with decreased amniotic fluid volume and increased skull circumference ratio / abdominal circumference fetal weight assessment sonography is essential in detecting and monitoring suspected IUGR fetuses.
Using ultrasound to determine pregnancy age have high accuracy in the first quarter, during which biological variability of the offspring size is reduced.In trimsetrul II and III genetic variations occur.It is believed that the association of biparietal diameter / femur length is quite accurate for estimating the age range 12-20 weeks pregnancy. After 20 weeks, combination-length creniului femur circumference seems more reliable.
IUGR diagnosis should include evaluation of fetal status, for the following tests may be recommended:- Fetal biophysical profile;- Acid-base balance research in umbilical cord blood (obtained by cordocentesis);- Velocimetria umbilical artery Doppler;- "Stress - test"

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