Fetal Conditions
Fetal Growth Restriction (IUGR)
When a baby is not growing at the expected rate in the womb, requiring specialist monitoring.
What is Fetal Growth Restriction (IUGR)?
Fetal growth restriction (FGR), also known as intrauterine growth restriction (IUGR), occurs when a baby is significantly smaller than expected for its gestational age. This is different from a constitutionally small baby — in FGR, the baby is not reaching its growth potential, usually because the placenta is not delivering enough nutrients and oxygen. It can be detected by ultrasound measurements that fall below expected thresholds.
Why is it a Concern?
FGR is associated with an increased risk of stillbirth, neonatal complications, and long-term health issues for the child. The degree of risk depends on the severity of the growth restriction, the gestational age, and the underlying cause. Timely detection allows appropriate monitoring and planned delivery.
Signs & Symptoms
- Fundal height (belly measurement) smaller than expected at antenatal visits
- Reduced fetal movement
- Baby measuring below the 10th percentile on ultrasound
- Abnormal Doppler blood flow studies
- Often no maternal symptoms — detection relies on ultrasound
How It is Monitored
Serial ultrasound scans track fetal growth, amniotic fluid volume, and Doppler blood flow through the umbilical artery and other vessels. The frequency of monitoring depends on the severity. CTG (cardiotocography) may be used to monitor the baby's heart rate pattern. Delivery timing is a critical decision that balances the risks of prematurity against the risks of a deteriorating placental environment.
Why See an MFM Specialist?
MFM specialists have advanced training in interpreting Doppler studies and making complex decisions about the timing of delivery in growth-restricted pregnancies. Their expertise in fetal assessment tools is essential for optimising outcomes in these pregnancies.
Dr. Kartik Balaraman Manages This Condition
Dr. Kartik provides detailed fetal growth assessment and Doppler monitoring for babies who are not growing as expected. If you have been told your baby is small, speak with Dr. Kartik.
Book ConsultationFrequently Asked Questions
Is my baby just small, or is something wrong?
Some babies are constitutionally small and perfectly healthy. FGR is diagnosed when growth falls below expected levels AND there are signs of placental insufficiency. Ultrasound and Doppler studies help distinguish between the two.
What causes fetal growth restriction?
The most common cause is placental insufficiency. Risk factors include pre-eclampsia, smoking, maternal medical conditions, and multiple pregnancies. Sometimes no specific cause is identified.
Will my baby catch up after birth?
Many growth-restricted babies show catch-up growth in the first two years of life. Long-term outcomes depend on the severity and cause of the restriction.
Does eating more help my baby grow?
No — FGR is typically caused by placental insufficiency rather than maternal nutrition. Increasing intake will not reverse the restriction. Specialist monitoring and timely delivery are what change outcomes.
Will I need a caesarean with FGR?
Not always. The mode of delivery depends on severity, Doppler findings, and the baby's response to labour. Some FGR pregnancies can be delivered vaginally; others require caesarean.
Related Conditions
Pre-eclampsia & Hypertension
Blood pressure disorders that can develop during pregnancy, requiring careful monitoring to protect both mother and baby.
Twin & Multiple Pregnancies
Pregnancies with two or more babies require specialist monitoring due to increased complexity.
Abnormal Amniotic Fluid
Too much or too little amniotic fluid around the baby, which can indicate underlying complications.
Reviewed by Dr. Kartik Balaraman, Consultant OBGYN & Maternal Fetal Medicine Sub-Specialist ·
This page is for general education and does not replace personalised medical advice. If you have concerns about your pregnancy or health, consult a qualified specialist directly.