Fetal Growth Restriction
This term is used by pregnancy doctors to describe a fetus that is not growing adequately.
It is also known as intrauterine growth restriction (IUGR) and is diagnosed when a baby’s weight is less than the 10th percentile for gestational age.
Fetal growth restriction is not always immediately obvious and due to the variation of ultrasound measurements, a minimum of two weeks is required between fetal growth scans.
Generally there is no sign that a bub is small for their gestational age, or occasionally mums may feel their belly is not as big as it should be.
If this is a concern, Dr Shetty is happy to organise tests for FGR.
Some of the underlying causes for FGR include
- Constitutional – meaning your baby is small because of your ethnic origin. These babies tend to be small but healthy.
- Placental cause – If your placenta is not developing well leading to poor blood flow to the baby.
- Chromosomal or genetic causes: In some cases, a chromosomal defect or underlying genetic condition can cause a growth issue
- Maternal conditions – previous small baby, twins or triplet pregnancy, maternal infections , maternal medical conditions like hypertension or chronic health condition. Use of smoking, excessive alcohol or drug use can also cause growth issues in the baby.
How is fetal growth restriction managed?
If Dr Shetty suspects fetal growth restriction in your pregnancy, rest assured as an MFM she is highly qualified to treat it. Some of the tests she may suggest include
- Detailed ultrasound
- A blood test to rule out infection
- Amniocentesis to identify possible genetic abnormalities.
- Ongoing ultrasound monitoring, generally fortnightly. Blood flow studies using Doppler ultrasound may also be needed.
- CTG monitoring to monitor your baby’s well being.
- Sometimes hospital admission may be required so that regular fetal heart rate surveillance can be tracked.
- If delivery is recommended early ( <37 weeks) Dr. Shetty may consider using medications to reduce the risk to the newborn of complications associated with preterm birth.
- While there is much you can’t control in terms of fetal growth restriction, it’s important to focus on the things you can do such as not smoking, eating well, increasing protein intake, maintaining optimal mental health (mindfulness and exercise), and keep a watch on fetal movements. .
- If your baby has had trouble growing in the uterus, she/he may need to spend time in the Westmead Hospital Neonatal ICU depending on weight, gestational weeks at delivery and how your bub has adapted outside of the womb.
How can Dr Shetty help me if I have fetal growth restriction?
- Dr Shetty has had extensive experience in managing many pregnancies with growth problems. Almost 20 percent of pregnancies can have growth related issues and Dr Shetty has helped many mums and babies dealing with this condition. Management of fetal growth restriction is ultrasound led.
- This requires a doctor like Dr Shetty who will scan your baby herself, carefully assessing your placenta and blood flow. Her extensive US experience helps her identify problems early so that she can provide you with the right management and prompt advice.
- When it comes to time of birth, Dr. Shetty also has vast experience in delivering the growth restricted babies. If delivery is recommended early (< 34 weeks) then you may require delivering at Westmead public Hospital. Dr Shetty will continue to look after you at Westmead public along with her team of specialists and neonatologists.
“My GP told me my baby would not survive”
My first pregnancy had been smooth, so when I conceived again and my NIPT test confirmed I was having a girl, I was ecstatic.
But my joy was quickly overshadowed by fear when the NIPT results also showed Trisomy 2—an extra chromosome in position 2.
I was told by my doctor that my baby could not survive and advised me to terminate the pregnancy.
Heartbroken and confused, I sought a consultation with Dr Shetty at the Fetal medicine department. With patience and clarity, she explained that since NIPT only screens placenta cells, the abnormality might be confined to the placenta rather than affecting my baby.
She recommended an amniocentesis—a test analysing the amniotic fluid—to confirm the diagnosis.
The relief was immense when the results showed my baby was healthy and the abnormality was indeed limited to the placenta.
However, this condition still posed risks, as it could affect the placenta’s ability to nourish my baby.
My daughter’s growth was severely restricted, and doubts crept in.
I even considered termination multiple times, fearing she wouldn’t make it. But while my hope wavered, my baby girl remained strong.
Dr Shetty closely monitored me with weekly scans, ensuring my daughter Inaya had every possible chance. At 31 weeks, when my placenta could no longer sustain her, I delivered my little fighter—a tiny but mighty 1.2 kg baby girl. She needed intensive care support at first, and those days in the NICU were tough. But each time I saw her tiny fingers grasp mine, each time she flashed a little smile, I knew she was here to stay.
Today, Inaya is over a year old—healthy, strong, and full of life. Looking back, I am endlessly grateful for the unwavering support, love, and expertise I received throughout this journey. To all expectant mothers facing difficult news, don’t give up hope. Trust in yourself, seek the right guidance, and believe in the strength of your little one.
Isha Kang
