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What to expect when you’re expecting a small baby

A guide to what to expect during pregnancy and how doctors diagnose intrauterine growth restriction (IUGR).

Congratulations on your pregnancy and new baby! Intrauterine growth restriction (IUGR) is a condition where a fetus, which is an unborn baby, does not grow enough before birth. IUGR babies are smaller than they should be. There are many causes of IUGR. Your doctor may run some tests, and will tell you what the most likely cause is for your baby.

Even if your pregnancy is complicated by intrauterine growth restriction (IUGR), you will most likely have a healthy baby. However, your doctor will monitor your pregnancy and your baby more closely to make sure that you and your baby have the best possible outcome.

Most babies with IUGR do well, but your doctor will likely do some additional testing and monitoring during pregnancy and after birth.

Most physicians and midwives will refer a pregnant mom to a high-risk pregnancy specialist, called a perinatologist, if he or she is concerned about a baby being too small. The perinatologist will measure your blood pressure and perform a physical exam. Also, the perinatologist will usually do an ultrasound to take measurements and confirm the baby's growth. The ultrasound can sometimes give clues as to why your baby's growth is slower than it should be.

The next tests the perinatologist usually performs are blood tests and possibly an amniocentesis to determine why your baby is small. Not every pregnancy needs to have blood tests or an amniocentesis, so you should talk to your doctor about whether you should have these tests done.

Your pregnancy will be monitored closely with ongoing ultrasounds. Typically either a non-stress test, or a more in-depth test called a biophysical profile, is done to gather more information. These tests give information to the physician about how your baby is doing and if your baby is under stress.

Most of the time IUGR babies can safely be delivered vaginally when the mom goes into labor. However, sometimes pregnancies with a severely affected IUGR baby will need to be induced or delivered by cesarean section. Talk with your doctor about the safest plan for both you and your baby.

After birth, your baby will need to be monitored for low blood sugar. Low blood sugar is common in IUGR babies and babies born prematurely. Having a low blood sugar can harm the baby’s brain, so it is very important to make sure that your baby’s blood sugar is normal.

Growing up, kids who were born IUGR have some extra challenges. They are more likely to have slower development and memory problems as children and adults. Also, they are more likely to have high blood pressure, obesity, diabetes, and high cholesterol as adults. Your child's physician should monitor your child for any concerns with development and metabolism.

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