IUGR: problems with your baby's growth in the womb

Intrauterine growth restriction (IUGR), also known as fetal growth restriction (FGR) is a condition in which a baby's growth slows or stops when they are in the womb.

Intrauterine growth restriction (IUGR) occurs in around 3 in every 100 pregnancies. Unborn babies with IUGR can grow so slowly in the womb that they are at risk of health problems. If the growth restriction is severe, the baby may have to be delivered, so it is also a cause of premature birth.

Causes of Intrauterine Growth Restriction

The majority of cases of IUGR are caused by failure of the placenta but there are also several other factors that could cause a baby's growth to be restricted:

  • multiple pregnancy
  • infection
  • Antiphospholid Syndrome
  • genetic problems or a congenital anomaly in the baby
  • pre-existing medical problems in the mother such as high blood pressure, kidney disease, diabetes, heart disease, lung disease, chronic anaemia
  • certain prescribed medications such as warfarin, some but not all anticonvulsants, and some anticancer drugs
  • low pregnancy weight
  • smoking or using drugs during pregnancy
  • drinking alcohol during pregnancy.

Around 10 in every 100 babies are small for gestational age. Most of these are small for normal reasons, such as the mother’s size and ethnicity, but around a third will be due to intrauterine growth restriction. 

Signs and symptoms of Intrauterine Growth Restriction

IUGR is normally diagnosed during routine antenatal appointments. Your baby’s size is monitored throughout your pregnancy in your routine appointments. The midwife will palpate your stomach gently to feel the baby’s size, and they will measure the fundal height. The measure is then put on a chart that plots the growth. If there are any concerns the midwife will refer you for a scan. This does not necessarily mean something is wrong, but it is important to have the scan as more accurate way of assessing the baby's growth.

Management of Intrauterine Growth Restriction

There is no 'treatment' for IUGR. Instead you will have a management plan. If IUGR is suspected, you will have regular scans to look at the baby’s growth. The blood flow through the placenta will be checked with a uterine artery doppler test. If there is concern about growth then a plan will be implemented including regular scans, CTG monitoring and consultant appointments in antenatal clinic at the unit.

You will be told to closely monitor your baby’s movements.

If the growth restriction is severe, your healthcare team will recommend additional scans for monitoring of growth and baby well-being. They may recommend delivering the baby early.

Fetal movements

It is very important to be aware of your baby’s pattern of movements and monitor this for change if you have been diagnosed with suspected IUGR.

More on growth restriction

  • My baby does not seem to be getting any bigger

    My baby is not growing in pregnancy

    A growing bump is the sign of a growing baby. Your midwife should start measuring your growing baby at antenatal appointments from 24 weeks to make sure they are growing at the right rate for your stage of pregnancy.

Sources

  1. NICE (2008) Antenatal care: routine care for the  healthy pregnant woman. National Institute for Health and Clinical Excellence.
  2. NICE (2011) CG129 Multiple pregnancy: The management of twin and triplet pregnancies in the antenatal period, National Institute for Health and Clinical Excellence.
  3. Norman J (2011) Preterm labour, managing risk in clinical practice. Cambridge: Cambridge University Press.
  4. RCOG (2013) The Investigation and Management of the Small–for–Gestational–Age Fetus. The Royal College of Obstetricians and Gynaecologists.
  5. James D, Steer P (2011) High risk pregnancy, management options. Fourth ed, Elsevier Saunders.
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Last reviewed on October 3rd, 2016. Next review date October 3rd, 2019.

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Comments

  • By Anonymous (not verified) on 22 Jul 2017 - 18:26

    Hi, I'm 13 weeks and 2 days pregnant. I lost my first at 8 weeks and my second at 16 weeks found out at 20 weeks. All pregnancies I have suffered with hg sickness so I thought was a good sign of a healthy pregnancy. I have started getting a lot of uncomfortable pain all around my lower and upper belly do you think this could be stretching pains? I had a scan recently on Wednesday due to brown spotting last weekend . Kind regards, Veronica

  • By Midwife @Tommys on 24 Jul 2017 - 15:09

    Hi Veronica. You must be very anxious after your last pregnancy. Was the scan last week reassuring? Mild cramping and stitch like pains are common in early pregnancy but if the pain in your abdomen persists or if you have any signs of bleeding, you should contact your doctor or midwife. Best wishes to you x

  • By Anonymous (not verified) on 22 Jun 2017 - 09:51

    Hi I would like to know I'm 30 weeks. On my last appointment (2weeks ago ). My doc said the baby is very under weight. And his pulse was No Accurate my belly isn't growing much I'm trying a lot of healthy foods and healthy m resting my self alot please advise me what more can I do.

  • By Midwife @Tommys on 22 Jun 2017 - 12:20

    Hi, It can be a shock when you go to your hospital appointment and receive news like you have, that your baby's isn't growing as much as it should. This can be for a number of reasons, some of which you don't have any control over but what is most important is that now your doctors are aware that your baby is small, they can monitor you as closely as possible. It sounds like you are doing all the rights things that we would advice for your baby, you are eating well and resting when you can. Keep monitoring your baby's movements and if you feel like they have changed at all then please call your maternity day assessment unit so that the midwives can check you over. You should expect to been seen at the hospital more regularly now, so that your baby's growth and development can be monitored, so please attend all you appointments. You should have a follow up appointment at the hospital soon if your last one was 2 weeks ago, if you haven't, then please call the antenatal clinic at your local maternity unit and explain your circumstances, they should be able to book you in to see your Obstetrician as soon as they can. Hope this has helped, take care Tommy's Midwives x

  • By Midwife @Tommys on 13 Jun 2017 - 12:47

    Hi, thank you for your comment and I am so sorry to hear that you have lost three babies. It would be great to speak or if you could email us here at Tommy's with more information we might be able to help.
    Our number is 0800 0147 800 and there are midwives available weekdays 9-5 pm or email us [email protected]
    We hope to be in touch again soon
    Anna-Tommy's Midwives Team

  • By Anonymous (not verified) on 13 Jun 2017 - 08:05

    I have lost 3baby "not growing in my womb what I do plesss help me

  • By Anonymous (not verified) on 1 Apr 2017 - 18:39

    Hello Sir/Mam, my name is Arun Biradar. We are staying in chennai from last three years. We are facing problem in my wife pregnancy. On first pregnancy we found fetal growth is too small as compared to current weeks and finally doctor adviced us to do abortion. We lost our child in first pregnancy. The same thing happened in next pregnancy exactly after 1 year. Now we are in a situation to do medical abortion again..please let me know the reason for low fetal growth during pregnancy and what should we have to do to avoid this in future..?

  • By Midwife @Tommys on 3 Apr 2017 - 10:00

    Hi Arun,
    it is very difficult to comment on the care that you are receiving in Chennai as we are a U.K based charity. I am ever so sorry to hear about the loss of one of your babies, and now the prospect of a second loss too.
    The majority of cases of IUGR are caused by failure of the placenta but there are also several other factors that could cause a baby's growth to be restricted-multiple pregnancy/infection/Antiphospholid Syndrome/genetic problems or a congenital anomaly in the baby.
    Some Pre-existing medical problems in the mother can also contribute to this, such as high blood pressure, kidney disease, diabetes, heart disease, lung disease, chronic anaemia
    certain prescribed medications such as warfarin, some but not all anticonvulsants, and some anticancer drugs.
    Having alow pregnancy weight/smoking or using drugs during pregnancy/drinking alcohol during pregnancy can also contribute.
    Around 10 in every 100 babies are small for gestational age. Most of these are small for normal reasons, such as the mother’s size and ethnicity, but around a third will be due to intrauterine growth restriction.
    Make sure you discuss all of your possible options with your wife's doctor before you both go ahead with any procedures. Please take good care of yourselves!

  • By Anonymous (not verified) on 26 Mar 2017 - 00:46

    Hi, my son was born via emergency c-section due to my severe preeclampsia at 31+4 on 1/1/17. He weighed 2lbs 13oz at birth and I was told the placenta was 1/3 of the size it should be.

    After the 20week scan of pregancy I had to go for regular growth scans- 2 to 3 weekly as he was measuring small, My question is..
    No one has ever mentioned IUGR to me but it seems to be exactly what me and my son went through. Would this affect him in his life outside the womb? and is it something I should bring up with the GP? Thanks

  • By Midwife @Tommys on 27 Mar 2017 - 10:13

    Hi Emma,
    This is outside our remit as midwives so I don't really know the full answer to your question I am afraid.
    I would certainly tell your GP and Health Visitor about the IUGR you and your son experienced during pregnancy so that they can keep a closer eye on his progress as he grows and develops.
    Take good care of yourself and your little man, Emma!

  • By Anonymous (not verified) on 19 Mar 2017 - 10:52

    hello there...my name is Themba and I'm worried since me and my girlfriend are expecting a baby.She is 9 months pregnant now and the baby is too small so she cant deliver since the child is small.So id like to know what is it that oftenly happens when the baby isn't growing and what can we do in order for our baby to grow because at hospital they give her medication and injection to help the baby to grow but my concern is its now the 9th month

  • By Midwife @Tommys on 20 Mar 2017 - 09:41

    Hi Themba.
    Without knowing your girlfriends full medical history it is a little difficult to fully understand your case. Your baby needs to be closely monitored by the midwife and obstetric dr's caring for your girlfriend. It would be sensible to visit your doctor/midwife as soon as possible if you are concerned about either of their health. Please take care of yourself.

  • By Midwife @Tommys on 22 Sep 2016 - 10:21

    We are very sorry to hear about William and hope our information can give you some understanding of what happened. Thank you for your feedback. Best wishes from all at Tommy's.

  • By Anonymous (not verified) on 21 Sep 2016 - 17:06

    I found this page informative and easy to follow. I wish I had known about it when I was diagnosed with placenta problems which
    led to William being growth restricted and eventually stillborn. I feel it was never fully explained to me at the time and I was told all it meant was I needed more monitoring and that I would not be going to term.

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