Intrauterine growth retardation.

The many problems of diagnosing IUGR are compounded by a lack of ability to detect the dysmature infant from the constitutionally small infant even at birth. Antenatal attempts at detecting IUGR must start with the accurate establishment of gestational age. This can be only accomplished by routine early ultrasound measurement of BPD for all pregnant patients. Subsequently, management is aimed at screening out a group at high risk for having a growth-retarded fetus. Clinical means are poor but SFH measurements or a repeat ultrasound in the third trimester can be expected to detect about 85% of IUGR patients. Diagnosis of IUGR is made by detailed measurement of growth parameters on a serial basis. The use of the H/A ratio chart allows the antenatal division of IUGR into asymmetric and symmetric, such that appropriate investigation and management can be undertaken. The study of flow velocity waveforms obtained by pulsed Doppler ultrasound might in the future help to provide a more rational basis for referring patients to intensive antenatal fetal monitoring.