Screening for intrauterine growth restriction

One of the most important pregnancy complications is childbirth before the 32nd week of pregnancy. Most babies born before the 24th week of pregnancy die, and most babies born after the 32nd week of pregnancy survive.

 

One of the reasons for prematurity is intrauterine growth retardation of the fetus, where due to disturbed blood supply to the placenta, the fetuses do not reach their growth potential, and in the case of a full-term pregnancy, their birth weight would be less than 2500 g.

 

Frequency of occurrence in 5% of children born. Intrauterine growth retardation of the fetus is a big challenge for the gynecologist monitoring the pregnancy, because so many times labor has to be induced earlier to save the life of the child suffering from lack of nutrients and oxygen.

 

The OSCAR test recognizes women of this risk group who may develop intrauterine growth retardation before the 37th week with an accuracy of 55.5%. The test is less sensitive in recognizing late growth retardation that occurs after the 37th week. This is 44.3%. But it is important to understand that early stunting is a great threat to the life and health of the mother and child.

 

Studies have shown that before the 16th week of pregnancy, aspirin in low doses, by promoting the blood supply of the developing placenta, reduces the development of fetal growth retardation in 59% of cases, due to which premature delivery is necessary before the 37th week of pregnancy. Therefore, it is recommended that high-risk pregnant women take aspirin 150 milligrams once a day in the evening until the 34th week of pregnancy. ( S. ROBERGE, K. H. NICOLAIDES, S. DEMERS, P. VILLA and E. BUJOLD. Prevention of perinatal death and adverse perinatal outcome using low-dose aspirin: a meta-analysis. Ultrasound Obstet Gynecol 2013; 41: 491–499 ) .

 

At the 20th week of pregnancy, a Doppler examination of the uterine arteries is recommended, and at the 28th week of pregnancy, fetal weight measurement is recommended to assess the effectiveness of prophylactic aspirin therapy.