Fetal Growth Restriction: Causes, Risks & How to Manage It

Fetal Growth Restriction (FGR), also known as intrauterine growth restriction (IUGR), is a condition where a baby fails to grow at the expected rate in the womb. This can lead to serious fetal development issues, increasing the risk of complications before and after birth.

But here’s the good news: With early detection and proper medical care, many FGR babies can go on to have healthy lives.

Dr. Hrishikesh Pai, a globally renowned fertility expert with over 40 years of experience, explains:
“Many parents worry about their baby’s growth but often don’t realize that early intervention can make a huge difference. The key is regular monitoring, a balanced diet, and proper medical guidance to ensure the best outcomes for both mother and baby.”

So, what exactly is FGR, and how does it affect pregnancy? Let’s dive in.

FGR occurs when a fetus is smaller than the expected size for its gestational age, typically falling below the 10th percentile on the fetal growth chart.

But what does this mean for your baby?

A baby experiencing FGR may not receive adequate oxygen and nutrients, which are essential for normal growth and organ development. In some cases, this condition may lead to preterm birth, low birth weight, and developmental delays.

Did you know? Some FGR babies experience ‘catch-up growth’ after birth, but early intervention during pregnancy is still crucial!

Now, let’s look at the different types of FGR.

Not all cases of FGR are the same. In fact, there are two major types, and each one has different causes and risks.

1. Symmetric FGR

• The baby is proportionally small, meaning all organs, bones, and tissues develop at a reduced rate.
• This is usually caused by genetic disorders, early infections, or chromosomal abnormalities.
• Often detected early in pregnancy, during the first or second trimester.

2. Asymmetric FGR

• The head and brain develop normally, but the rest of the body remains smaller.
• Typically results from placental insufficiency, where the placenta fails to provide adequate nutrients.
• More commonly diagnosed in the third trimester.

Why does this matter? Knowing the type of FGR helps doctors determine the best course of action to ensure a safe pregnancy.

FGR doesn’t happen randomly—it’s usually caused by a mix of different factors. Let’s break it down:

Maternal Causes:

Preeclampsia & high blood pressure – Reduce blood flow to the baby.
Poor maternal nutrition – A diet lacking in essential vitamins and proteins affects fetal development.
Smoking, alcohol, and drug use – Toxins restrict oxygen and nutrient supply to the fetus.
Chronic illnesses – Conditions like diabetes, anemia, and kidney disease increase FGR risk.

Placental Causes:

Placental insufficiency – The placenta does not function properly, reducing oxygen transfer.
Placental abruption – The placenta detaches too soon, disrupting blood flow.
Umbilical cord abnormalities – Such as a short umbilical cord or knots, affecting circulation.

Fetal Causes:

Chromosomal abnormalities – Genetic disorders like Down syndrome.
Infections like cytomegalovirus (CMV) and rubella – Can hinder fetal growth.
Congenital heart defects – Affect blood circulation within the fetus.

Remember: FGR isn’t always caused by just one issue. Often, it’s a combination of factors that contribute to growth problems.

FGR can be difficult to detect, but doctors look for these warning signs:

Small fundal height – The uterus measures smaller than expected.
Low fetal movements – A baby that moves significantly less may indicate distress.
Irregular Doppler ultrasound results – Poor placental blood flow.

Still unsure? Let’s explore the potential complications of FGR.

FGR can lead to several short-term and long-term complications, including:

Preterm birth – Babies may be delivered early.
Low birth weight – Can lead to feeding difficulties and weak immune systems.
Stillbirth – Severe cases may result in fetal loss.
Developmental delays – Some babies may experience learning disabilities and slower growth.

But here’s the hopeful part: With the right care, many FGR babies thrive and catch up in growth post-birth!

Doctors use several tests to detect FGR, including:

Ultrasound scans – Track fetal size and growth rate.
Doppler blood flow studies – Check circulation between the placenta and baby.
Non-Stress Test (NST) – Monitors fetal heart rate and movement.
Amniotic fluid assessment – Low fluid levels can signal growth issues.

The sooner FGR is diagnosed, the better the outcome.

Fetal Growth Restriction is a serious condition, but it doesn’t have to define your pregnancy journey. With early diagnosis, personalized care, and proper medical management, the risks can be significantly reduced.

Here’s what matters most: Regular prenatal check-ups, proper nutrition, and timely interventions can improve pregnancy outcomes and support your baby’s healthy growth.

At Bloom IVF, Dr. Hrishikesh Pai and his team offer advanced fetal monitoring and high-risk pregnancy care to ensure the best possible outcomes for both mother and baby. With a patient-first approach and cutting-edge medical technology, they help families navigate FGR with confidence and peace of mind.

Dr. Hrishikesh Pai emphasizes:
 “Every baby deserves the best possible start in life. With proper medical guidance and care, we can ensure that FGR doesn’t stand in the way of a healthy pregnancy and delivery.”

If you have concerns about fetal growth, don’t wait—seek expert guidance today.

Reference Links:

1. American College of Obstetricians and Gynecologists – FGR Guide
2. World Health Organization – Fetal Development