Although there are many causes of IUGR, the treatment consists of
either delivery or remaining in utero and improving blood flow to the
uterus. When blood flow is improved, the delivery of oxygen and other
nutrients to the fetus occurs. If the fetus is lacking in these
substances, their increased availability may result in improved growth
and development.
A number of studies have examined different forms of treatment
for IUGR. As you recall, IUGR has many causes, therefore, there is not
one treatment that always works. The following summarizes different
treatment options that have been considered.
Maternal Treatment
Maternal Bed Rest
This is the initial approach for the
treatment of IUGR. The benefit of bed rest is that it results in
increased blood flow to the uterus. Studies have shown, however, that in
most cases bed rest at home is just as effective as bed rest in the
hospital environment. Click GRAPH to review a typical case of a fetus with IUGR that responded to maternal bed rest.
Aspirin Therapy
The use of aspirin to treat fetuses with IUGR is still
controversial. If aspirin is used, it may be advantageous if given to
patients before 20 weeks of gestation.
It is minimal to limited benefit if given at the time of diagnosis
(third trimester). At the present time it is not recommended as a form
of prevention for low risk patients.
Other Forms of Treatment
Others forms of treatment that have been studied are zinc supplementation, fish oil, and oxygen therapy. Limited studies are available regarding the use of these modalities in the treatment of IUGR.
Fetal Surveillance
Unless delivery occurs, once treatment begins the fetus must
undergo surveillance. The purpose of this is to identify further
progression of the disease process that would jeopardize the fetus to a
point that it would be better to be delivered than to remain in utero.
There are four testing modalities, each of which addresses different
aspects of surveillance, which are helpful. Most physicians agree that a
combination of tests are better than an isolated test.
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