Intrauterine growh retardation: Clinical management

Lots of diagnostic procedures are assessed to evaluate intrauterine retardation (IUGR), among them ultrasounds are the most relevant ones. Foetal surveillance includes assessment of growth, detection of the Doppler blood flow and volume of amniotic fluid. There is an evidence of the association between IUGR and foetal blood perfusion. Pregnancies with early onset of IUGR remain a challenge not solved yet, even if the velocimetry of the foetal middle cerebral artery is considered mandatory for neurological risk when altered. In mid-late onset, IUGR cerebral and umbilical blood Doppler is useful to detect the potential damage of the foetus and avoid the hypoxic risk. Ductus venous flow is also an indicator offoetal jeopardy in case of abnormal umblical artery waves. Review of literature shows that middle cerebral, umbilical arteries, ductus venosus and uterine arteries are the most relevant vessels to be evaluated in order to establish the foetal well-being when IUGR arises. Obstetric management aims to lead what is the better choice: prematurity with associated Infant Respiratory Distress Syndrome (IRDS) or, on the contrary, waiting with correlated either stillbirth risks or catch-upgrowth advantage.