23-4-2008 - DS's Conditions - IUGR

My mood while writing this blog: Ok

People often ask me about DS progress. Its very hard to give a simple answer as he has so many health conditions and concerns, all of which interact with one another. Its taken many months in NICU and much time with the staff for me to thoroughly understand, NICU is another world and it takes time to adjust and get used to the new language. It gets increasingly difficult to relate to people outwith the 'NICU world' as the stress and worry consumes me both emotionally and physically. For those who are interested, i thought i chould give a brief description of some of the things we are dealing with, it might help you lovely mami's understand :)

IUGR - Intra-Uterine Growth Restriction

IUGR can begin at any time in pregnancy. Early-onset IUGR is often due to chromosomal abnormalities, maternal disease, or problems with the placenta. Late-onset growth restriction (after 32 weeks) is usually related to other problems.

With IUGR, the growth of the baby's overall body and organs are limited, and tissue and organ cells may not grow as large or as numerous. When there is not enough blood flow through the placenta, the fetus may only receive low amounts of oxygen. This can cause the fetal heart rate to decrease placing the baby at great risk.

Many babies are born 'small'. These babies are called SGA - small for gestational age - and they are in the 10% percentile for growth. SGA and IUGR are very different issues. SGA babies will not have any health implications from their small size. IUGR babies are under the 5-3% percentile for growth, and are often not on the growth charts at all. IUGR babies are weaker and more vulnerable. Of all babies born small, only 1/3 will have IUGR.

Babies with IUGR may have problems at birth including:

• Decreased oxygen levels
• Low Apgar scores
• Meconium aspiration (inhalation of the first stools passed in utero)
• Difficulty breathing
• Low resistence to infection
• Hypoglycemia (low blood sugar)
• Difficulty maintaining normal body temperature
• Polycythemia (too many red blood cells)
• Severe IUGR may result in stillbirth. It may also lead to long-term growth problems in babies and children.

Generally IUGR babies will remain in hospital until they are 5lbs and can maintain their temperature, breathe and feed normally. On average, a baby with mild IUGR is expected to have reached 'normal' size by the age of 2. Moderately affected babies will catch up later on in childhood, and those most severely affect can sometimes remain small and never 'catch up'.