Fetal Growth Restriction

What is fetal growth restriction?

Fetal growth restriction (FGR) is a condition where a baby is smaller than expected or when a baby’s growth slows or stops during pregnancy.

This can affect 10% of pregnancies and happens when the placenta is not working well enough to provide the baby with the nutrients they need to grow normally or sometimes due to chromosomal problems or infections (e.g. cytomegalovirus, toxoplasmosis).

Risk factors

The most common risks are:

  • if you’ve had a previously small baby, pre-eclampsia or stillbirth.
  • if you’ve had complications earlier in this pregnancy, particularly heavy bleeding.
  • having a pre-existing medical problem such as high blood pressure, kidney problems, diabetes, or heart disease
  • smoking, drinking alcohol or using illegal or recreational drugs.
  • being over 35 years of age.

If you are considered at risk of FGR you may be offered low dose aspirin 75mg-150mg from 12 weeks of pregnancy.

FGR can be picked up from routine ultrasound scans and/or from the size of you bump when it is measured with the midwife during routine antenatal visits. You will then have a further ultrasound scan to monitor the size and growth of your baby, and some may have scans to view the blood flow to the placenta (uterine artery Doppler).

Sadly, FGR has an increased risk of complications including stillbirth and hence the need for obstetric support and monitoring. It is important to monitor your baby’s movements and to contact your maternity unit immediately if they have slowed down or stopped.

The Obstetric team will also talk to you about the best time for you to give birth. This is likely to be earlier than your due date, but many will be able to try for a vaginal birth, if there are no other complications.