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Archives of Gynecology and Obstetrics

, Volume 276, Issue 6, pp 633–640 | Cite as

The IUGR prognostic scale

  • Mohammad Sami Walid
  • Olga Victorovna Astafyeva
  • Alexei Victorovich Pomortsev
Original Article

Abstract

Objective

Complex evaluation of the functional system “mother–placenta–fetus” in intrauterine growth restriction (IUGR) for the prognosis of risk of perinatal complications and optimization of choice of method of delivery.

Methods

We created an objective scale for the evaluation of pregnancies complicated by IUGR using 19 fetometric, dopplerometric and pulsometric parameters. We prospectively followed 130 fetuses classified into three risk groups determined by our prognostic scale with a control group of 25. Operative method of delivery was recommended for medium and high risk groups. We examined newborns with the help of neurosonography and compared them to 139 retrospective newborns classified into three groups according to severity of IUGR with a control group of 25.

Results

C-sections were higher by 27 and 12% in the prospective medium and high risk groups. Ventriculomegaly, brain edema, hemorrhages and pathological vascular pulsation decreased by 9, 27, 12 and 21%. Perinatal mortality decreased by 4%.

Conclusions

The developed IUGR prognostic scale optimized the choice of method of delivery and led to decreased rates of neurological morbidity and mortality in newborns with IUGR.

Keywords

IUGR Prognosis Scale Neurologic Complication Perinatal Mortality 

References

  1. 1.
    Abramtshenko VV, Shabalov NP (2004) Clinical perinatology. Intellect, PetrozavodskGoogle Scholar
  2. 2.
    Efkarpidis S et al (2004) Case–control study of factors associated with intrauterine fetal deaths. Med Gen Med 6(2):53Google Scholar
  3. 3.
    Ashworth A (1998) Effects of intrauterine growth retardation on mortality and morbidity in infants and young children. Eur J Clin Nutr 52(1):S34–S41PubMedCrossRefGoogle Scholar
  4. 4.
    Aucott SW, Donohue PK, Northington FJ (2004) Increased morbidity in severe early intrauterine growth restriction. J Perinatol 24(7):435–440PubMedCrossRefGoogle Scholar
  5. 5.
    Leitner Y, Valevski FA, Geva R, Bassan H, Posner E, Kutai M, Many A, Jaffa AJ, Harel S (2000) Six year follow-up of children with intrauterine growth retardation: long-term, prospective study. J Child Neurol 15(12):781–786PubMedGoogle Scholar
  6. 6.
    Leeson CPM, Kattenhorn M, Morely R, Lucas A, Deanfield JE (2001) Impact of low birth weight and cardiovascular risk factors on endothelial function in early adult life. Circulation 103:1264–1268PubMedGoogle Scholar
  7. 7.
    Qiu Q, Basak A, Mbikay M, Tsang BK, Gruslin A (2005) Role of pro-IGF-II processing by proprotein convertase 4 in human placental development. Proc Natl Acad Sci USA 102(31):11047–11052PubMedCrossRefGoogle Scholar
  8. 8.
    Shingo K, Katsumi A, Cunming D (2005) Insulin-like growth factor-binding protein-1 (IGFBP-1) mediates hypoxia-induced embryonic growth and developmental retardation. Proc Natl Acad Sci USA 102(4):1240–1245CrossRefGoogle Scholar
  9. 9.
    Winick M (1971) Cellular changes during placental and fetal growth. Am J Obstet Gynecol 12(1)Google Scholar
  10. 10.
    Benson CB, Boswell SB, Brown DL, Saltzman DH, Doubilet PM (1988) Improved prediction of intrauterine growth retardation with use of multiple parameters. Radiology 168(11):7–12PubMedGoogle Scholar
  11. 11.
    Niknafs P, Sibbald J (2001) Intrauterine growth retardation index. Ultrasound Q 17(4):255–260PubMedCrossRefGoogle Scholar
  12. 12.
    Vаnia MA, Marco AB, Antоnio AS, Heloísa B, Valdinar SR (2005) Risk factors for intrauterine growth restriction: a comparison between two Brazilian cities. Pediatr Res 57(5 Pt 1):674–679Google Scholar
  13. 13.
    Pomortsev AV (1998) The functional status of the pregnant woman and her fetus in normal and complicated pregnancy. In: Abstract of doctoral thesis in medical science (14.00.17; 14.00.01). Kuban State Medical Academy, KrasnodarGoogle Scholar
  14. 14.
    Zubakhin AG, Pomortsev AV, Penjoyan GA (1996) The use of computerized system during ultrasound screening of pregnant women for the complex evaluation of fetal growth, vol 3. Ultrasound Diagnostics, Moscow, pp 48–49Google Scholar
  15. 15.
  16. 16.
    De Onis M, Blossner M, Villar J (1998) Levels and patterns of intrauterine growth retardation in developing countries. Eur J Clin Nutr 52:S5–S15PubMedGoogle Scholar
  17. 17.
    Kortshagina EE (2004) Complex evaluation of the functional status of the system mother-placenta-fetus in pregnant women with type 1 diabetes mellitus for the optimization of tactics of prenatal care and delivery. In: Abstract of candidate thesis in medical science (03.00.13; 14.00.01). Kuban State Medical Academy, KrasnodarGoogle Scholar
  18. 18.
    Nicolaides KH, Berry S, Snijders RJM, Thrope-Beeston JG, Godsen C (1990) Fetal lateral cerebral ventriculomegaly: associated malformations and chromosomal defects. Fetal Diagn Ther 5:5–14PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Mohammad Sami Walid
    • 1
  • Olga Victorovna Astafyeva
    • 2
  • Alexei Victorovich Pomortsev
    • 2
  1. 1.Department of Obstetrics and GynecologyKuban State Medical UniversityKrasnodarRussian Federation
  2. 2.Department of Ultrasound DiagnosticsKuban State Medical UniversityKrasnodarRussian Federation

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