Selective Intrauterine Growth Restriction - Maximed Turkey

What is Selective Intrauterine Growth Restriction?

"Severely premature infants who survive to a gestational age of 24 weeks or more are said to be in the 'immuno-privileged' period. This developmental phase occurs just before immunological tolerance, which lasts from 24 weeks to 28 weeks postpartum. The intestine and lungs develop during this time and therefore, they are highly vulnerable."

Selective Intrauterine Growth Restriction Diagnosis

Somewhere between 20 and 30 weeks, the fetal gut has matured enough to start digesting milk, but the baby is not yet able to digest it. If a mother introduces cow's milk into her diet, her breastmilk will have higher levels of immunoglobulins, which are foreign to an infant of this age.

The baby's immature immune system may have difficulty fighting off the 'foreign' antigens, causing an inflammatory reaction. This can be seen in the immature gut as well as in the skin. The skin will become red and raised at times during this period also known as 'allergic contact dermatitis or 'atopic dermatitis.

Selective Intrauterine Growth Restriction Management and Treatment

How is SIRS treated?

For many infants, the milk allergy will subside once the mother stops feeding cow's milk. Babies who are allergic to cow's milk should not be given any food or drink containing cow's milk.

If there is no resolution of the skin reaction, then an elimination diet can be carried out to try to identify an allergen that could be the cause of the allergic reaction. The American Academy of Pediatrics (AAP) states that if there is no resolution with this diet then further testing will need to occur. This can include blood testing for specific antibodies or another targeted lab testing.

Steroids are not indicated for the treatment of SIRS, however, they may be used in cases where there is also chronic lung disease or gastrointestinal problems. Steroids should never be given to treat atopic dermatitis alone.

If the mother is allergic to cow's milk products she should consult with her healthcare provider about which products she can safely consume. The AAP states that breastmilk should continue to be the baby's only source of nutrition.

The prognosis for Patients with Selective Intrauterine Growth Restriction

Research indicates that 30-40% of pregnancies are complicated by structural anomalies. Structural malformations account for about 60% of these complications.

Multiple categories encompass structural anomalies, including triploidy, fetal aneuploidy, cervical shortening, and pelvic disproportion. Structural abnormalities can result in various levels of short-term and long-term effects on the mother's health as well as the fetus' health or death.

Frequently Asked Questions on Selective Intrauterine Growth Restriction

Is there a risk for me to undergo selective intrauterine growth restriction (SIGR)?

Yes. There is a risk of complications and side effects for both mother and fetus. These effects include preterm birth or early delivery, low Apgar scores or "poor neonatal outcomes", maternal infection, pregnancy-induced hypertension, and infertility.

What are the risks for me to undergo selective intrauterine growth restriction?

There are risks for both mother and fetus. These risks include preterm birth or delivery, low Apgar scores or "poor neonatal outcomes", maternal infection, pregnancy-induced hypertension, and infertility. Also, long-term complications of selective intrauterine growth restriction include uterine scarring/adhesions/myometritis, placental abruption, shoulder dystocia during labour, uteroplacental insufficiency in the postpartum period (e.g. bleeding postpartum, "low milk supply" for breastfeeding), and premature menopause.

What are the long-term effects of selective intrauterine growth restriction?

The long-term effects are unknown. The main complication is preterm birth or delivery. Also, some risks occur in the postpartum period which includes uterine scarring/adhesions/myometritis, placental abruption, shoulder dystocia during labour, uteroplacental insufficiency in the postpartum period (e.g. bleeding postpartum, "low milk supply" for breastfeeding), and premature menopause.

What are the short-term effects of selective intrauterine growth restriction?

The short-term effects are not known. The main complication is preterm birth or delivery. Also, some risks occur in the postpartum period which includes uterine scarring/adhesions/myometritis, placental abruption, shoulder dystocia during labour, uteroplacental insufficiency in the postpartum period (e.g. bleeding postpartum, "low milk supply" for breastfeeding), and premature menopause.