Background: Intrauterine growth restriction (IUGR) is the term simply used to imply a fetus which is pathological small. Most epidemiological studies use small for gestational age as a surrogate marker. Intrauterine can be a serious problem in neonates because it is associated with increased morbidity and mortality and long term consequences in the future. The most common method used to identify a fetus that is small for gestational age is the estimated weight of the fetus below the 10th percentile for its gestational age which is also not accurate since it involves even the small but healthy babies and average sized unhealthily babies that should have a been born big.

Each fetus is believed to have an inherent growth potential of which under ideal conditions should produce a healthy baby of an appropriate size. Attaining this growth potential depends on some factors like a healthy mother, well-functioning placenta and absence of any pathologies. If the in utero circumstance are not conducive for the growing fetus then the growth potential will be affected causing failure to thrive for a new born. This condition is seen frequently in Sekou Toure hospital but then again intrauterine growth restriction cannot be reliably diagnosed without an accurate knowledge of gestation age since low birth weight may result from variety of causes.

Intrauterine fetal growth restriction is commonly associated with stillbirth, neonatal deaths and perinatal morbidity, confidential enquiries have demonstrated that most stillbirths caused by intrauterine growth restriction are most likely associated with suboptimal care and are potentially avoidable. A recent epidemiological analysis based on the comprehensive west midlands database has underlined the impact that fetal growth restriction has on stillbirth rates and the significant reduction which can be achieved through antenatal detection of pregnancies at risk.

However, very high risk of complication related to pattern delivery and negligible effect of mild preeclampsia on fetal growth and maternal health. It’s equally important to save both mother and child by carefully selecting the appropriated time for delivery considering the fact that there is intrauterine growth restriction as a complication of preeclampsia.

Perinatal complication associated with low birth weight are primary associated with fetal prematurity or intrauterine growth restriction. Common classification for underweight newborns is based on birth weight alone i.e. low birth weight: 1501-2500g, very low birth weight: 1001-1500g, extremely low birth weight: 500-100g. New international standard developed for evaluation of newborn size, according to WHO international growth standards for fetuses suggests that every normal fetus weighs between the 10th and the 90th percentile
Estimated fetal weight percentile
Gestational age in weeks Averege estimated fetal weight (grams) 10th percentile 90th percentile
20 331 275 387
25 785 652 918
30 1559 1294 1824
34 2377 1973 2781
36 2813 2335 3291
38 3236 2686 3786
40 3619 3004 4234

One of main maternal risk factors of IUGR is preeclampsia in pregnancy. Preeclampsia is a multisystem disorder characterized by hypertension and proteinuria usually new onset after the gestational age 20 weeks. It is as well established that preeclampsia is one of two main types i.e. early onset which manifests before 34 weeks gestation period and late onset manifests after 34 weeks gestation. Preeclampsia can be determined by failure of placentation particularly the physiological transformation of spiral arteries resulting a stresses under perfused may be a bit tricky since proteinuria may not be adequately measured and also a lack of information on preexisting hypertension since most patients present to the clinic when the disease is more advanced.

Among the sub Saharan countries, the exact prevalence of preeclampsia remains unknown since there has been a lack of detailed clinical records of all births. However, a study was made in the US to review the incidence of preeclampsia among the black community and immigrants from Africa as compared to other ethnic groups. Incidence was higher among the blacks and Africa immigrants.

General objectives: Relationship between IUGR and preeclampsia

Specific objectives: Assessing incidence of preeclampsia. Assessing how preeclampsia onset affects intrauterine growth. Assessing how maternal age, GA, gravidity contributes to IUGR to preeclampsia patients. Assessing birth weight of children from preeclampsia.