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Fetal hypotrophy

03.05.2023

3 min. Reading time

During the ultrasound examination, the estimated weight of the baby is determined, among other things. This allows the gynaecologist to assess whether the foetus is growing properly for the given gestational age. If growth is restricted, hypotrophy is present. Find out what the difference is between early and late hypotrophy and how you should proceed with such a diagnosis.

Hypotrophy – what is it?

During an ultrasound examination, the gynaecologist assesses the growth of the foetus, among other things. He or she relates the estimated weight of the baby to the appropriate percentile grid for the respective gestational age. If the weight is below the 10th percentile, fetal hypotrophy is diagnosed. This means that the baby is too small compared to other babies of the same gestational week.

The abbreviations used to describe hypotrophy are SGA and FGR. These are abbreviations for “small for gestational age” and “fetal growth restriction”. SGA refers to a fetus that is small but without pregnancy complications or disease. This is usually associated with genetic conditions, i.e. the parents are also underweight. FGR, on the other hand, is a growth restriction associated with higher perinatal risk and often associated with pregnancy complications, e.g. poor blood flow.

Hypotrophy used to be divided into symmetrical and asymmetrical hypotrophy. This division has now been abandoned in favour of early-onset and late-onset growth restriction. The cut-off is at a gestational age of 32 weeks.

Hypotrophy – Treatment

Pregnant patients diagnosed with hypotrophy require more frequent visits to the gynaecologist, usually every 2 weeks, to monitor the well-being of the foetus. In addition, an ECG scan with STV (short term variability) assessment is performed. Pregnant women can also be cared for in special fetal hypotrophy clinics attached to maternity hospitals. More frequent monitoring is necessary to detect possible complications, e.g. in the form of abnormal blood flow, in time to terminate the pregnancy earlier. Induction of labour in fetal hypotrophy usually occurs after 37.Pregnant patients diagnosed with hypotrophy require more frequent visits to the gynaecologist, usually every 2 weeks, to monitor the well-being of the foetus. In addition, an ECG scan with STV (short term variability) assessment is performed. Pregnant women can also be cared for in special fetal hypotrophy clinics attached to maternity hospitals. More frequent monitoring is necessary to detect possible complications, e.g. in the form of abnormal blood flow, in time to terminate the pregnancy earlier. Induction of labour in fetal hypotrophy usually occurs after the 37th week of pregnancy.

If fetal growth restriction is detected, additional diagnostics can be performed in the Department of Pregnancy Pathology, including for TORCH disorders that can cause hypotrophy. Some patients are also offered diagnostic amniocentesis.

 

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Hypotrophy – Effects

A common complication of pregnancy with fetal hypotrophy is hypoxia and centralisation of the fetal circulation, which requires a more rapid termination of the pregnancy. Signs that the baby is at risk can also be seen, for example, in the KTG recording as tachycardia (acceleration of heart rate) or decreased short-term variability.  Hypotrophy also increases the risk of premature birth and its complications. If the cause of growth restriction was TORCH infectious disease, the newborn may have other symptoms caused by the infection. After birth, babies with hypotrophy are more likely to have low blood sugar or suffer from respiratory distress. However, it is important that the newborn is constantly cared for by a specialist if a growth disorder is detected.

 

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