Trophoblast and Intrauterine Fetal Growth Restriction

Normal fetal growth depends on genetically predetermined growth potential and is modulated by fetal, placental, maternal and external factors. Fetal growth restriction refers to a fetus that has failed to achieve its growth potential and affects up to 5-10% of all pregnancies. Fetal growth restriction is associated with an increase in perinatal mortality and morbidity because of a high incidence of intrauterine fetal demise, intrapartum fetal morbidity and operative deliveries. In a preterm fetus affected by intrauterine fetal growth restriction (IUGR) which occurs before 34 weeks of gestation, iatrogenic prematurity is a pertinent issue. IUGR fetuses suffer from respiratory difficulties, polycythemia, hypoglycemia, intraventricular hemorrhage and hypothermia. In the long term cerebral palsy, developmental delay and behavioral dysfunction can occur. Although there are many underlying etiologies, IUGR resulting from placental insufficiency is the most relevant clinically because its outcome could be altered by appropriate diagnosis and timely delivery.