Monitoring the IUGR fetus

Intrauterine growth restriction(IUGR) according to the present definition is encountered in abou 15 % of the pregnancies.lt can be associated to many fetal or adnexai abnormal conditions but the most frequent and dangerous complication is represented hy foetal hypoxaemia observable in 30-35 % of the cases. This is the principal cause of fetal demişe and /or neonatal morbidity and mortality. As a conseqence in order to improve the clinical outeome an objeetive monitoring of the fetal oxygenation is crucial particularly for assessing the timing of the deliveıy. in case of hypoxaemia the fetus adapts to this condition by altering the vital funetions. Blood flow redistribution first oecurs ancl the cardiac funetions tire also altered. Doppler technology allows to obsei"ve haemodynamic changes and cardiotochography (CTG) depicts. if assistecl by computer evaluation,even subtle changes in heart activity particularly the variability of the heart rate.
By investigating with Doppler umbilical arteries and fetal aorta and studying the fetal heart rate variability it is possible to assess with good accuracy the presence or absence of hypoxaemia and the risk to develop acidemia therefore modulating the characteristics of the control and of the management improving the perinatal outcome.