IUGR: The past, the present, the future

To know the past can make more complete the understanding of the present and facilitate the possible future. Intrauterine growth restriction represent also today an impotrtant issue in perinatal medicine.In fact this clionical condition is present in about 8% of the pregnancies and is the second cause of perinatal mortality and morbidity only second to prematurity. The two conditions are often associated. The relationshipè between birthweight espresse as percentile for gestational age and neonatal mortality and morbidity has been first documented more that 40 years ago by Lubchenko and others interoducing the concept of newborns Small for Gestational Age (SGA). This occurrence has been attibuted to defective fetal growth and the term Intrauterine retardation (IUGR) was introduced. For a long rtime SGA and IUGR became synonimous as the only possibilità to assess the fetal growth waas offered by checking the final result: the birthweight.
After the introduction in clinical practice of the ultrasonic fetal biometry it became possible to evaluate the fetal size aestimating also the fetal weight but more important to monitor the characteristic of the growth by serial mesurement. It became soon evident that the birthweight was not reflecting always the fetal growth.In fact in it possible to observe SGA newborns not growth retarded and others presenting BW over the 10th percentile that habe sufered of growth resrtiction in utero. By using BW or fetal aestimated weight the size of the clnical problem can be over- or under-aestimate. The term “retardation” has been substituted by “restriction” and today the definition of IOUGR should be that of a fetus that presents a growth inferior to the individialized expectation. Surprinsigly still now looking at the medical lietrature it is possible to find 30 different definitons of IUGR. It is evident that umniform and objective definition must be adepte

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