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Fetal growth restriction is the second leading cause of perinatal morbidity and mortality, followed only by prematurity.12 The incidence of intrauterine growth restriction (IUGR) is estimated to be approximately 5 percent in the general obstetric population.3 However, the incidence varies depending on the population under examination (including its geographic location) and the standard growth curves used as reference.4 In assessing perinatal outcome by weight, infants who weigh less than 2,500 g (5 lb, 8 oz) at term have a perinatal mortality rate that is five to 30 times greater than that of infants whose birth weights are at the 50th percentile.5 The mortality rate is 70 to 100 times higher in infants who weigh less than 1,500 g (3 lb, 5 oz).5 Perinatal asphyxia involving multiple organ systems is one of the most significant problems in growth-restricted infants.3Timely diagnosis and management of IUGR is one of the major achievements in contemporary obstetrics.If the growth-restricted fetus is identified and appropriate management instituted, perinatal mortality can be reduced,6IUGR is the pathologic counterpart of small-for-gestational-age.

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The fetus is thought to have an inherent growth potential that, under normal circumstances, yields a healthy newborn of appropriate size.

The maternal-placental-fetal units act in harmony to provide the needs of the fetus while supporting the physiologic changes of the mother.

Early ultrasound examination, ideally at eight to 13 weeks of gestation, is more accurate for estimating gestational age than ultrasound assessment later in pregnancy.

Although ultrasound assessment is used later in pregnancy to estimate fetal weight, ultrasound dating is only accurate to about three weeks when it is performed at term.

Certain pregnancies are at high risk for growth restriction, although a substantial percentage of cases occur in the general obstetric population.

Accurate dating early in pregnancy is essential for a diagnosis of IUGR.A lag in fundal height of 4 cm or more suggests IUGR.Serial ultrasonograms are important for monitoring growth restriction, and management must be individualized.Growth percentiles for fetal weight versus gestational age are shown in Accurate dating in early pregnancy is essential for making the diagnosis of IUGR.The usual qualifier for reliable dating and establishment of an accurate gestational age is a certain date for the last menstrual period in a woman with regular cycles or assessment of gestational age by an ultrasound examination performed no later than the 20th gestational week, when the margin of error is seven to 10 days.Although both parents' genes affect childhood growth and final adult size, maternal genes mainly influence birth weight.3Unfortunately, it can be concluded that a fetus is constitutionally small only after a pathologic process has been excluded, which requires examination of the newborn.

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