8. Classification Campbell and Thoms (1977) described the use of the sonographically determined head-to-abdomen circumference ratio (HC/AC) to differentiate growth-restricted fetuses. Symmetrical IUGR (type I) Asymetrical IUGR (type II) Combined type
9. Classification 1.Symmetrical growth restriction 20 % of IUGR Infants proportional decrease in all organs HC/AC ratio is normal Occurs inearly pregnancy : cellular hyperplasia Increase risk for long term neurodevelopmental dysfunction
17. Classification 2.Asymmetrical growth restriction 75 % of IUGR Infants Increase HC/AC ratio : decrease in abdominal size Brain sparing effects Occurs in late pregnancy : cellular hypertrophy Risk for perinatal hypoxia, neonatal hypoglycemia Good prognosis LOGO
21. Resultant diminished glucose transfer and hepatic storage would primarily affect cell size and not number, and fetal abdominal circumference which reflects liver size would be reduced.LOGO
22.
23. The fetal brain is normally relatively large and the liver relatively small. Accordingly, the ratio of brain weight to liver weight during the last 12 weeks, usually about 3 to 1, may be increased to 5 to 1 or more in severely growth-restricted infants.LOGO
90. associated with fetal growth restrictionNormal velocimetry pattern with an S/D ratio of <30. The diastolic velocity approaching zero reflects increased placental vascular resistance. During diastole, arterial flow is reversed (negative S/D ratio), which is an ominous sign that may precede fetal demise
