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Dr.Ambrose Igwe Daniel, Jaba, Kano (2025)

03/12/2025

TREATMENTS FOR FETAL GROWTH RESTRICTION.

There's no establish treatment protocol for fetal growth restriction.

The ultimate goal therefore, in the management of fetal growth restriction is to deliver the most mature fetus in the best clinical state, while preserving the health and life of the mother.

The management for fetal growth restriction primarily involves more diligent fetal monitoring.

This closer monitoring is achieved by way of more frequent checks using ultrasound scanning and several blood tests.

The goal of monitoring is to catch the onset of any complications early and abort them, and to manage any underlying health conditions adequately.

EARLY DELIVERY is usually the option if the fetus is at risk or is observed to have stopped developing, or if the pregnancy poses significant health risks to the mother.

The processes of Labor and delivery are initiated before 37weeks of pregnancy using medications. It's called induction of labor.

In many cases, a Cesarean Section is recommended because the already fragile, growth restricted baby may not survive the hassles of the birth canal (va**nal delivery).

If early delivery is the plan, your doctor may also recommend CORTICOSTEROID injections to help your baby's lungs mature faster.

AFTER BIRTH, growth restricted babies usually catch up. Most babies will eventually attain the size of children who were born at term around age 3.

📍Do not attempt to overfeed your baby because you want to make up for their growth restriction.

If you do, you may be putting your baby at increased risk of developing other problems like obesity, diabetes, and heart disease later in their lives.

If you have any problems persisting after the birth of your baby, see your pediatrician.

More on Fetal Growth Restriction tomorrow.
Stay tuned...

❤️

01/12/2025

DIAGNOSIS OF FETAL GROWTH RESTRICTION- 2

We said in previous posts that fetal growth restriction is the case if your baby's growth rate is less than the expected as per age of your pregnancy.

The most vital parameter for accurate diagnosis is your baby's Gestational age (age in the womb).

Fundal height (length between your p***c bone- a bone in front of your bladder, and the topmost part of your baby bump), and maternal weight, are also relevant for further evaluation of fetal growth restriction. See previous posts on this page for details.

Other tools important for confirming the diagnosis of fetal growth restriction include:

ULTRASOUND SCAN.

The ultrasound scan is an indispensable tool in the diagnosis of fetal growth restriction.

During a scan of your fetus, the doctor will take measurements of various areas and body parts of your fetus and with those calculate an estimate of the size and weight of your baby.

With a doppler ultrasound scan your doctor can also visualize blood flow through the placenta and umbilical cord. Diminished flow of blood through the cord and placenta may indicate the cause of fetal growth restriction.

The doppler ultrasound is also useful for visualizing blood flow through the baby's brain. Abnormalities in brain blood flow have been linked with cases of fetal growth restriction in recent studies.

Your doctor or sonogrpher can also measure your amniotic fluid volume (the fluid in which your baby is swimming) with the ultrasound scan. Amniotic fluid volume is often reduced in fetal growth restriction.

The ultrasound scan also checks your baby's heart rate for abnormalities.

AMNIOCENTESIS.

Amniocentesis refers to a procedure during which a small amount of amniotic fluid is taken from your womb.

This sample of amniotic fluid contains cells from your baby and can be used to test for Chromosomal or genetic abnormalities, which are a frequent cause of fetal growth restriction.

Tomorrow, we shall talk about how fetal growth restriction is managed.

Stay tuned...

❤️

28/11/2025

DIAGNOSIS OF FETAL GROWTH RESTRICTION

The diagnosis of fetal growth restriction depends on the accuracy of your baby's gestational age (womb age).

Gestational age is best determined using the date of your last menstrual period. The calculation is made from the first day of your last menstruation.

It is therefore important to monitor your menstrual cycles, and to diligently take note of the start dates of your monthly periods.

An estimate of your baby's gestational age can also be determined using an ultrasound scan.

Figures for gestational age from an ultrasound scan are usually the most accurate if the scan is done early in the pregnancy, especially within the first trimester (the first 12 weeks) of pregnancy.

Other useful parameters in the diagnosis of fetal growth restriction include-

FUNDAL HEIGHT.

Fundal height refers to the size of your "baby bump."

With a measuring tape, your doctor will try to get the distance from your public bone, just below your bladder to the topmost part of your bump.

This gives a rough estimate of the length of your uterus (womb), and also an estimate of the height of your baby.

This measurement is taken in centimeters and should tally with your baby's gestational age from after 20 weeks.

For instance, if your baby's gestational age is 30 weeks, the fundal height measurement should be around 30 centimeters (30 cm).

Fetal growth restriction is suspected if the fundal height is up to 4cm less than your baby's gestational age.

WEIGHT.

During your routine prenatal/antenatal visits, your Healthcare providers will measure your weight.

If you are not gaining weight appropriately during pregnancy, your baby is also likely not gaining weight and may be small for age.

What is considered normal weight gain during pregnancy depends on your pre-pregnancy weight or body mass index (BMI).

Women with BMI within the normal range (18.5 - 24.9) before pregnancy are expected to gain a total of 11.5 - 16 kg, or 25 - 35 pounds throughout their pregnancy.

The values are higher for women who were underweight before pregnancy, and lower for women who were overweight or obese before pregnancy.

We shall discuss more useful parameters for the diagnosis of Fetal Growth Restriction in our next post.

Stay tuned...

❤️

27/11/2025

SYMPTOMS OF FETAL GROWTH RESTRICTION.

There are generally no physical symptoms that indicate your baby is small for age.

Some women may notice that their baby bump is not as big as it should be as per the age of their pregnancy.

However, only your doctor can determine the estimated size and weight of your baby in the womb, and make a diagnosis of Fetal Growth Restriction.

DIAGNOSIS OF FETAL GROWTH RESTRICTION

The diagnosis of fetal growth restriction depends on the accuracy of your baby's gestational age (womb age).

Gestational age is best determined using the date of your last menstrual period. The calculation is made from the first day of your last menstruation.

It is therefore important to monitor your menstrual cycles, and to diligently take note of the start dates of your monthly periods.

An estimate of your baby's gestational age can also be determined using an ultrasound scan.

Figures for gestational age from an ultrasound scan are usually the most accurate if the scan is done early in the pregnancy, especially within the first trimester (the first 12 weeks) of pregnancy.

Other useful parameters in the diagnosis of fetal growth restriction include-

FUNDAL HEIGHT.
Fundal height is a measure of the size of your "baby bump."

With a measuring tape, your doctor will try to get the distance from your public bone, just below your bladder to the topmost part of your bump.

This gives an estimate of the length of your uterus (womb), and also a rough estimate of the height of your baby.

This measurement is taken in centimeters and should tally with your baby's gestational age from after 20 weeks.

For instance, if your baby's gestational age is 30 weeks, the fundal height measurement should be around 30 centimeters (30 cm).

Fetal growth restriction is suspected if the fundal height is up to 4cm less than your baby's gestational age. So, in this example, fetal growth restriction would be the suspicion if fundal height is 26cm or less.

More on Fetal Growth Restriction tomorrow.
Stay tuned...

❤️

26/11/2025

CAUSES OF FETAL GROWTH RESTRICTION (FGR).

In previous posts on this subject, we defined fetal growth restriction as a fetal growth rate that is less than what is generally expected for that age of pregnancy.

The causes of fetal growth restriction could be
~Maternal (from the mother),
~Placental (due to problems with the placenta), or
~Fetal (from the baby)

MATERNAL CAUSES OF FETAL GROWTH RESTRICTION (FGR).

🔸️You have Chronic hypertension.
This means that you've been hypertensive even before you got pregnant. And your blood pressure has not been under good control.

🔸️You have pregnancy-induced hypertension.
It means that your high blood pressure began during the pregnancy.

🔸️Heart diseases, especially the kind that reduces oxygen supply to other parts of your body.

🔸️Anemia in pregnancy.
🔸️Diabetes.
🔸️Kidney disease.
🔸️Autoimmune diseases.
Your body is fighting itself.

🔸️Hemoglobinopathies.
Blood related diseases like sickle cell anemia, thrombophilias, and others.
🔸️Smoking, Alcohol consumption, and other substance abuse.
🔸️Protein-calorie malnutrition.
You're protein malnourished. Means you've not been eating enough proteins in your diet.
🔸️You have an abnormal womb structure.
🔸️You live at high altitudes.
It means you live in a place that is on a mountain.
The problem with mountain regions is that atmospheric oxygen levels are lower as you go higher.

🔸️Infections like rubella, Syphilis, cytomegalovirus, or Toxoplasmosis.
🔸️You're having multiple gestation.
It means you're pregnant with more than one (twins, triplets, or more)
🔸️You've had a previous baby with fetal growth restriction.

PLACENTAL OR UMBILICAL CORD CAUSES OF FGR.

🔹️Twin to twin transfusion syndrome.
Among the twins in your womb, one is getting more blood that the other. So the one getting less blood is much smaller.
🔹️Abnormalities of the placenta.
🔹️Placental abruption.
The placenta is pulling away from the wall of your womb, so it's not delivering sufficient blood to your baby.
🔹️Placenta previa.
The placenta is overlying the cervix and causing bleeding during pregnancy.
🔹️Problems with the umbilical cord.

FETAL CAUSES OF FGR.

▪️Genetic abnormalities, or errors.
▪️Congenital malformations.

Any condition that limits nutrient and oxygen supply to your baby is likely to cause fetal growth restriction.

More on Fetal Growth Restriction.
Stay tuned...

❤️

25/11/2025

TYPES OF FETAL GROWTH RESTRICTION.

The hallmark of Fetal Growth Restriction (FGR) which we introduced yesterday is that the fetus (baby) is not growing at the normal rate in your womb as determined by its genetic composition.

This means that not every small for age baby has a problem. Your Health care provider must probe deeper to find a cause if there's any.

There are two main types of fetal growth restriction (FGR)-
~Symmetrical, and
~Asymmetrical.

SYMMETRICAL (FGR).

This is also called Primary Fetal Growth Restriction.

When fetal growth restriction is symmetrical, all the parts of the fetus' body are proportionally small or equally small.

In this case, no part of the baby's body is bigger than the other. 30% of fetal growth restrictions are in this category.

Symmetrical or primary fetal growth restriction occurs much earlier in pregnancy, and is often caused by genetic abnormalities, or infections passing from the mother to the fetus during pregnancy.

Cellular differentiation is usually at its lowest. Therefore the fetus has a reduced number of cells.

ASYMMETRICAL (FGR).

Also called Secondary fetal growth restriction.

Fetuses or babies with Asymmetrical growth restriction have normal sized head and brains, but small abdomen and limbs.

Most other parts of the baby's body are disproportionately small for age, except the head and brains. This is the case in about 80% of babies with fetal growth restriction.

Unlike Symmetrical (FGR), Asymmetrical or Secondary fetal growth restriction occurs much later during the pregnancy.

Common causes of Secondary fetal growth restriction are mostly Placental problems like-

●Placenta abruption (the placenta is detaching itself from the wall of your womb, causing insufficient delivery of oxygen to the fetus),

●Placenta previa (the placenta overlies the cervix and casues bleeding during pregnancy),

●Placental insufficiency (the placenta doesnt grow well and hence is not able to deliver blood and nutrients adequately to the fetus).

Here the baby may have normal cell differentiation and number, but the body will be small, especially the abdomen.

More on Fetal Growth Restriction.
Stay tuned...

❤️

24/11/2025

FETAL GROWTH RESTRICTION.

Fetal growth restriction refers to an estimated fetal weight that falls below the 10th percentile for its gestational age (age of the baby in the womb).

It is also called Intrauterine Growth Restriction (IUGR).

It means that your baby's weight, as estimated by your doctor, is less than 90% of what it is expected to be as per the age of the pregnancy.

In other words, fetal growth restriction means that your baby in the womb weighs less than 90 babies out of 100 babies of the same age.

This is an indication that your baby is not growing at the expected rate inside your womb.

Several factors determine the rate at which a baby grows, one of which is genetic make up. Therefore a smaller weight does not always mean that there is a problem with your baby.

Just like being short or smaller does not mean a person is unhealthy or has a challenge with their health.

However, a diagnosis of fetal growth restriction calls for a closer look, or a search to rule out possible causes (like underlying diseases or health problems with the mother), and for closer fetal monitoring.

In the days ahead we shall look into all the details, including Types, Causes, Symptoms, Treatments, and Prevention of Fetal/ Intrauterine Growth Restriction.

Stay tuned...

❤️

21/11/2025

BLIGHTED O**M vs MOLAR PREGNANCY.

SIMILARITIES.

🔸️They're both abnormal pregnancies that will not progress.

🔸️Both essentially result from chromosomal abnormalities (genetic errors that occur during replication or multiplication of the cells.)

🔸️They're often discovered and diagnosed during the first trimester (first 12 weeks or 3 months) of pregnancy.

🔸️Both may present symptoms of abdominal pain, cramps, or va**nal bleeding.
Many women in both cases don't have any symptoms. The discovery is made incidentally during a routine ultrasound scan.

🔸️A blood pregnancy test is positive in both, but Human Chorionic Gonadotropin (hCG) levels may vary when measured.

🔸️In both cases, the diagnosis is confirmed by ultrasound scans.

🔸️They both end in a miscarriage.

🔸️In both cases, treatment requires removal of the pregnancy if a miscarriage does not occur spontaneously. This is done either by use of medications, or a surgical procedure

KEY DIFFERENCES

🔹️Molar pregnancy is the abnormal or overgrowth of placental tissue, with or without an embryo.

In a Molar pregnancy, there's an abnormality of placental growth, which increases the risk of cancer development.

In a blighted o**m, the placenta and sac are normal. There's no overgrowth, there's just no embryo (baby). The yolk sac is empty.

🔹️A molar pregnancy results from genetic errors during fertilization that lead to either absent maternal chromosomes, or extra copies of paternal chromosomes.

A blighted o**m results from genetic errors that prevent the fertilized egg from developing into an embryo (baby), despite the normal growth of placenta and yolk sac.

🔹️A molar pregnancy is seen in an ultrasound scan as multiple collections of fluid called cysts, looking like a bunch of grapes 🍇.
There may or may not be a developing embryo.

A blighted o**m on the other hand is seen as an empty yolk sac, looking like a "black hole" on ultrasound scan.

The "black hole" indicates that the place where the baby should be visible is empty.

🔹️A molar pregnancy is marked by abnormally high levels of the pregnancy hormone (human chorionic gonadotropin-hCG).

In a blighted o**m, pregnancy hormone levels begin to decline from normal at some point.

More on Your Health in PREGNANCY🤰
Stay tuned...

❤️

20/11/2025

TREATMENTS FOR A BLIGHTED O**M.

In many cases of a blighted o**m treatment may not be required, because a miscarriage occurs spontaneously as soon as the body senses there's no embryo (baby) in the yolk sac.

In some cases however, the body may need some help to remove the contents of the uterus (the placenta and empty yolk sac).

This can be achieved in several ways-

🔹️Natural.
After making a diagnosis of a blighted o**m, and depending on certain circumstances, your doctor may give you the option of waiting to see if your body will pass out the pregnancy through a natural spontaneous miscarriage.

This may take days or weeks of waiting.
Some of the symptoms of a miscarriage include-
~Lower abdominal pain, like period pain.
~Cramping (pain that waxes and wanes).
~Vaginal bleeding.

🔹️Medications.
Medications that help your womb contract to expel its contents are also often used.

The most commonly used medication for this purpose is Misoprostol, sometimes with another drug called Mifepristone.

These medications essentially help your body to initiate a miscarriage.

You may begin to experience symptoms of a miscarriage within 30 minutes - 10 hours after taking the medication.

🔹️Surgery.
This usually involves a procedure called DILATION and CURETTAGE (D&C).

During this procedure, your doctor will manually open your cervix (entrance to your womb), and with the aid of certain medical instruments, scrape and suction out the contents of your womb (products of conception).

This will be done while you're sedated or under general anesthesia.

📍Follow up visits will be required around 4-6 weeks after a miscarriage or D&C, during which your doctor may recommend a repeat ultrasound scan to confirm that your womb is now empty.

The visits are also important to check for infections and other complications of the procedure.

COMPLICATIONS.

Complications, though very rare, still do occur following a blighted o**m, and most commonly on account of a D&C.

They include-
🔻Scarring of your cervix or uterus from a D&C procedure.
🔻Uterine tears or puncture (injuries to your womb or cervix) following a D&C procedure.
🔻Excessive bleeding.
🔻Infection.

More on Your Health in PREGNANCY🤰
Stay tuned...

❤️

19/11/2025

HOW A BLIGHTED O**M IS DIAGNOSED.

Like we've explained in previous posts on the subject, a blighted o**m summerily refers to an empty pregnancy.

Your pregnancy test result is positive.
The ultrasound scan shows the placenta and yolk sac (an early sac of yolk containing nutrients for the baby's nourishment before the placenta is fully formed), but there's no baby.

The yolk sac is empty.

The primary method of diagnosing a blighted o**m is by a TRANSVAGINAL ULTRASOUND.

Diagnosed usually between seven and nine weeks of pregnancy. This is when the newly developing baby should be clearly visible on ultrasound.

During the test, your doctor will put a long probe into your va**na, and from there scan through your uterus (womb).

A blighted o**m will appear like an empty, black hole on the scan (see the picture on this post). The "black hole" is a fluid filled yolk sac without an embryo.

In a normal pregnancy, you will find a strand of tissue (the embryo) dangling freely from its attachment to the placenta inside the sac (the black hole).

✔️Your doctor may also want to check your pregnancy hormone levels (that's your human chorionic gonadotropin- hCG levels).

Series of this test may be done to check for rapidly rising levels of your pregnancy hormone (hCG), which is usually the case in early pregnancy.

This rapid rise of hCG continues until the 8th to 10th week of gestation. If hCG levels are not rising fast or is low, that may indicate an abnormal pregnancy (like a blighted o**m) or an ongoing miscarriage.

Several days of hCG testing is usually required for proper evaluation and diagnosis of a blighted o**m.

More on Your Health in PREGNANCY🤰
Stay tuned...

❤️

18/11/2025

CAUSES, RISKS, AND SYMPTOMS OF A BLIGHTED O**M.

Lots of research is still ongoing on what the causes of Anembryonic pregnancies might be.

However, the commonest known cause is chromosomal abnormalities or genetic problems occuring at the time of fertilization of the egg, or shortly after.

These genetic errors are sometimes due to poor s***m or egg quality (chromosomal problems in the s***m or egg). They can also occur randomly during fertilization.

Right after fertilization (the joining of s***m and egg), the fertilized egg cell begins to divide or multiply into news cells. These news cells grow together into an embryo (the earliest form of your baby).

In a blighted o**m, the embryo never forms or stops growing right after it is formed.

📍Some Risk factors for a blighted o**m include-

● A history of miscarriage.
Women who have had a miscarriage, especially if the cause was not known, are more likely to have a blighted o**m.

● Age older than 35 years and pregnant.
The risk of chromosomal problems in the egg increase as a woman grows older.

● You have a poorly managed health condition or infection.
If you have other health challenges, especially pelvic infections, ensure they're adequately treated.

SYMPTOMS.

A blighted o**m generally occurs very early in the pregnancy.

It is often discovered when women go for evaluation on account of suspicion of pregnancy following a missed period or having early symptoms of pregnancy.

Many women don't even know until a miscarriage occurs with symptoms of-
~Vaginal bleeding.
~Abdominal pain or cramps.

The only way to confirm a blighted o**m is by an ultrasound scan, which reveals an empty gestational sac (an early sac of yolk containing nutrients for the baby's nourishment before the placenta is fully formed).

More on Your Health in PREGNANCY🤰
Stay tuned...

❤️

Dr.Ambrose Igwe Daniel

03/12/2025

01/12/2025

28/11/2025

27/11/2025

26/11/2025

25/11/2025

24/11/2025

21/11/2025

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18/11/2025

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