الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 82 |  |  |
| | | from | 82 | | |
Abstract
IUGR is defined as a pathological decrease in the rate of fetal growth below 10th percentile for age. IUGR ranks third after prematurity and malformations as cause of perinatal deaths. It affects up to 10% of pregnancies
IUGR types are symmetrical, asymmetrical or mixed.
Causes of IUGR are maternal, fetal, metabolic, placental and genetic causes. It’s most common etiology is utero-placental dysfunction. Maternal factors such as age of the mother, inter-pregnancy interval (less than 6 months or 120 months or more), and maternal infection affect the growth of the fetus and are responsible for causing IUGR. Fetal factors as fetal congenital infections and genetic syndromes or fetal anomalies.
To diagnose IUGR it is important to estimate gestational age accurately. Although this is usually calculated from the last menstrual period, when known with certainty, the reliability of this estimate is low as timing of ovulation is variable. A first trimester ultrasound can date the pregnancy more reliably. Most accurately by Crown Rump Length (CRL) between 8 to 13 weeks (best 9 to 11 weeks).
Growth-restricted fetuses with severe impairment of umbilical artery blood flow are at increased risk of adverse outcomes such as intrauterine fetal demise (IUFD) and neonatal death, as well as increased neonatal morbidity, including hypoglycemia, hyperbilirubinemia, hypothermia and respiratory distress syndrome.
The aim of this study was to evaluate the predictive value of mid-trimester maternal serum alpha-fetoprotein and beta- Human Chorionic gonadotropin in cases at high risk of intra-uterine growth restriction (IUGR).