Fetal Growth Restriction (FGR / IUGR)

FGR (the current term; IUGR is older) describes a fetus that has not reached its growth potential. Causes include placental insufficiency, maternal conditions (hypertension, autoimmune disease), infection, and fetal factors. Management centers on identifying the cause when possible, serial growth scans, umbilical artery Doppler studies, antenatal testing, and timing delivery to balance prematurity against continued in-utero risk.

Each link opens the full review on the publisher's site in a new tab.

• SMFM Consult Series #52: Diagnosis and management of fetal growth restriction↗SMFM
• TRUFFLE Trial↗The Lancet

• ·Detection lets you and your team plan monitoring and delivery timingReview sources ↓
• ·Steroids for lung maturation if delivery before 34 weeks is likelyReview sources ↓

• ·Stillbirth, preterm birth, cesarean for non-reassuring fetal statusReview sources ↓
• ·Neonatal complications including hypoglycemia, hypothermia, feeding difficultyReview sources ↓

• ·Serial growth scans every 3–4 weeks; Doppler studies as clinically indicatedReview sources ↓
• ·Antenatal testing (NSTs, BPPs) usually starting at 32 weeks or diagnosis if laterReview sources ↓
• ·Individualized timing of delivery (typically 36–39 weeks depending on severity and Doppler)Review sources ↓

SMFM Consult Series #52 (2020) provides current management guidance; the TRUFFLE trial (2015) informs timing decisions based on Doppler and CTG findings.

For most topics, guidelines from ACOG, WHO, and other major bodies broadly agree on the core safety points (when to act in an emergency, informed-consent standards, monitoring baselines). Where reasonable people — and even guidelines — differ tends to be around thresholds (when to start or stop something), preferences (comfort, environment, support), and values (how you weigh small risks against benefits). Use the questions below to explore those pieces with your care team.

Educational only. Your care team can help you weigh what applies to your specific situation.

• Oligohydramnios (Too Little Amniotic Fluid)Less amniotic fluid than expected. Meaning depends heavily on gestational age and whether membranes have ruptured.
• High Blood Pressure in PregnancyElevated blood pressure that existed before pregnancy (chronic), appeared after 20 weeks without other findings (gestational), or is part of preeclampsia.
• Preeclampsia (High Blood Pressure + Protein in Urine)A pregnancy-related condition where blood pressure rises after 20 weeks, often with protein in the urine or other signs of organ strain.
• The NICU — What to Expect and How to Be InvolvedA parent-friendly orientation to the NICU: levels of care, common reasons for admission, the equipment and team, how to be involved, discharge criteria, and support.

A short BRAIN-style set you can bring to any conversation about interventions, monitoring, or care decisions.

• ?Why are you recommending this now — is it urgent, routine, or optional?
• ?What happens if we wait an hour (or longer) before deciding?
• ?What signs would tell us this is working — or that we need to change course?
• ?What are the alternatives, including doing nothing?
• ?What would you recommend if this were your family?
• ?What would change your recommendation?

Tap a source to open the original guideline or review in a new tab.

• ·SMFM Consult Series #52: Diagnosis and management of fetal growth restriction↗ — SMFM
• ·TRUFFLE Trial↗ — The Lancet

Plain-language paraphrase. Re-verify before publish.

Last reviewed: 2026-07-03

• v1.0.0 · 2026-07-03 · LlaMamma editors

  Initial FGR/IUGR topic.

New guidance from ACOG, WHO, Evidence Based Birth, or other listed sources is recorded here and can be updated remotely without a new app release.