Retardo del crecimiento intrauterino (RCIU)

  • Juan Carlos Sabogal

Resumen

Se realizó una revisión bibliográfica de los últimos 10 años por medio del MED-LINE, de los tópicos más relevantes del retardo de crecimiento intrauterino. Se definen el concepto y la incidencia de acuerdo al consenso internacional. Posteriormente, se revisan los principales aspectos relacionados con la epidemiología del RCIU a la luz de la literatura actual. Se presenta de manera sucinta la fisiopatología de la entidad y su clasificación ecográfica en retardo simétrico y asimétrico. Los recientes avances en el diagnóstico del RCIU, son divididos en métodos clínicos y paraclínicos los cuales son discutidos en su eficiencia para identificar la entidad. En el aspecto imagenológico, se mencionan los parámetros ecográficos clásicos y de reciente desarrollo que la literatura refiere como útiles en el diagnóstico y se discute la información disponible referente a la aplicacion del doppler en éstos casos. Por último, se discute el manejo de los fetos ya identificados y la manera de vigilarlos y abordarlos terapéuticamente.

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Biografía del autor/a

Juan Carlos Sabogal

Instructor Asistente, Departamento de Ginecología y Obstetricia, Facultad de Medicina. Universidad Nacional de Colombia.

Citas

Arias F. Practical guide lo high risk pregnancy and delivery. Mosby Year Book, Second edition. 1993.

Creasy RK., Resnik R. Maternal-Fetal Medicine. Principles and Practice. W.B. Saunders Company, Third Edition. 1994.

Brenner WE., Edelman DA., Hendricks CH. A standart for fetal growth in the United States of America. Am. J. Obstet. Gynecol. 1976; 126: 555.

Galbraith RS.. Karchmar EJ., Piercy WM, Low JA. The clinical prediction of intrauterine growth retardation. Am. J. Obstet. Gynecol. 1979; 133: 281.

Haworth JC., Ellestad-Sayed JJ., King J et al: Fetal growth retardation in smoking mothers is not due to decreased maternal food intake. Obstet. Gynecol. 1980; 137: 719.

Keith L., MacGregor S., Friedel S et al. Substance abuse in pregnant women: Recent experience at the perinatal center for chemical dependence of Northwestern Memorial Hospital. Obstet. Gynecol. 1989; 73: 715.

Stone MI.,Salerno LJ.,Greene M., Zelson C. Narcotic Addiction In pregnancy. Am. J. Obstet. Gynecol. 1971; 109:716.

Hanson JW., Myrianthopoulos NC., Harvey MAS el al. Risks to the offspring of women treated with hydantoin anti-convulsants with emphasis on the fetal hydantoin syndrome. J. Pediatr. 1976; 89: 662.

Jones JS., Newman RB., Miller MC. Cross-sectional Analysis of triplet birth weight. Am. J. Obstet. Gynecol. 1991; 164:135.

Alford CA jr: Rubella, en Remington JS.. Klein JO ( editores ): Infectous diseases of the Fetus and Newborn Infant. Philadelphia, WB. Saunders. Co. 1976.

Thomson AM., Billewicz WZ.. Hytten FE. The assessment of fetal growth. J. Obstet. Gynaecol. Br. Commonw. 1968; 75: 906.

Peuschel SM., Rothman KJ., Ogilvy JD. Birth weight of children with Down's syndrome. Am. J. Ment. Defic. 1976; 80: 442.

Naeye RL. Unsuspected organ abnormalities associated with congenital heart disease. Am. J. Pathol. 1965; 47: 905.

Anatov AN. Children born during the siege of Leningrad in 1942. J. Pediatr. 1947; 30: 250.

Lee MML., Yeh M. Fetal microcirculation of abnormal human placenta: I. Scanning electron microscopy of placental vascular casts from small for gestational age fetuses. Am. J. Obstet. Gynecol. 1986;154: 1133.

Polín RA., Fox WW. Fetal and Neonatal Physiology. WB Saunders, 1992.

Naeye RL., Kelly JA. Judgement of fetal age. III. The pathologists' evaluation. Pediatr. Clin. North. Am. 1966; 13: 849.

Roord JJ., Ramekers LHF., Van Engelshoven JMA. Intrauterine malnutrition and skeletal retardation. Biol. Neonate. 1978; 34: 167.

Zilianli M., Fernandez S., Azuaga A., Jorges J et al. Ultrasound evaluation of the distal femoral ephiphyseal ossification center as a screening test for intrauterine growth retardation. Obstet. Gynecol. 1987;70:361.

Campbell S., Dewhurst CJ. Diagnosis of the Small-for -dates fetus by serial ultrasound cephalometry. Lancet. 1971; 2: 1002.

Low JA., Galbraigh RS. Pregnancy Characteristics of intrauterine growth retardation. Obstet. Gynecol. 1974;44: 12.

Fescina RH ., SchwarczR., Diaz AG. Vigilancia del crecimiento fetal. Publicación Científica CLAP No. 1261, 1992.

Tulchinsky D. Endocrine evaluation of IUGR. Clin. Obstet. Gynecol. 1977; 20: 969.

Spellacy WN., Usategui-Gomez M., Fernandez-Decastro A. Plasma human placental lactogen, oxytocinase, and placental phosphatase in normal and toxemic pregnancies. Am. J .Obstet. Gynecol. 1976; 127:10.

Fleisher AC., Romero R., Manning FA., Jeanty P„ James AE. The principles and practice of ultrasonography in obstetrics and gynecology . Fifth Edition. Prentice-Hall International Inc. 1996.

Callen PW. Ultrasonography in obstetrics and gynecology. Third Edition. WB Saunders. 1992.

Goldstein Y., Reece EA., Hobbins JC. Sonographic appearance of the fetal heel ossification centers and foot length measurement provide independent markers for gestational age estimation. Am. J. Obstet. Gynecol. 159/4 (923-926) 1988.

Campbell S., Thomas A. Ultrasonic measurement of the fetal head-to-abdomen circumference ratio in the assessment of growth retardation. Br. J .Obstet. Gynaecol. 1977; 84: 165.

Hadlock FP., Deter RL., Harrist RB et al. A date independent predictor of intrauterine growth retardation. Femur lenght / abdominal circumference ratio. AJR 1983; 141: 979.

Reece EA., Goldstein Y., Gianluigi G et al. Fetal cerebelar growth Unaffected by intrauterine growth retardation. A new parameter for prenatal diagnosis. Am. J. Obstet. Gynecol. 1987; 157: 632.

Bertagnoli L., Lalatta F., Gallicchio R et al. Quantitative characterization of growth of the fetal kidney. J. Clin. Ultrasound. 1983; 11: 349.

Goldstein I., Lockwood C., Hobbins JC. Ultrasound assessment of fetal intestinal development in the evaluation of gestational age. Obstet. Gynecol. 1987; 70: 682-686.

Vintzileos AM.. Lodeiro JG., Feinstein SJ etal. Value of fetal ponderal index in predicting growth retardation. Obstet. Gynecol. 1986; 67: 584.

Goldstein I., Reece EA., Hobbins JC. Sonographic appearance of the fetal heel ossification centers and foot length measurement provide independent markers for gestational age estimation. Am. J. Obstet. Gynecol. 159/4 (923-926), 1988.

Goldstein I., Lockwood C., Belanger K., Hobbins JC. Ultrasonographic assessment of gestational age with the distal femoral and proximal tibial ossification centers in the third trimester. Am. J. Obstet. Gynecol. 158/1 (127-130), 1988.

Mahony BS.. Bowie JD.,' Killiam AP et al. Epiphyseal ossification centers in the assessment of fetal maturity: Sonographic correlation with the amniocentesis lung profile. Radiology. 1986; 159: 521.

Gentili P., Trasimeni A., Giorlandino C. Fetal ossification centers as predictors of gestational age in normal and abnormal pregnancies. J. Ultrasound. Med. 1984; 3: 193-197.

Balouet P . Hamel P.. Domessent D.. Allouche D et al. Estimation du poids foetal par la mesure de la graisse des membres. Application au diagnostic de l'hypotrophie. J. Gynecol. Obstet. Biol. Reprod. Paris. 1994: 23(1): 64-68.

Erskine RLA., Ritchie J WK. Umbilical artery blood flow characteristics in normal and growth- retarded fetuses. Br. J.Obstet. Gynaecol. 1985; 92: 605-610.

MarsalK., Persson PH. Ultrasonic measurement of fetal blood velocity waveform as a secundary diagnostic test in screening for intrauterine growth retardation. J. Clin. Ultrasound. 1988; 16: 239-244.

Rochelson B., Schulman H., Farmakides G et al. The significance of absent end-diastolic velocity in umbilical artery velocity waveforms. Am. J. Obstet. Gynecol. 1987; 156: 1213-1218.

Todros T., Ferrazzi E., Arduini D., Bastonero S et al. Performance of doppler ultrasonography as a screening test in low risk pregnancies:results of a multicentric study. J. Ultrasound. Med. 1995; 14(5): 343-348.

Alfirevic Z., Neilson JP. Doppler ultrasonography in high-risk pregnancies: Systematic review with meta-analysis. Am. J. Obstet. Gynecol. 1995;172: 1379-1387.

Kurjak A., Kupesic S., Zudenigo D. Doppler ultrasound in all three trimesters of pregnancy. Curr. Opin. Obstet. Gynecol. 1994; 6(5): 472-478.

Arbeille P., Maulik D., Stree JL., Fignon A et al. Fetal cerebral and renal Doppler in small for gestational age fetuses in hipertensive pregnancies. Eur. J. Obstet. Gynecol. Reprod. Biol. 1994; 56(2): 111-116.

Torres PJ.,Gratacos E., Alonso PL. Umbilical artery doppler ultrasound predicts low birth weight and fetal death in hypertensive pregnancies. Acta Obstet. Gynecol. Scand. 1995; May:4/5: 352-355.

Craigo SD. The role of ultrasound in the diagnosis and management of intrauterine growth retardation. Semin. Perinatol. 1994; 18(4): 292-304.

Lefevre ML., Bain RP., Ewigman BG., Frigoletto FD et al. A randomized trial of prenatal ultrasonographic screening: impact on maternal management and outcome. RADIUS study group. Am. J. Obstet. Gynecol. 1993; 169(3): 483-489.

Nicolaides KH., Rodeck CH., Soothill PW., Campbell S. Ultrasound-guided sampling of umbilical cord and placental blood to assess fetal wellbeing. Lancet. 1986; 1: 1065.

Klein JO., Remington JS. Infectous diseases of the fetus and newborn infant. 3rd de. Philadelphia, WB. Saunders. Co., 1990, Chapter 1.

De Voe LD., Castillo RA., Sherline DM. The nonstress test as a diagnostic test: A critical reappraisal. Am. J. Obstet. Gynecol. 1985;152: 1047-1053.

Smith CV., Phelan .JP., Platt LD. et al: Fetal acoustic stimulation testing:II. A randomized clinical comparison with the nonstress test. Am. J. Obstet. Gynecol. 1986;155:131-134.

Thacker SB., Berkelman RL. Assessing the accuracy and efficacy of selected antepartum fetal surveillance techniques. Obstet. Gynecol. Surv. 1986; 41: 121-141.

Vintzileos AM., Campbell WA., Ingardia CJ et al. The biophysical profile and its predictive value. Obstet. Gynecol. 1983; 62: 271.

Vintzileos AM., Campbell WA., Nochimson WJ., Weinbaum PJ. The use and misuse of the fetal biophysical profile. Am. J. Obstet. Gynecol. 1.987; 156: 527-533.

Philipson EH., Sokol R.J., Williams MA. Oligohydramnios: Clinical associations and predictive value for intrauterine growth retardation. Am. J. Obstet. Gynecol. 1983; 146: 271.

Physical Status. The use and interpretation of anthropometry. Report of a WHO expert committee. Technical Report Series No. 854. Geneva: World Health Organization, 1995.

Hadlock FP., Harrist RB., Sharman RS et al. Estimation of fetal weight with the use of head, body and femur measurements. A Prospective Study. Am. J. Obstet. Gynecol. 1985; 151: 333.

Hadlock FP., Deter RL.,Harrist RB. Sonographic detection of abnormal fetal growth patterns. Clin. Obstet. Gynecol. 1984; 27: 342.

Nicolini U., Nicolaidis P., Fisk NM et al. Limited role of fetal blood sampling in prediction of outcome in intrauterine growth retardation. Lancet. 1990; 336: 768-772.

Cunningham FG., MacDonald PC., Leveno KL, Gant NF et al. Williams Obstetrics. 19th Edition. Appleton & Lange 1993.

Nicolaides KH, Bradley RJ, Soothill PW et al. Maternal oxygen therapy for intrauterine growth retardation. Lancet 1987; 942.

Uzan S., Beaufils S., Breart G et al. Prevention of fetal growth retardation with low-dose aspirine: Findings of the EPREDA trial. Lancet. 1991; 337:1427.

McParland P., Pearce JM., Chamberlain GVP. Doppler ultrasound and aspirine in recognition and prevention of pregnancy induced hypertension. Lancet. 1990;335: 1552.

Gülmezoglu M., de Onis M., Villar J. Effectiveness of interventions to prevent or treat impaired fetal growth. Obstet. Gynecol. Survey-1997; 52(2): 139-149.

Brook CGD. Consequences of intrauterine growth retardation. BMJ 1983; 286: 164.

Blair E., Stanley F. Intrauterine growth and spastic cerebral palsy. I. Association with birth weight for gestational age. Am. J. Obstet. Gynecol. 1990; 162: 229.

Blair E., Stanley F. Intrauterine growth and spastic cerebral palsy. II. The association with morphology at birth. Early Human Dev 1992; 28: 91.

Bakketeig LS., Bjerkedal T., Hoffman HJ. Small-for-gestational age births in successive pregnancy outcomes: Results of a longitudinal study of births in Norway. Early Human. Dev. 1986; 14: 187.

Patterson RM., Gibbs CE., Wood RC. Birthweight percentile and perinatal outcome: Recurrence of intrauterine growth retardation. Obstet. Gynecol. 1986; 68: 464.

Publicado
1997-06-28
Cómo citar
1.
Sabogal JC. Retardo del crecimiento intrauterino (RCIU). Rev. Colomb. Obstet. Ginecol. [Internet]. 28 de junio de 1997 [citado 17 de octubre de 2019];48(2):107-13. Disponible en: https://revista.fecolsog.org/index.php/rcog/article/view/1146