MCQ – 99040

Which one of the following statements regarding intrauterine growth restriction is NOT correct?

A.	Defined according to biparietal diameter
B.	Doppler studies are indicated
C.	There is danger of fetal asphyxia during delivery
D.	Generally not seen in women with gestational diabetes

Show Answer

Correct Answer » A Explanation

Intrauterine Growth Restriction (IUGR), also known as Fetal Growth Restriction (FGR), refers to a fetus that fails to achieve its genetically determined growth potential.

According to current guidelines, FGR is diagnosed when:

• Estimated fetal weight (EFW) or abdominal circumference (AC) is less than the 10th percentile for gestational age.
• Doppler studies are used to assess fetal well-being and placental insufficiency.

Explanation of the Correct Answer

Option A. It is defined according to biparietal diameter (BPD) – Correct

• IUGR is not defined by biparietal diameter (BPD) alone.
• Diagnosis is based primarily on:
  • Estimated fetal weight (EFW).
  • Abdominal circumference (AC).
  • Growth velocity on serial ultrasound examinations.
• BPD is only one fetal biometric parameter and is insufficient to diagnose IUGR.

Why the Other Options are Incorrect

Option B. Doppler studies are indicated

• Incorrect.
• Doppler velocimetry is an essential investigation in suspected IUGR.
• Umbilical artery Doppler is the primary study used to assess placental insufficiency.
• Additional Doppler studies may include the middle cerebral artery (MCA) and ductus venosus.

Option C. There is a danger of fetal asphyxia during delivery

• Incorrect.
• Fetuses with IUGR have reduced placental reserve and are at increased risk of:
  • Intrapartum fetal distress.
  • Fetal hypoxia.
  • Birth asphyxia.
• Continuous fetal monitoring during labor is recommended.

Option D. Generally not seen in women with gestational diabetes mellitus (GDM)

• Incorrect.
• Most pregnancies complicated by gestational diabetes are associated with fetal macrosomia, not IUGR.
• IUGR may occur only in women with long-standing diabetes and significant vascular disease.