الفهرس 
Intrauterine Growth Restriction (IUGR)Only 14 pages are availabe for public view
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Abstract
T
he main objectives of modern antenatal care programs are to identify high risk pregnancies then to predict any possibility of adverse pregnancy outcome as early as possible. The invention of ultrasound & Doppler allowed obstetricians to study the fetus & the placenta properly & very early.
The development of the human placenta is as uniquely intriguing. During its brief intrauterine existence, the fetus is dependent on the placenta for pulmonary, hepatic, and renal functions. The placenta accomplishes these functions through its unique anatomical association with the mother.
Hypertension is the most common medical disorder with pregnancy and pre-eclampsia constitutes two thirds of cases of hypertension with pregnancy. Preeclampsia is a major contributor to the maternal and neonatal mortality and morbidity. However the cause of preeclampsia remains a matter of mystery. Abnormal placentation is considered one of most important accepted theories for preeclampsia & subsequent IUGR & low birth weight development. Accordingly, inutero placental assessment may help in the prediction of these conditions.
By 2D ultrasound placental location can be determined easily. Placental location has been introduced as an indicator for pregnancy complications. Magann et al. (2007), in their study found that low placentae are associated with low risk of pregnancy-induced hypertension (PIH) and high risk for IUGR. They also reported that unilateral placentae are associated with high risk of PIH and IUGR). Finally they reported that high fundal placentae are associated with low risk of PIH. This study confirms this finding.
The development of 3D ultrasound enabled us to measure placental volume and vascularity reliably in the second and third trimester. Placental volume can be used as predictor for pregnancy complications including development of PIH also it gives an idea about expected fetal weight at birth. Placental volume in the second trimester could provide important information about the reserve capacity of the placenta which means that a large second-trimester placenta will be better able to cope with its task of fetal support in the third trimester.
In our study small placental volumes and low vascularity indices were associated with cases of intrauterine growth restriction (IUGR).
An important milestone in attempts to identify pregnancies at risk of complications such as pre-eclampsia or severe intrauterine growth restriction by measuring placental volume and placental vascularity indices. It could be shown that uterine perfusion in high-risk pregnancies behaves differently from normal, expressed partly by a decreased Vascularization index (VI), flow index (FI) and vascularization flow index (VFI) caused by increased blood flow resistance, and partly by placental volume.
In this study we found that decreased VI & FI and VFI as well as a decrease in placental volume was associated with diagnosed cases of IUGR. We also found no correlation between pulsatility index of the uterine artery and the placental volume.
Finally, the cause of IUGR remains under study for better early prediction and management for its occurrence. However abnormal placentation remains one of the most important theories for development of IUGR for maternal reasons.