If the fetal growth of one or both twins suddenly slows down or even stops while they are in the womb, this condition is known as IUGR. About 25% of twin pregnancies are affected by IUGR and IUGR twins face big risks.
This is why never missing a prenatal checkup is extremely important to check fetal growth as well as taking the necessary steps to reduce the impact of this condition on your twins.
What is IUGR?
IUGR refers to Intrauterine Growth Restriction. To diagnose IUGR in twin pregnancies, a comparison of the babies’ weight percentile at birth is taken into account. The comparison should be based on the standards of the gestational age of the babies which includes infant length.
If a baby is born with an inappropriately low weight (less than 2.5 kg) for the duration of pregnancy, then the growth is considered inadequate and thus points to IUGR. Some babies who are born small for their gestational age may catch up during the first two to three years of life, but there may also be some that will remain small.
In a nutshell, IUGR happens because more than one baby is competing for the resources in the mother’s womb causing the restricted growth.
IUGR Causes in Twin Pregnancy
The most known causes include hypertension, diabetes, history of restricted fetal growth, chronic illness, raised levels of hCG, having low weight before pregnancy, or unsatisfactory maternal weight gain which is less than 10 kg at 40 weeks.
Other causes are alcohol use, drug use, tobacco, vaginal bleeding, maternal anemia, severe lung disease, infections (syphilis, CMV, rubella, HBV, HSV, HIV, toxoplasmosis), congenital disorders, placental pathology and maternal smoking which is the culprit of 30% to 40% cases of IUGR.
Risks of Intrauterine Growth Restriction Twins
IUGR twins with delayed growths are at risk to certain health concerns during pregnancy, at delivery, and even after giving birth. One of which is these babies have low birth weight, low blood sugar (hypoglycemia), low resistance to infection, and low Apgar scores – a test given after birth that evaluates the newborn’s physical condition.
Decreased levels of oxygen are to be expected and difficulty handling vaginal delivery stresses. Meconium aspiration is likely to happen which leads to problems breathing. Babies may also have a very high red blood cell count and will experience trouble with maintaining body temperature.
Other twin risks that come along with sharing one placenta is the unequal distribution of blood and nutrients among the babies. Twin-Twin Transfusion Syndrome (TTTS) may also be developed because of the unequal exchange of blood between twins. The umbilical cords may also be tangled which restricts blood flow in one or both twins.
How is IUGR Treated? When to deliver IUGR baby
The treatment for IUGR will depend on how far along a mother is in her pregnancy. If the gestational age is already 34 weeks or more, being induced for early delivery may be recommended by doctors. If, however, the fetus is less than 34 weeks, then healthcare professionals will keep monitoring the fetal well-being and amount of amniotic fluid of the babies.
When delivery happens to be done before 34 weeks, an amniocentesis will be performed. This helps evaluate the lung maturity of both twins. Mothers who have IUGR twins are expected to visit their health professional every two to six weeks until delivery.
How can I prevent the impact of IUGR in my babies?
To prevent IUGR’s drastic effects from happening on your twins, be sure to get the best nutrition while pregnant, stop smoking, and get plenty of rest. Maternal nutrition is critical for both the mother and the twins.
A total of 25 to 35 pounds weight gain is the standard to achieve throughout the pregnancy. A mom should eat three well-balanced meals a day and have a few snacks in between to keep blood sugars stable.
Having a IUGR baby is not at all an easy thing to deal with but can be managed with the support and encouragement from your health professional, friends and of course, family members.
Find comfort in knowing that 90% of babies who are born with IUGR catch up quite well before your twins turn 3.