FETAL GROWTH ABNORMALITIES

Abnormalnosti fetalnog rasta uključuju dva temeljna pojma : makrosomiju i intrauterini zastoj u rastu. Definicija makrosomije razlikuje se ovisno o literaturi, a određena je masom novorođenčeta u rasponu od 4000 do 5000 grama. Makrosomno novorođenče nalazi se iznad 90. percentile u percentilnim krivuljama za određenu gestacijsku dob. Rizični faktori koji mogu dovesti do razvoja takvog stanja su: dijabetes mellitus majke, multiparitet, prethodno rađanje makrosomnog djeteta te pregestacijski BMI iznad 25,0. Nažalost, dolazi do rađanja djece bez navedenih rizičnih faktora, zbog nedovoljno jako prediktivne vrijednosti istih. Intrauterini zastoj u rastu označava fetus koji nije postigao u potpunosti svoj potencijal za rast. Uzročnici koji dovode do tog stanja su genetske anomalije u fetusa i okolišni čimbenici koji uključuju abnormalnosti u uteroplacentarnom protoku i bolesti trudnice. Dijagnostika uključuje monitoriranje životnih funkcija fetusa color doppler-om, kardiotokografijom i ultrazvučnim praćenjem rasta fetusa. Terapija koja bi djelovala na etiološkog agensa koji dovodi do poremećaja rasta fetusa nema, međutim rješenje predstavlja odabir ispravnog trenutka za porod djeteta.There are two main types of fetal growth abnormalities: macrosomia and intrauterine growth restriction. Depending on literature, macrosomia is characterised by an excessive fetus birth weight, which can be from 4000 g up to 5000 g, or even greater. A macrosomic newborn founds itself above the 90th percentile in the percentile curves for the established gestational age. The risk factors that may lead to the development of such condition are: gestational diabetes mellitus, multiparity, premature macrosomic birth and pregestational BMI greater than 25. Unfortunately, babies are born without knowing those risk factors, because of their unsufficient predictive values. Intrauterine growth restriction is characterized by a fetus which has not achieved its genetically determined potential size. The factors leading to this condition are fetal genetic anomalies and others which include abnormalities in the uteroplacental blood flow and pregnant women diseases. The diagnosis includes fetal monitoring of its vital functions by means of color doppler ultrasound, cardiotocography and ultrasound observation of fetal growth. There is no treatment that could act properly on the etilogic agent that causes the fetal growth disfunction, but a solution could be choosing the proper moment of the childbirt