Symmetrical intrauterine growth restriction is a type of intrauterine growth restriction (IUGR) where all fetal biometric parameters tend to be less than expected (below the 10th percentile) for the given gestational age. Both length and weight parameters are reduced.
Please, refer to the article on asymmetrical intrauterine growth restriction for a particular discussion of this other type of IUGR.
As a general rule, fetuses with this type of IUGR pattern may present at an earlier stage in gestation compared with the asymmetrical IUGR pattern.
- aneuploidic syndromes
- infections, e.g. TORCH 7
- topical use of maternal fluorinated glucocorticoid (rare) 3
- external agents, e.g. nicotine, alcohol, heroin, ionizing radiation 7
All sonographic biometric parameters tend to be symmetrically reduced. Therefore, fetuses have normal or near normal:
- HC (head circumference) : AC (abdominal circumference) ratio
- FL (femoral length) : AC (abdominal circumference) ratio
Differential considerations on ultrasound assessment include:
- incorrect dates
- lower end of normal variation, i.e. if parents are small
- 1. Rosenberg A. The IUGR newborn. Semin. Perinatol. 2008;32 (3): 219-24. doi:10.1053/j.semperi.2007.11.003 - Pubmed citation
- 2. Cox P, Marton T. Pathological assessment of intrauterine growth restriction. Best Pract Res Clin Obstet Gynaecol. 2009;23 (6): 751-64. doi:10.1016/j.bpobgyn.2009.06.006 - Pubmed citation
- 3. Katz VL, Thorp JM, Bowes WA. Severe symmetric intrauterine growth retardation associated with the topical use of triamcinolone. Am. J. Obstet. Gynecol. 1990;162 (2): 396-7. - Pubmed citation
- 4. Salafia CM, Minior VK, Pezzullo JC et-al. Intrauterine growth restriction in infants of less than thirty-two weeks' gestation: associated placental pathologic features. Am. J. Obstet. Gynecol. 1995;173 (4): 1049-57. Am. J. Obstet. Gynecol. (link) - Pubmed citation
- 5. Nyberg DA, McGahan JP, Pretorius DH. Diagnostic imaging of fetal anomalies. Lippincott Williams & Wilkins. (2003) ISBN:0781732115. Read it at Google Books - Find it at Amazon
- 6. Merz E, Bahlmann F. Ultrasound in obstetrics and gynecology. Thieme Medical Publishers. (2005) ISBN:1588901475. Read it at Google Books - Find it at Amazon
- 7. Merz E. Ultrasound in Obstetrics and Gynecology, Volume 1 Obstetrics. Thieme. (2011) ISBN:3131614722. Read it at Google Books - Find it at Amazon