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New Approaches to Treatment of 

Severe Intrauterine Growth 

Restriction  

Zhanar Kurmangali1,2  
 
1National Research Center for Maternal 
and Child Health, Astana, Kazakhstan; 
2Center for Life Sciences, Nazarbayev 
University, Astana, Kazakhstan 

 

 

 

 

 

 

 

 

 

Vol. 3, Suppl. (2014)   |   ISSN 2166-7403 (online)    

DOI 10.5195/cajgh.2014.166   |   http://cajgh.pitt.edu 

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KURMANGALI 

 

 

This work is licensed under a Creative Commons Attribution 4.0 United States License. 

 

This journal is published by the University Library System of the University of Pittsburgh as part  

of its D-Scribe Digital Publishing Program and is cosponsored by the University of Pittsburgh Press. 

 

Central Asian Journal of Global Health 

Volume 3, Suppl. (2014)  |  ISSN 2166-7403 (online)  |  DOI 10.5195/cajgh.2014.166  |  http://cajgh.pitt.edu 

  

 

Abstract 

Introduction. Intrauterine growth restriction (IUGR) is a leading cause of perinatal morbidity and mortality due to placental 

insufficiency. Currently, one of the new approaches to treating this disease is the injection of nutrients to the fetus through 

intravascular port-systems (catheters). 

Objective. To assess the impact of nutrient injections as treatment to fetuses with severe growth retardation. 

Materials and methods. Pregnant women with IUGR (abdominal circumference (AC) < 5th percentile) with the absence of 

diastolic flow in the umbilical artery and a fetal gestational age of less than 30 weeks were randomly divided into two groups. The 

treatment group included six pregnant women who had an intravascular port-system for the infusion of nutrients (amino acids and 

glucose) in the umbilical vein of the fetus for 14 ± 3 days. The control group consisted of eight patients who received only traditional 

dynamic monitoring and delivery at the optimum time of pregnancy. Fetal status was assessed using ultrasound equipment Accuvix 

V20 (Medison, South Korea) by examining indicators of biometry and Doppler study of blood flow in utero, umbilical arteries, 

middle cerebral artery, and ductus venosus with fetal vascular resistance index calculation - pulsatility index (PI). Criteria for blood 

flow disturbances in the vessels were considered PI values above normal values for their gestational age, which were defined as 

absence or reverse blood flow in a diastole in the umbilical artery. 

Results. In a comparative analysis of the two groups, the treatment led to a 44.7% increase in AC of the fetus (121.0 ± 11.5 mm 

and 219.3 ± 18.3 mm, respectively, p ˂ 0.001). In all cases, the profile of blood flow in the umbilical artery had a positive diastolic 

component. As a result, there was a 45.3% decrease in PI in the umbilical artery (2.14 ± 0.54 and 1.17 ± 0.15, respectively, p < 

0.05). Average fetal weight in the study group was not significantly higher than the control group (1,120.3 ± 213.6 g and 909.6 ± 

131.4 g, p > 0.05).  

Conclusion. Thus, injection of nutrients to the fetuses through intravascular port-system improved placental perfusion and 

metabolism, which has the potential for improved fetal growth. This, in turn, promoted full-term pregnancy and improved perinatal 

outcomes in fetal pathology. 

Keywords: intrauterine growth restriction, pregnancy, fetal growth 

 

 

 

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