All are the causes of intrauterine growth retardation except:
Correct Answer: Gestational diabetes
Description: Ans. is d, i.e. Gestational diabetesRef. Dutta Obs. 7/e, p 287,463, 464; Fernando Arias 3/e, p 11 for a,115 for d, 106 for bAs far as, Pregnancy induced hypertension and maternal heart disease are concerned, there is no doubt that both these conditions cause IUGR.For 'Anemia' Dutta Obs. 6/e, p 463 says: Anemia causes IUGR.Williams Obs. 23/e, p 848 says: "In most cases, maternal anemia does not causes fetal growth restriction, Exception include sickle cell disease."Fernando Arias 3/e, p111 says: "Sickle cell anemia causes fetal growth retardation""Awathi et al (2001) reported an incidence of IUGR of 37% among Indian women suffering from moderately severe anemia."So sickle cell anemia and moderately severe anemia with Hb <8g/dL causes IUGR.As far as diabetes is considered: "Growth restriction is less commonly observed and is associated with maternal vasculopathies". --Dutta Obs. 7/e, p 287Fernando Arias 3/e, p 106 says: Diabetes with vascular disease is a cause of IUGR.It is further supported by following lines from Fernando Arias 3/e, p 115."Insulin dependant diabetes with microvascular disease are at high risk for having IUGR fetuses.""Diabetic Vasculopathy and excessively tight control of diabetes mellitus in pregnancy has been linked to intrauterine growth restriction"Mgt of High Risk Pregnancy, SS Trivedi and Manju Puri p 328, 329But here friends all texts refer to overt diabetes complicated with vasculopathies leading to IUGR, gestational diabetes is diabetes which is first recognized during pregnancy and it does not lead to vasculopathies so no IUGR. Rather gestational diabetes leads to macrosomia.
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Gynaecology & Obstetrics
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