While we can’t discuss your personal situation in detail, it’s best to consult your own doctor for personalized advice. In general, there are risks related to this serious complication of pregnancy, depending on how severe the signs and symptoms are. Before birth, FGR may lead to stillbirth if the oxygen problem gets worse. If the baby is at an acceptable gestational age and estimated weight, doctors will monitor its condition and attempt to prevent stillbirth by timely delivery. After birth, problems can affect the lungs, bowels, blood, and brain, and sometimes these can cause the baby to die.

Several factors are very important for understanding risks. First, how far along the pregnancy is when the baby is born is key. The later the pregnancy is, the better the chances for a good result. This is the most important sign to look at. The second factor is how much the baby’s growth is delayed. A bigger growth delay means a higher chance of problems after birth. The third important factor is the baby’s condition at birth. If the baby is too young, too small, and has a serious oxygen problem around birth, this is not a good sign.

There are several important factors for the risks. First, the gestational age at birth matters. The further along the pregnancy is when the baby is born, the better the chances of avoding serious complications. This is the most important factor. The second important factor is how severely stunted the growth is. The more the growth affected, the higher the risk of problems after birth. The third important factor is the condition of the baby at birth. If the baby, in addition to being too young and too small, also has a serious oxygen problem around birth, this is not good.

After birth, the baby needs help with many body functions. That’s why the baby must stay in an incubator until the baby is old and big enough. This usually takes several weeks to months. We often recommend that the baby stays in the hospital until the due date if everything goes well. It is also important to check the baby’s development over time, so the baby should come back to the hospital regularly.

This is a very common question. In almost all situations, the answer is simple: “no, you did not do anything wrong.”

We know that heavy smoking or hard physical work by a woman might affect the situation, but we do not think these are the main causes.

It is common for early-onset FGR to be diagnosed only when it is already advanced or when the mother has high blood pressure (hypertension). This is because FGR gets worse over time, and before it becomes severe, the baby’s size is still normal for its age. Whether it could have been seen earlier depends on your situation. Sometimes, it might have been detected a bit earlier if previous measurements showed a need for closer monitoring. However, this probably wouldn’t have changed the outcomes in most cases, because there is no way to improve placenta function. It would only have led to an earlier diagnosis, but the timing of birth is what matters to avoid serious complications for the baby.

Most likely, you did not do anything wrong, so there is not much you can change to improve the placenta insufficiency. If you smoke or do heavy physical work, we strongly recommend you stop. But you do not need to take complete bed rest, and you can keep doing light exercise.

It is also important to take good care of yourself, talk to family and friends for support, and communicate with your doctor to make sure you ask all your questions and that you are well-informed.

Finally, if you feel something is wrong, whether you are in the hospital or at home, let your caregiver know! If you have symptoms related to pre-eclampsia, if there is blood loss or severe abdominal pain, or if you are worried that the baby’s movements have changed, let them know! You can reach out anytime, day or night.

Your doctor will look at your situation, and the frequency of monitoring will depend on your situation. If necessary, you may be admitted to the hospital for closer monitoring or for an earlier birth.

Currently, there is no medication to treat placental insufficiency once it has been diagnosed.

We think that low-dose aspirin might help prevent placental problems in high-risk pregnancies. However, there is no proof that it helps once the problems have already started. Other medications have been suggested to improve placental function, but they either have not been tested yet or have been shown to not be helpful in trials.

As long as the baby’s health is good and oxygen exchange is adequate, the pregnancy can usually continue. However, if the risk of sudden oxygen problems increases (based on ultrasound findings) or if there are signs of oxygen problems (based on the baby’s heart rate pattern), stillbirth can only be prevented by timely birth. This balance is specific to each situation.

Once it is decided that an early birth is needed, your doctor will plan the timing based on the baby’s state. If the baby needs to be born very soon or might not handle contractions well, a cesarean section will be chosen. This often happens with early-onset fetal growth restriction, as your doctor will wait as long as possible to help the baby. However, in some cases, a vaginal birth may still be possible.

This is a time to take care of yourself, eat healthy and do things that help you relax. Talk to your family and friends friends for (emotional) support. If you need it, seek help from a professional to get through these tough times.

From women who have gone through this, we have learned some helpful tips:

• Prepare for doctor’s visits by writing down your questions so you don’t forget anything. If your doctor is okay with it, record the conversation to listen to later.
• Listen carefully to the risks that are discussed, but also remember the hope for a good outcome. It is the hope that will keep you going
• Keep a diary so you can look back at your emotions from these days if you want to later.
• Take pictures.

Right after birth, the baby will be checked by the pediatrician and stabilized. Depending on the situation, the baby may get support, receive an intravenous line and may be transferred to the NICU for further support.

In the next days, weeks, and months all important organ systems will be monitored and supported where necessary. Here are a few examples:

• Lungs: the baby might only need a little help with airflow through their nose, sometimes with extra oxygen. In more serious cases, they might need help for better breathing, like a mask or tube.
• Gut: in severe early-onset FGR, it may take a long time for the baby’s gut to full feedings. At first, they may be fed through a tube in their stomach. Until that time, they will also need extra feeding thourh the intravenous line. Pumped breast milk is preferred for feeding.
• Brain: premature babies with FGR are at higher risk for brain bleeds. While these bleeds are different from those in older people, they can lead to problems with brain development.
• Immune system: infections are a big risk, so it is important to have strategeies to prevent them and to use antibiotics quickly if needed.

Breastfeeding is strongly recommended (but not required), and most NICUs and maternity wards will help with it. Because babies often do not have enough muscle strength to drink from the breast, the breast milk is usually pumped. Pumping breast milk is a big effort for a mother who is busy and worried, but many mothers find it very valuable because it is a concrete way to support their baby.

Luckily, in most cases of early-onset FGR, the next pregnancy will either be without complications or have FGR at a later stage, when the effects of prematurity are usually milder. Only a small number of patients will have a similar pregnancy.

To understand this better, it is helpful to know the placental pathology of the current pregnancy, as it can tell us about the risk of recurrence. Also, checking for antiphospholipid syndrome is useful. In most cases, using use low-dose aspirin and calcium during pregnancy and checking fetal growth with ultrasound at planned times is recommended.

Mothers (and their partners or families) may have mental health problems for a long time, such as depression, anxiety, post-traumatic stress, and trouble with memory or focus. It is important to know that this is common and to seek help if you need it.

We know that placental problems during pregnancy can lead to lasting problems with blood vessel health in mothers. It’s important to be aware of this risk so that treatable problems like obesity, high blood pressure, and high cholesterol can be addressed early. This might help prevent heart attacks or strokes at a young age. While these problems are rare, women with placental problems are at a higher risk than those who had normal pregnancies.

Among babies born after early-onset FGR, most will show catch-up growth, meaning that in 2-3 years they slowly but surely go back to the normal infant size for that age, corrected for the prematurity.

Some will show adverse neurological development, varying in severity. This will show in motor impairments or cognitive impairments, that can severely affect quality of life. However, depending on the point of departure, many will survive healthy or with minor consequences, and will therefore have a happy and meaningful life.

Lastly, in adulthood, there are associations with hypertension, obesity and diabetes.

This website is for educational purposes only. If you have questions about your personal situation, please reach out to your caregiver.

We welcome any feedback about the website, and we’d love to hear your personal story, especially if it can help others in our community. If you’d like to share, please use the contact form. We will keep your information private.

Yes, there are multiple patient organizations patients are often referred to. Patient organizations can provide information, advocate for patients’ interests, and organize support groups.

See below some of the patient organizations:

• The Netherlands
  • Care4Neo
  • Hellp Foundation
• Denmark
  • …
• Belgium
  • …

We encourage you to take part in any studies that are offered to you, because this helps the medical knowledge to improve. Before any study starts, it is carefully checked by an ethics committee to make sure it is good quality and reasonable.

This also applies to the SAVE FGR study, but participation can only happen at hospitals that are part of the study.

If you have a question that is not answered in the FAQ, you can ask it here, and we might be able to help. It may take some time for us to answer your question.

For specific questions about your own pregnancy or situation, please contact your healthcare provider.