ABSTRACT

The consequences of the severe quantifiable variety are well established: stillbirth or fetal distress in labor, severe neonatal problems, and deficits in later development. The severely growth retarded are at risk for many types of physical or mental handicap. Many associations of disease with fetal growth retardation have been described. In some of these, such as the rubella-affected fetus, the underlying mechanism is known. The physiopathology of fetal growth retardation similarly involves the fetus, the placenta, the mother, or a combination of all of these. In growth retardation the islets of Langerhans are reduced in size and the occasional fetus which totally lacks insulin is very markedly underweight. The marked growth retardation and anaemia of one twin with a heavy plethoric sibling is associated with unbalanced flow to each. Arteries rising from the umbilical arteries of the smaller communicate with veins running to the larger.