Abstract

COMPLEX MATERNAL-FETAL MANAGEMENT IN SEVERE EARLY-ONSET INTRAUTERINE GROWTH RESTRICTION (IUGR) AND NEPHROTIC RANGE PROTEINURIA IN A HIGH-RISK PREGNANCY

Wajeeha Qhudsia Siddiqua*, Ayesha Sara, Pranitha Rachel, Ayesha Ambereen and
Tripura Sundari

ABSTRACT

Intrauterine Growth Restriction, affecting approximately 10% ofpregnancies, significantly contributes to neonatal morbidity andmortality. This case study concerns a 32-year-old woman, gravida 6para 5, at 29 weeks of gestation, who presented with early-onsetintrauterine growth restriction, severe proteinuria, hypothyroidism, andFactor XIII B deficiency. Her condition was further complicated bypre-eclampsia and placental insufficiency, necessitating an emergencycesarean section due to absent end-diastolic flow in the umbilicalartery. The infant, born prematurely at 775 grams, required intensiveneonatal care for respiratory distress syndrome and sepsis. Maternaltreatment included antihypertensive medication, magnesium sulfate forneuro protection, and intravenous albumin for hypoalbuminemia. Postdelivery,both the mother and infant showed significant improvement.This case underscores the importance of a multidisciplinary approachin managing high-risk pregnancies, emphasizing the role of timely Doppler ultrasound monitoring, appropriate pharmacological interventions, and advancedneonatal care.

Keywords: Intrauterine growth restriction (IUGR), pre-eclampsia, proteinuria, Doppler ultrasound, neonatal care, high-risk pregnancy.