Q: I am a 29 years old woman into my fifth month of pregnancy. My first pregnancy got terminated because of intrauterine growth retardation. Can the problem recur? What precautions should I take this time to ensure a safe pregnancy?

A:Yes, the problem can recur, depending upon the cause. There are several maternal, fetal, placental or general causes for intrauterine growth retardation (IUGR), and investigation and treatment depends upon the suggested cause as obtained from your history. Please see the high-risk obstetrician, for care from the beginning to achieve the best result. IUGR can develop any time, early or late in pregnancy. Usually the early IUGR, is more severe and can be due to fetal abnormality, which can be detected by ultrasound. The late IUGR can be treated with rest, high protein diet, and high calorie diet, along with treatment of the cause. If the blood pressure is also high, then tablet Aspirin may be started from 12-14th week of pregnancy, but it has to be stopped in the last 4 weeks. Regular checkups and serial ultrasound, electronic fetal testing for distress and Doppler is required after 32 weeks, if the baby is growing slowly.