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If your doctor finds out that your baby is small due to improper blood supply through the placenta, the doctor takes necessary steps to monitor the growth and well-being. Only way to monitor growth and well-being of the foetus is by performing an ultrasound scan. At the time of the initial scan, the basic measurements of the foetus are taken and estimated weight of the baby is calculated. Starving small babies have a smaller abdominal circumference compared to the head measurements.

The size of the liver contributes to the measurement around the abdomen and when the foetus is starving the fetus has less stored energy in the form of glycogen and therefore the liver becomes small reducing the size of abdominal circumference. When the blood supply through the umbilical cord is less than normal, the foetus reacts by maintaining the normal blood supply to the vital organs like brain ( head sparing effect) whilst curtailing the blood supply to less important organs(kidneys, intestines etc) for survival inside the womb. The blood flow of the umbilical cord can be assessed by performing a Doppler Ultrasound scan. When the blood supply to the kidneys is reduced, the foetus would produce less urine and the amount of water around the baby becomes less. This can be measured by an ultrasound scan.

Starving small babies have a smaller abdominal measurement compared to head measurements. Next step is to find out if the blood supply is acceptable at the time of examination. If the blood supply is normal (normal Doppler flow Ultrasound scan) with normal amount of water around the baby (normal Amniotic fluid), serial scans are done once in two to three weeks to check if growth is parallel. This is done by performing an ultrasound scan to take the measurements of head, abdomen and thigh bone and plotting the measurements on a standard growth chart. Parallel growth shows that the baby is growing inside the womb and the nutrients are adequate for growth. When there is flattening of growth implying that there is a slower growth rate, the blood flows and amniotic fluid levels are checked. If the blood flow or amniotic fluid level is below normal or not acceptable, a decision has to be taken to consider delivery.

Timing and mode of delivery is done depending upon the period of gestation, the estimated weight of the baby, amount of water around the baby and blood supply etc. A steroid injection is given to the mothers of premature babies before the delivery to enable baby’s lung maturation to minimize problems associated with breathing.