Differential Diagnosis for Unborn Child with Symmetrically Small Head and Femurs, Slow Growth, and Possible Placenta Issues

• Single Most Likely Diagnosis

  • Intrauterine Growth Restriction (IUGR): This condition is characterized by a fetus that does not grow at a normal rate inside the womb. The symmetrically small head and femurs, along with slow growth, are indicative of IUGR, which can be caused by placental insufficiency among other factors.

• Other Likely Diagnoses

  • Chromosomal Abnormalities (e.g., Down Syndrome, Turner Syndrome): These conditions can lead to growth restriction and symmetrically small fetal measurements. However, they often present with additional anomalies.
  • Congenital Infections (e.g., CMV, Toxoplasmosis): Infections during pregnancy can affect fetal growth and development, potentially leading to symmetric growth restriction.
  • Maternal Hypertension or Preeclampsia: These conditions can impair placental function, leading to fetal growth restriction.

• Do Not Miss Diagnoses

  • Placenta Accreta Spectrum (PAS) Disorders: Although more related to placental attachment issues, severe cases can lead to significant maternal and fetal complications, including growth restriction due to compromised placental function.
  • Fetal Alcohol Spectrum Disorders (FASD): Exposure to alcohol in utero can cause growth restriction and developmental issues, including symmetric smallness of the head and femurs.

• Rare Diagnoses

  • Russell-Silver Syndrome: A rare genetic disorder characterized by growth restriction, with some cases presenting with symmetrically small fetal measurements.
  • Primordial Dwarfism: A group of rare genetic disorders that result in severe growth restriction, often with proportional smallness of all body parts, including the head and femurs.
  • Congenital Zika Syndrome: Although less common in areas without recent outbreaks, Zika virus infection during pregnancy can cause severe fetal growth restriction and microcephaly, among other symptoms.