I have had two pregnancies which I lost pre-term due to IUGR which from my doctors was not discovered on time. My question is how can this be averted. From the few things I read about the causes of IUGR, I believe non of the causes were related to me in anyway. I also read about cord accident at some point and would like to know if this could also result in a case of IUGR.

What preventive measures can be taken to avoid a repetition in my next pregnancy?

Was a reason determined in the prior circumstances? There are a number of possible reasons... but a history of IUGR itself would make it suspect again.
Did you discuss with your doctor what measures you could take when becoming pregnant again? Much may be determined if a possible reason, or reasons, were found before.

Blood pressure concerns, your nutrition and weight gain, smoking, drinking, low amniotic fluid (which can account for some cord accidents), fetal developmental problems, genetic concerns, etc. are all possibilities.

Making sure your doctor closely monitors your next pregnancy is key. Many times, baby will be delivered early to limit any concerns.

Eat well, drink plenty of fluids, stop smoking (if that is relevant), genetic counseling if that might be a possible concern, avoid any exposure to possible chemicals in a working environment, etc..

Some possible causes may be in your control, some may not. As you can see, there are so many possibilities that it would be wise to speak with your doctor to discuss what steps they feel would be important in your particular situation.

To add to what Doula has said, and I agree with it 100%, you need to find a high risk OB.

Thank you so much for your reply, but it has only helped me to ask more questions (I just hope you do not mind). I am currently based in Nigeria where the health care system has challenges and that may provide answers to some of your concerns.

Like I noted in my earlier post, all the causes of IUGR does not apply to me other than maybe stress and the history although I live in an area with rough roads where the only means of transportation is motorbike... could the ups and downs on the road cause cord accident or insufficient oxygen to the baby in uthero or could that daily movement on motorbikes be associated with the cases of IGUR?

I am also ruling out the fact that it may be hereditary as my Mum never experienced such. However, I agree that I may have lacked close monitoring with my Doctors but considering that they also have their challenges (lack of facilities and large population of expectant mothers ratio not enough practitioners to attend to them) which explains the fact that they may not be too attentive during visits...

Could depression be associated in any way with this occurrence? The first incident happened when I was about 28weeks gone while the second one happened with I was about 35weeks... Although, all my ultrasound results shows that my babies are very active, I do not usually feel that their kicks/movements tallies with description of the ultrasound.

I am looking at trying again later in the year or early next year as the case may be, what tests can I do to determine my current state of health and what I can do to prevent the re-occurrence of IUGR in my future pregnancies. What other observations should I look out for during another pregnancy?

Thanks

The possibility of a genetic trait may not have been evident with your mother. Since you have already experienced this twice, it may be something you will want to look into. As an example, once a woman has given birth prematurely a couple of times, it can increase the likelihood that she will continue to give birth prematurely. It is not guaranteed, but indications for an early birth would be more closely watched for.

Can I ask what your babies' weights were? Usually IUGR is suspected during an ultrasound. Did the doctor say IUGR was the problem? Were they small/underdeveloped because of IUGR or because they were early? Was a cord accident evident or determined, or are you just wondering if that could be a reason?
Is there anyway you could get a referral to a highrisk doctor in the area or in a neighboring area?

If no specific reason was given, about all you could do would be to make sure you are eating well, drinking a good deal of fluids regularly throughout the pregnancy, see your doctor as required, and ask to be more closely monitored, including a few extra ultrasounds to watch baby's growth pattern and development.

The first and second babies were not up to 2kg before they were gone... Although I can't really remember the first incident clearly now but with the second which happened late last year, I remembered that earlier that morning when I went visiting by Doctor, she had told me she felt (by measuring my tommy) the baby smaller that it should have been considering the age and she has minuted IUGR on my file and advised that I proceed for an ultrasound. (as it is around here, your Doctor may not be the one to carry out the ultrasound as they do not have immediate facilities to do that. You can only visit a lab with such facilities and then return to see your Doctor with the results) By the time I went for the ultrasound in the afternoon, the attending just minuted IUFD on my card.

Unfortunately too, no tests were carried out on the baby was expelled to determine what the possible cause of the death was. Regarding cord accident, I was only just asking to satisfy my curiosity based on the little readings I have done over the internet.

I'm afraid I may not be able to get any referral considering that the hospital is a teaching hospital where other hospitals even refer cases to.

Are you very familiar with the Nigeria health care system? Are you in contact with any OB-GYN Doctor (High-risk) that you could recommend? F yes, I wouldn't mind consulting a high-risk Doctor you recommend in this environ (Lagos, Nigeria).

Thanks