Fetal growth retardation

　　The main mechanism of fetal growth retardation is the weakness of the parents' endowment, or improper nourishment after pregnancy, leading to deficiency of the uterine and fetal nourishment, and slow growth. It is more common in pregnant women with weak constitution or chronic diseases, or severe pregnancy vomiting in the early stage of pregnancy, with a long duration and little eating, causing the fetus to lack nutrition and develop slowly. From the perspective of traditional Chinese medicine, this disease is rooted in deficiency. Common ones include deficiency of vital energy and blood, deficiency of Yang in the spleen and kidney, and Yin deficiency in the liver and kidney.

　　The characteristics of fetal growth retardation are that it occurs in the middle and late stages of pregnancy, with an incidence rate of 3%-10.8%, belonging to high-risk pregnancy, and is an important factor in perinatal mortality and morbidity. Survivors often have long-term complications, such as poor physical development, intellectual disability, and motor nerve disorders.

　　The common types of fetal growth retardation include deficiency of kidney Qi, deficiency of vital energy and blood, and Yin deficiency and blood heat. The specific types are as follows:

　　1, Deficiency of kidney Qi
　　Inherited kidney deficiency, or improper sexual activity after pregnancy, causing injury to kidney Qi. The fetal Qi is internally connected to the kidney, insufficient kidney essence leads to insufficient nourishment of the fetus and slow growth, resulting in fetal growth retardation.

　　2, Deficiency of vital energy and blood
　　Insufficient vital energy and blood, or severe morning sickness after pregnancy, insufficient source of vital energy and blood, or prolonged bleeding from fetal leakage consumes vital energy and blood, leading to insufficient vital energy and blood in the Chong and Ren meridians, the fetus losing its nourishment, and leading to fetal growth retardation.

　　3, Yin deficiency and blood heat
　　Pregnant women with inherent Yin deficiency, or prolonged illness with blood loss and Yin injury, or excessive intake of spicy and hot foods and drugs for warming the uterus after pregnancy, leading to burning of Yin and blood by pathogenic heat, the fetus being injured by pathogenic heat, and losing the nourishment of Yin and blood, thus causing fetal growth retardation.

　　Fetal growth retardation is often due to maternal deficiency or improper nourishment during pregnancy, so it is necessary to appropriately increase nutrition and Chinese herbal medicine dialectical treatment, enhance the maternal constitution, and help the growth and development of the fetus. In addition to distinguishing from stillbirth, it is also necessary to diagnose whether the fetus has malformations or physiological defects, and can be examined by B-ultrasound, blood biochemical examination, or karyotype examination.

　　Patients with fetal growth retardation should maintain a light diet and avoid greasy and cold foods. Eat more vegetables and fruits, reasonably match the diet, and pay attention to adequate nutrition.Patients with fetal growth retardation should avoid smoking and drinking alcohol in their daily life.

　　The treatment of fetal growth retardation in traditional Chinese medicine requires dialectical treatment. The main basis for dialectical diagnosis is the determination of the syndrome type according to the accompanying systemic symptoms, tongue and pulse signs, etc., to guide the treatment. The focus of treatment is to replenish the spleen and stomach, nourish the source, nourish the essence and blood, and benefit the fetus. At the same time, during the treatment process, if abnormalities or stillbirth are found, then it is necessary to induce labor to benefit the mother.

　　1. Kidney Qi Deficiency Type
　　Main Symptoms: The abdominal shape of pregnancy is smaller than the pregnancy month, the fetus survives, dizziness and tinnitus, lumbar and knee weakness, or feeling cold and afraid of cold, the hands and feet are not warm, fatigue and weakness, pale tongue, white coating, deep and thin pulse.
　　Analysis of Symptoms: Congenital deficiency or improper postpartum care, kidney Qi decline, and insufficient source of essence and blood, then the uterine vessels lose nourishment, so the fetus does not grow; kidney deficiency then the marrow sea is insufficient, the orifices lose nourishment, so dizziness and tinnitus; kidney deficiency and the external fu lose nourishment, so lumbar and knee weakness, fatigue and weakness; kidney deficiency and Yang Qi deficiency, so the body feels cold and afraid of cold, the hands and feet are not warm. The tongue is pale, the coating is white, and the pulse is deep and thin, which is a sign of kidney Qi deficiency.
　　Treatment Principles: Tonify the kidney, invigorate Qi, fill essence, and nourish the fetus.
　　Example of Prescription: Shou Tai Pill plus dangshen, fructus rubi, and mulberry seeds.

　　2. Qi and Blood Deficiency Type
　　Main Symptoms: The abdominal shape of pregnancy is smaller than the pregnancy month, the fetus survives, the body is weak, dizziness and palpitations, less Qi and talkativeness, pale complexion, pale tongue, thin coating, thin pulse.
　　Analysis of Symptoms: The fetus originally comes from Qi and blood, after pregnancy, blood deficiency and Qi weakness, then the fetus loses Qi and blood nourishment and grows slowly, so the abdominal shape of the pregnant mother is smaller than the pregnancy month; Qi and blood deficiency, the body loses nourishment, so the body is weak; blood deficiency and the heart and brain lose nourishment, so dizziness and palpitations; Qi deficiency and Yang Qi not distributed, so there is less Qi and talkativeness; blood deficiency and Qi weakness, the skin loses its luster, so the face is pale. The tongue is pale, the coating is thin, and the pulse is thin and weak, which is a sign of Qi and blood deficiency.
　　Treatment Principles: Tonify Qi and nourish blood to cultivate the fetus.
　　Example of Prescription: Tai Yuan Drink plus续断、Chinese wolfberry.

　　3. Yin Deficiency and Blood Heat Type
　　Main Symptoms: The abdominal shape of pregnancy is smaller than the pregnancy month, the fetus survives, the cheeks are red and the lips are red, the palms and soles are hot, restless and anxious, dry mouth and thirst, the tongue is red and dry, the pulse is thin and rapid.
　　Analysis of Symptoms: Yin deficiency and blood heat, heat injury to the fetus and loss of nourishment, so the fetus withers and does not grow, the abdominal shape is smaller than the pregnancy month; deficiency of虚 heat rises, so the cheeks are red and the lips are red; Yin deficiency and internal heat, then the palms and soles are hot; heat disturbs the mind, then restlessness and anxiety; Yin deficiency and blood heat; insufficient body fluid, so dry mouth and thirst. The tongue is red and dry, the pulse is thin and rapid, which is also a sign of Yin deficiency and blood heat.
　　Treatment Principles: Nourish Yin and Clear Heat, nourish blood and cultivate the fetus.
　　Example of Prescription: Bao Yin Decoction plus Chinese wolfberry and mulberry seeds.
　　When there is a suspicion of chromosomal abnormalities, viral infection, radiation injury, and other conditions during the treatment of this disease, prenatal diagnosis should be made after 16 weeks of pregnancy to prevent the birth of malformed infants.