OBJECTIVE: Complex evaluation of the functional system "mother-placenta-fetus" in intrauterine growth restriction (IUGR) for the prognosis of risk of perinatal complications and optimization of choice of method of delivery. METHODS: We created an objective scale for the evaluation of pregnancies complicated by IUGR using 19 fetometric, dopplerometric and pulsometric parameters. We prospectively followed 130 fetuses classified into three risk groups determined by our prognostic scale with a control group of 25. Operative method of delivery was recommended for medium and high risk groups. We examined newborns with the help of neurosonography and compared them to 139 retrospective newborns classified into three groups according to severity of IUGR with a control group of 25. RESULTS: C-sections were higher by 27 and 12% in the prospective medium and high risk groups. Ventriculomegaly, brain edema, hemorrhages and pathological vascular pulsation decreased by 9, 27, 12 and 21%. Perinatal mortality decreased by 4%. CONCLUSIONS: The developed IUGR prognostic scale optimized the choice of method of delivery and led to decreased rates of neurological morbidity and mortality in newborns with IUGR.