Evaluation and Management of Suspected Fetal Growth Restriction

Obstet Gynecol Clin North Am. 2021 Jun;48(2):371-385. doi: 10.1016/j.ogc.2021.02.007.

Abstract

Impaired fetal growth owing to placental insufficiency is a major contributor to adverse perinatal outcomes. No intervention is available that improves outcomes by changing the pathophysiologic process. Monitoring in early-onset fetal growth restriction (FGR) focuses on optimizing the timing of iatrogenic preterm delivery using cardiotocography and Doppler ultrasound. In late-onset FGR, identifying the fetus at risk for immediate hypoxia and who benefits from expedited delivery is challenging. It is likely that studies in the next decade will provide evidence how to best integrate different monitoring variables and other prognosticators in risk models that are aimed to optimize individual treatment strategies.

Keywords: Cardiotocography; Doppler ultrasound; Fetal growth restriction; Placental insufficiency; Small for gestational age.

Publication types

  • Review

MeSH terms

  • Cardiotocography / methods
  • Delivery, Obstetric / methods
  • Female
  • Fetal Development
  • Fetal Growth Retardation / diagnostic imaging*
  • Fetal Growth Retardation / etiology
  • Fetal Growth Retardation / therapy*
  • Fetus / diagnostic imaging
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Placental Insufficiency / diagnostic imaging
  • Pregnancy
  • Premature Birth / etiology
  • Prenatal Care / methods
  • Ultrasonography, Doppler / methods
  • Ultrasonography, Prenatal / methods
  • Umbilical Arteries / diagnostic imaging