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Chapter 9 - Fetal Growth Restriction

from Section 1 - Obstetric Aspects of Antenatal Care

Published online by Cambridge University Press:  23 February 2023

By
Amira El-Messidi ,
Juliana Martins  and
Alfred Abuhamad
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 29-year-old G2P1 at seven weeks’ gestation is referred to your tertiary center for consultation and prenatal care. Obstetric history is significant for fetal growth restriction (FGR) requiring preterm delivery at 33 weeks’ gestation. Her son’s birthweight was 1400 g. The patient’s prenatal care and delivery were at another center, and her medical chart is unavailable at the time of initial consultation.

Keywords

Early fetal growth restrictionDefinitionRisk factorsCounsellingManagementFetal Doppler, arterial and venousMaternal serum analytesFetal risksFetal pulmonary corticosteroidsMagnesium sulfate neuroprotectionDelivery timingMode of deliveryNeonatal metabolic derangementsOffspring long-term morbiditiesOrgan-system pathophysiologyBreus’ moleBarker hypothesis
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 109 - 126
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

Fetal growth restriction: ACOG Practice Bulletin, No. 227. Obstet Gynecol. 2021;137(2):e16–e28.Google Scholar
Figueras, F, Gratacos, E. Stage-based approach to the management of fetal growth restriction. Prenat Diagn. 2014; 34(7):655–659.Google Scholar
Kingdom, JC, Audette, MC, Hobson, SR, et al. A placenta clinic approach to the diagnosis and management of fetal growth restriction. Am J Obstet Gynecol. 2018;218(2S):S803–S817.CrossRefGoogle Scholar
Khong, TY, Mooney, EE, Ariel, I, et al. Sampling and definitions of placental lesions: Amsterdam placental workshop group consensus statement. Arch Pathol Lab Med. 2016;140(7): 698–713.Google Scholar
Lausman, A, Kingdom, J. Intrauterine growth restriction: screening, diagnosis, and management. J Obstet Gynecol Can. 2013;35(8):741–748.CrossRefGoogle ScholarPubMed
Lees, CC, Stampalija, T, Baschat, AA, et al. ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction. Ultrasound Obstet Gynecol. 2020; 56(2):298–312.Google Scholar
McCowan, LM, Figueras, F, Anderson, NH. Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy. Am J Obstet Gynecol. 2018;218(2S): S855–S868.CrossRefGoogle ScholarPubMed
Melamed, N, Baschat, A, Yinon, Y, et al. FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: best practice advice for screening, diagnosis, and management of fetal growth restriction. Int J Gynaecol Obstet. 2021;152(Suppl 1):3–57.Google Scholar
Robson, SC, Martin, WL, Morris, RK. The investigation and management of the small-for-gestational age fetus. Green Top Guideline No. 31, 2013. 2nd ed. Available at www.rcog.org.uk/globalassets/documents/guidelines/gtg_31.pdf. Accessed August 15, 2020.Google Scholar
Salomon, LJ, Alfirevic, Z, Da Silva Costa, F, et al. ISUOG Practice Guidelines: ultrasound assessment of fetal biometry and growth. Ultrasound Obstet Gynecol. 2019;53(6):715–723.CrossRefGoogle ScholarPubMed
Society for Maternal-Fetal Medicine, Martins, JG, Biggio, JR, et al. Society for Maternal-Fetal Medicine (SMFM) Consult Series No. 52: diagnosis and management of fetal growth restriction. Am J Obstet Gynecol. 2020;223(4):B2–B17.Google Scholar

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