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Review
. 2011:2011:640715.
doi: 10.1155/2011/640715. Epub 2011 Apr 13.

Diagnosis and management of fetal growth restriction

Affiliations
Review

Diagnosis and management of fetal growth restriction

Jacqueline E A K Bamfo et al. J Pregnancy. 2011.

Abstract

Fetal growth restriction (FGR) remains a leading contributor to perinatal mortality and morbidity and metabolic syndrome in later life. Recent advances in ultrasound and Doppler have elucidated several mechanisms in the evolution of the disease. However, consistent classification and characterization regarding the severity of FGR is lacking. There is no cure, and management is reliant on a structured antenatal surveillance program with timely intervention. Hitherto, the time to deliver is an enigma. In this paper, the challenges in the diagnosis and management of FGR are discussed. The biophysical profile, Doppler, biochemical and molecular technologies that may refine management are reviewed. Finally, a model pathway for the clinical management of pregnancies complicated by FGR is presented.

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Figures

Figure 1
Figure 1
Doppler velocimetry of fetal vessels. (a) depicts a normal umbilical artery flow waveform. (b) depicts a normal waveform of the middle cerebral artery, and (c) depicts an abnormal ductus venosus waveform, showing a reversed “a” wave.
Figure 2
Figure 2
A proposed monitoring scheme in pregnancies complicated by FGR. This figure focuses on FGR associated with placental dysfunction. See text for additional details.

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