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. 2020 Oct;80(10):1016-1025.
doi: 10.1055/a-1232-1418. Epub 2020 Sep 25.

Fetal Growth Restriction - Diagnostic Work-up, Management and Delivery

Dietmar Schlembach  1
Affiliations

Fetal Growth Restriction - Diagnostic Work-up, Management and Delivery

Dietmar Schlembach. Geburtshilfe Frauenheilkd. 2020 Oct.

Abstract

Fetal or intrauterine growth restriction (FGR/IUGR) affects approximately 5 - 8% of all pregnancies and refers to a fetus not exploiting its genetically determined growth potential. Not only a major cause of perinatal morbidity and mortality, it also predisposes these fetuses to the development of chronic disorders in later life. Apart from the timely diagnosis and identification of the causes of FGR, the obstetric challenge primarily entails continued antenatal management with optimum timing of delivery. In order to minimise premature birth morbidity, intensive fetal monitoring aims to prolong the pregnancy and at the same time intervene, i.e. deliver, before the fetus is threatened or harmed. It is important to note that early-onset FGR (< 32 + 0 weeks of gestation [wks]) should be assessed differently than late-onset FGR (≥ 32 + 0 wks). In early-onset FGR progressive deterioration is reflected in abnormal venous Doppler parameters, while in late-onset FGR this manifests primarily in abnormal cerebral Doppler ultrasound. According to our current understanding, the "optimum" approach for monitoring and timing of delivery in early-onset FGR combines computerized CTG with the ductus venosus Doppler, while in late-onset FGR assessment of the cerebral Doppler parameters becomes more important.

Keywords: Doppler sonography; computerised cardiotocography; fetal growth restriction (FGR); intrauterine growth restriction (IUGR); small for gestational age (SGA).

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Conflict of interest statement

Conflict of Interest/Interessenkonflikt The authors declare that they have no conflict of interest./Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Figures

Fig. 1
Fig. 1
Diagnostic examination algorithm in suspected SGA/FGR.
Fig. 2
Fig. 2
Management protocol in fetal growth restriction (data from 1 ).
Abb. 1
Abb. 1
Untersuchungsalgorithmus zur Abklärung bei V. a. SGA/FGR.
Abb. 2
Abb. 2
Betreuungsschema bei fetaler Wachstumsrestriktion (Daten aus 1 ).
See this image and copyright information in PMC

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