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A Rat Model of Mild Intrauterine Hypoperfusion with Microcoil Stenosis
Published on: January 7, 2018
The fetus that is small for gestational age
Nikolaos Vrachnis1, Dimitrios Botsis, Zoe Iliodromiti
1Second Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieion Hospital, 124B Vas. Sofias Av., 115-26, Athens, Greece. nvrachnis@med.uoa.gr
Insights
Managing symmetric small for gestational age (SGA) fetuses is complex. This condition impacts lifelong health, requiring careful diagnosis and monitoring to predict outcomes and guide treatment effectively.
Area of Science:
- Perinatal Medicine
- Fetal Development
- Obstetrics
Background:
- Symmetric small for gestational age (SGA) fetuses pose significant management challenges.
- Fetal growth restriction impacts morbidity and mortality throughout life.
- Differential diagnosis includes constitutional smallness, pathology, or incorrect dating.
Purpose of the Study:
- To outline the diagnostic and management strategies for symmetric SGA fetuses.
- To highlight the role of ultrasonography and other imaging modalities.
- To discuss the implications for perinatal outcome and delivery decisions.
Main Methods:
- Ultrasonographic examination for anomaly detection, infection signs, and serial growth assessment.
- Utilizing individualized fetal growth curves to improve biometric accuracy.
- Employing uterine artery Doppler for perinatal outcome prediction.
- Magnetic resonance imaging (MRI) for anomaly evaluation.
Main Results:
- Ultrasonography is key for detecting anomalies and assessing fetal growth.
- Individualized growth curves enhance biometric accuracy.
- Uterine artery Doppler aids in predicting poor perinatal outcomes.
- MRI is valuable for evaluating fetal anomalies.
Conclusions:
- Symmetric SGA diagnosis requires differentiating between constitutional size, pathology, and dating errors.
- Accurate fetal biometry and serial growth assessment are crucial.
- Uterine artery Doppler and MRI are important surveillance tools.
- Cesarean section is not universally indicated for all symmetric SGA fetuses due to guarded prognoses.
Abstract:
The symmetric small for gestational age (SGA) fetus presents a complex management problem for the obstetrician, but the growth restriction affects morbidity and mortality at all stages of life. The differential diagnosis in symmetric growth aberration includes the constitutionally small fetus, the fetus with pathology, and the cases with incorrect dating of pregnancy. The ultrasonographic examination focuses in the detection of anomalies, signs of intrauterine infection, and serial assessment of fetal growth. Accuracy of fetal biometry may be improved by using individualized fetal growth curves. From the available surveillance tools, the uterine artery Doppler has a value in predicting poor perinatal outcome. Magnetic resonance imaging is also useful in the evaluation of anomalies. Cesarean section is not justified for all symmetric SGA fetuses that may carry a guarded prognosis.
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