Fetal growth restriction: a modern approach

Area of Science:

• Perinatal Medicine
• Reproductive Biology
• Fetal Development

Background:

• Fetal growth restriction (FGR) is a complex perinatal condition with diverse etiologies.
• It shares pathophysiological links with preeclampsia and placental abruption, contributing significantly to indicated preterm births.
• These conditions underscore the importance of understanding placental disease in pregnancy outcomes and long-term adult health.

Purpose of the Study:

• To review the current understanding of Fetal growth restriction (FGR) pathophysiology and management.
• To highlight the role of placental ischemia as a primary cause of FGR.
• To emphasize the implications of accurate diagnosis and timely intervention for perinatal health.

Main Methods:

• Review of current literature on Fetal growth restriction (FGR) and placental disease.
• Analysis of diagnostic tools, focusing on ultrasound and Doppler velocimetry.
• Evaluation of management strategies, particularly the timing of delivery.

Main Results:

• Placental ischemia is the leading cause of FGR, linked to alterations in angiogenic mediators.
• Ultrasound remains the primary tool for diagnosing FGR and determining optimal delivery timing.
• While common patterns of fetal deterioration exist, individual progression varies; gestational age at delivery is a key determinant of outcomes.

Conclusions:

• Fetal growth restriction (FGR) represents a late-stage outcome of early placental development abnormalities.
• Abnormal Doppler velocimetry signals the need for close surveillance.
• Management decisions, including delivery timing, must integrate antepartum testing results with the fetus's gestational age.