Defining normal and abnormal fetal growth: promises and challenges

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Perinatology

Background:

• Normal fetal growth is vital for pregnancy outcomes and long-term child health.
• Accurate definition of abnormal fetal growth remains a clinical and research challenge.
• Current standards for evaluating fetal growth have limitations and pitfalls.

Purpose of the Study:

• To review existing references and standards for fetal growth evaluation.
• To discuss challenges and limitations in defining abnormal fetal growth.
• To explore recent advancements towards an integrated definition of fetal growth restriction.

Main Methods:

• Literature review of current fetal growth references and standards.
• Analysis of common pitfalls in existing definitions of abnormal fetal growth.
• Discussion of approaches for customizing fetal growth standards.
• Exploration of recent advances in integrated definitions for fetal growth restriction.

Main Results:

• Various references and standards are used for fetal growth evaluation, each with pros and cons.
• Current definitions of abnormal fetal growth present common pitfalls.
• An integrated definition for fetal growth restriction is proposed, incorporating fetal size, placental health (Doppler velocimetry, biomarkers), biophysical findings, and genetics.

Conclusions:

• An integrated definition for fetal growth restriction shows promise for improving clinical and research practices.
• Further development and validation of the integrated definition are necessary.
• An improved definition will enhance the diagnosis and management of abnormal fetal growth.