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Growth assessment in diagnosis of Fetal Growth Restriction. Review
A R Albu1, I A Horhoianu1, M C Dumitrascu1
1"Carol Davila" University of Medicine and Pharmacy; Bucharest University Emergency Hospital, Department of Obstetrics and Gynecology.
Insights
Accurately assessing fetal growth is crucial for identifying growth-restricted fetuses at risk of complications. This review discusses methods like Symphyseal-Fundal Height (SFH) and ultrasound parameters (AC, EFW) to differentiate between normal and abnormal fetal growth.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Perinatal Health
Background:
- Fetal growth assessment is vital for identifying growth restriction, linked to perinatal morbidity and mortality.
- Distinguishing physiologically small fetuses from growth-restricted ones remains a clinical challenge.
- Accurate assessment aids in targeted surveillance and management of at-risk pregnancies.
Purpose of the Study:
- To review and discuss methods for assessing fetal growth.
- To highlight the strengths and weaknesses of various fetal growth assessment tools.
- To address the ongoing debate in differentiating normal small fetuses from growth-restricted ones.
Main Methods:
- Review of clinical tools for fetal growth assessment.
- Discussion of Symphyseal-Fundal Height (SFH) measurement.
- Analysis of fetal ultrasound parameters: Abdominal Circumference (AC) and Estimated Fetal Weight (EFW).
- Examination of different types of growth charts: populational, standard, individualized, customized, and growth trajectories.
Main Results:
- Various clinical and ultrasound methods exist for fetal growth assessment.
- Different growth charts (populational, standard, individualized, customized) offer varied approaches.
- No single method perfectly discriminates all cases, highlighting the need for comprehensive evaluation.
Conclusions:
- Accurate fetal growth assessment is critical for perinatal outcomes.
- A combination of clinical and ultrasound methods, alongside appropriate growth charts, is recommended.
- Further research may refine methods to better distinguish between normal and abnormal fetal growth patterns.
Abstract:
The assessment of fetal growth represents a fundamental step towards the identification of the true growth restricted fetus that is associated to important perinatal morbidity and mortality. The possible ways of detecting abnormal fetal growth are taken into consideration in this review and their strong and weak points are discussed. An important debate still remains about how to discriminate between the physiologically small fetus that does not require special surveillance and the truly growth restricted fetus who is predisposed to perinatal complications, even if its parameters are above the cut-off limits established. In this article, we present the clinical tools of fetal growth assessment: Symphyseal-Fundal Height (SFH) measurement, the fetal ultrasound parameters widely taken into consideration when discussing fetal growth: Abdominal Circumference (AC) and Estimated Fetal Weight (EFW); several types of growth charts and their characteristics: populational growth charts, standard growth charts, individualized growth charts, customized growth charts and growth trajectories.
