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Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Fetal growth restriction: current knowledge
Luciano Marcondes Machado Nardozza1, Ana Carolina Rabachini Caetano1, Ana Cristina Perez Zamarian1
1Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo-SP, CEP 05089-030, Brazil.
Insights
Fetal growth restriction (FGR) impacts 5-10% of pregnancies. Early FGR diagnosis is crucial for monitoring fetal status and minimizing risks like premature birth and hypoxia.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Fetal Medicine
Background:
- Fetal growth restriction (FGR) affects 5-10% of pregnancies, being a leading cause of perinatal mortality.
- This review synthesizes current knowledge on FGR, covering its causes, classification, prediction, diagnosis, management, and neurological sequelae.
Purpose of the Study:
- To provide a comprehensive overview of the latest advancements in understanding and managing fetal growth restriction (FGR).
- To highlight the importance of early diagnosis and appropriate management strategies for FGR.
Main Methods:
- A systematic literature search was conducted across major scientific databases (PubMed, SCOPUS, Embase).
- The search term used was "fetal growth restriction" to identify relevant studies.
Main Results:
- FGR is classified as early (<32 weeks) or late (≥32 weeks), with distinct placental and cardiovascular adaptations.
- Early FGR is linked to higher perinatal morbidity and mortality due to significant placental issues and hypoxia.
- Late FGR has milder placental deficiencies, lower hypoxia, and reduced perinatal risks.
- Diagnosis relies on clinical assessment and Doppler ultrasound; no current treatments exist, making timing of delivery critical.
Conclusions:
- Early identification of FGR is vital for determining etiology and enabling close fetal monitoring.
- Timely diagnosis and management of FGR can significantly reduce the risks of premature birth and intrauterine hypoxia.
Background:
Fetal growth restriction (FGR) is a condition that affects 5-10% of pregnancies and is the second most common cause of perinatal mortality. This review presents the most recent knowledge on FGR and focuses on the etiology, classification, prediction, diagnosis, and management of the condition, as well as on its neurological complications.
Methods:
The Pubmed, SCOPUS, and Embase databases were searched using the term "fetal growth restriction".
Results:
Fetal growth restriction (FGR) may be classified as early or late depending on the time of diagnosis. Early FGR (<32 weeks) is associated with substantial alterations in placental implantation with elevated hypoxia, which requires cardiovascular adaptation. Perinatal morbidity and mortality rates are high. Late FGR (≥32 weeks) presents with slight deficiencies in placentation, which leads to mild hypoxia and requires little cardiovascular adaptation. Perinatal morbidity and mortality rates are lower. The diagnosis of FGR may be clinical; however, an arterial and venous Doppler ultrasound examination is essential for diagnosis and follow-up. There are currently no treatments to control FGR; the time at which pregnancy is interrupted is of vital importance for protecting both the mother and fetus.
Conclusion:
Early diagnosis of FGR is very important, because it enables the identification of the etiology of the condition and adequate monitoring of the fetal status, thereby minimizing risks of premature birth and intrauterine hypoxia.
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