Clinician performed ultrasound in fetal growth restriction: fetal, neonatal and pediatric aspects

Area of Science:

• Perinatal Medicine
• Cardiology
• Medical Imaging

Background:

• Fetal growth restriction (FGR) affects 7-10% of pregnancies.
• Cardiac compromise is observed in fetuses and neonates with FGR.
• Ultrasound plays a crucial role in assessing FGR-related cardiac and vascular changes.

Purpose of the Study:

• To review ultrasound parameters for assessing cardiac function and vascular health in FGR across different age groups.
• To highlight the predictive value of feto-placental parameters for perinatal outcomes and later hypertension.
• To discuss the clinical relevance of these parameters in intervention strategies.

Main Methods:

• Review of conventional and tissue Doppler imaging in fetal and neonatal FGR.
• Analysis of sonographic parameters in fetal life, early postnatal, and pediatric periods.
• Discussion of vascular imaging findings, including arterial stiffness and blood pressure.

Main Results:

• Fetal sonographic parameters predict adverse perinatal outcomes and later hypertension.
• Postnatal FGR infants show altered heart morphology and sub-clinical cardiac dysfunction.
• Vascular imaging reveals thickened, stiffer arteries and elevated blood pressure in FGR individuals, persisting into childhood.

Conclusions:

• Ultrasound parameters are vital for assessing FGR manifestations from fetal life through childhood.
• Point-of-care ultrasound aids clinicians in identifying sub-clinical FGR cardiac and vascular changes.
• These findings support the development and monitoring of targeted interventions for FGR.