Screening for fetal growth restriction and placental insufficiency

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Biomarker Discovery

Background:

• Fetal growth restriction (FGR) is a major cause of stillbirth and poor neurodevelopmental outcomes.
• FGR is often conflated with small for gestational age (SGA), hindering effective clinical management.
• Distinguishing pathological FGR from constitutionally small fetuses is essential for improved outcomes.

Purpose of the Study:

• To review current understanding of FGR etiology, diagnosis, and management.
• To highlight novel approaches for effective FGR screening.
• To emphasize the potential of new biomarkers and imaging techniques in antenatal care.

Main Methods:

• Comprehensive review of literature on FGR etiology, diagnosis, antenatal surveillance, and management.
• Analysis of recent advances in novel imaging methods for fetal assessment.
• Evaluation of maternal blood biomarkers, such as placenta growth factor, for FGR detection.

Main Results:

• Understanding the multifactorial pathogenesis of FGR, including placental pathologies, is key to developing targeted treatments.
• Maternal blood biomarker placenta growth factor shows significant potential for FGR screening.
• Stepwise multi-parametric testing using novel imaging offers a basis for cost-effective FGR screening.

Conclusions:

• Effective distinction between pathological FGR and constitutionally small fetuses is critical for clinical practice.
• Integrating novel biomarkers and advanced imaging into antenatal care systems can improve FGR screening.
• Targeted treatment strategies preserving placental function are needed for better fetal outcomes.