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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Fetal Mouse Cardiovascular Imaging Using a High-frequency Ultrasound 30/45MHZ System
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Stillbirth at term: Does size really matter?

Conrado Milani Coutinho1,2, Karen Melchiorre3, Basky Thilaganathan2,4

  • 1Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|May 22, 2020
PubMed
Summary
This summary is machine-generated.

Identifying placental dysfunction is key to preventing stillbirth. Fetal size is a poor predictor near term; maternal serum and Doppler parameters offer superior detection of at-risk fetuses.

Keywords:
Customized fetal growthEstimated fetal weightFetal growth chartsFetal growth reference standardsFetal growth restrictionPlacental dysfunctionSmall for gestational ageStillbirth

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Fetal Medicine

Background:

  • Placental dysfunction adversely affects fetal growth, increasing perinatal morbidity and mortality.
  • Fetal size evaluation is a strategy to identify placental dysfunction and prevent stillbirth.
  • Optimal methods for detecting small for gestational age (SGA) fetuses remain unclear.

Purpose of the Study:

  • To review current strategies for detecting placental dysfunction and SGA.
  • To evaluate the effectiveness of fetal size versus other parameters in predicting adverse perinatal outcomes.
  • To highlight the need for improved methods for identifying compromised fetuses.

Main Methods:

  • Review of existing literature on fetal size estimation, SGA detection, and placental dysfunction.
  • Analysis of the relationship between fetal size, gestational age, and adverse perinatal outcomes.
  • Evaluation of maternal serum biochemical and Doppler parameters as predictors of fetal compromise.

Main Results:

  • The association between small fetal size and adverse outcomes weakens significantly near term.
  • The majority of stillbirths and adverse perinatal outcomes occur in normally sized fetuses near term.
  • Maternal serum biochemical and Doppler parameters show superiority over fetal size in identifying fetuses at risk.

Conclusions:

  • Routine fetal size evaluation is insufficient for detecting placental dysfunction near term.
  • Maternal serum and Doppler parameters are more effective in identifying fetuses at risk of demise.
  • Multiparameter models require prospective validation to demonstrate their clinical utility.