Evaluation and Management of Suspected Fetal Growth Restriction

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Fetal Medicine

Background:

• Placental insufficiency leads to impaired fetal growth, a significant cause of adverse perinatal outcomes.
• Current interventions do not alter the underlying pathophysiology of fetal growth restriction.
• Monitoring strategies for early-onset fetal growth restriction (FGR) aim to optimize delivery timing via cardiotocography and Doppler ultrasound.

Purpose of the Study:

• To address the challenge of identifying fetuses with late-onset FGR who require expedited delivery due to immediate hypoxia risk.
• To highlight the need for improved risk stratification in late-onset FGR.
• To outline future research directions for optimizing individualized treatment strategies.

Main Methods:

• Review of current monitoring practices for early-onset FGR (cardiotocography, Doppler ultrasound).
• Discussion of challenges in risk identification for late-onset FGR.
• Conceptual framework for future risk model development.

Main Results:

• No current intervention modifies the pathophysiology of FGR.
• Identifying fetuses at risk for hypoxia in late-onset FGR remains challenging.
• The need for integrated risk models incorporating multiple variables is emphasized.

Conclusions:

• Optimizing individualized treatment for FGR requires better risk assessment.
• Future studies will focus on integrating various monitoring variables and prognosticators into risk models.
• The goal is to improve perinatal outcomes in fetuses with FGR.