Dynamic growth changes in fetal growth restriction using serial ultrasonographic biometry and umbilical artery...

Area of Science:

• Perinatology
• Fetal Medicine
• Obstetrics

Background:

• Fetal growth restriction (FGR) is a significant concern in pregnancy.
• Monitoring fetal growth is crucial for identifying and managing potential complications.
• Understanding the dynamic growth patterns of fetuses initially diagnosed with FGR is important for optimizing perinatal care.

Purpose of the Study:

• To investigate the growth dynamics of fetuses initially diagnosed with fetal growth restriction (FGR).
• To analyze perinatal outcomes and maternal factors in fetuses that outgrew their initial FGR diagnosis.
• To determine if antenatal surveillance strategies need adjustment for fetuses showing catch-up growth.

Main Methods:

• A multicenter prospective study involving 1116 pregnancies with singleton gestations.
• Ultrasound surveillance was conducted between 24 and 36 weeks of gestation.
• Biometry, Doppler analysis, delivery details, and adverse perinatal outcomes were recorded.

Main Results:

• 193 fetuses (17%) initially diagnosed with FGR surpassed the 10th centile for estimated fetal weight before delivery, termed "growers."
• Mothers of "growers" were less likely to be smokers or have hypertensive pregnancy complications compared to the true FGR group.
• Abnormal umbilical artery Doppler was observed in 25% of "growers," often as a transient finding.

Conclusions:

• Fetal growth is dynamic, with a notable proportion of fetuses outgrowing an initial FGR diagnosis.
• Positive growth spurts in fetuses were more common in mothers without significant health issues.
• Antenatal surveillance may be adjusted for fetuses that have outgrown the 10th centile after an initial FGR diagnosis.