Common Issues in Prenatal Care: Fetal Growth Restriction

Area of Science:

• Obstetrics and Gynecology
• Perinatology
• Neonatology

Background:

• Fetal growth restriction (FGR) affects up to 10% of pregnancies.
• FGR is associated with increased risks of intrauterine mortality and significant postnatal complications.
• These complications include intraventricular hemorrhage, necrotizing enterocolitis, respiratory distress, hypoglycemia, and developmental issues.

Purpose of the Study:

• To define FGR and outline diagnostic and management strategies.
• To highlight the importance of early diagnosis and appropriate interventions for FGR.
• To discuss the role of genetic testing and delivery timing in managing FGR.

Main Methods:

• Definition of FGR based on ultrasound (US) parameters (estimated fetal weight or abdominal circumference <10th percentile).
• Recommendation for detailed US in early-onset FGR (<32 weeks' gestation).
• Consideration of genetic testing (including chromosomal microarray) when FGR is associated with polyhydramnios or fetal anomalies.

Main Results:

• FGR significantly elevates risks for adverse fetal and neonatal outcomes.
• Early-onset FGR necessitates detailed US evaluation.
• Genetic testing is indicated in specific FGR cases with additional anomalies.
• Delivery timing is guided by growth restriction severity and fetal well-being tests.

Conclusions:

• FGR management requires a multi-faceted approach including accurate diagnosis and risk assessment.
• Tailored delivery timing based on fetal well-being is crucial.
• Low-dose aspirin may reduce FGR risk in high-risk preeclampsia patients, but no routine prevention is recommended for FGR itself.