Clinical practice guidance for the management of fetal growth restriction: an expert review

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Maternal-Fetal Medicine

Background:

• Fetal growth restriction (FGR) is linked to higher rates of perinatal morbidity and mortality.
• Early prenatal identification and intervention are crucial for improving outcomes in FGR pregnancies.
• Existing management strategies vary significantly across different healthcare settings globally.

Purpose of the Study:

• To provide comprehensive recommendations for the clinical management of pregnancies with suspected FGR.
• To address diverse scenarios, including high-income and low-middle-income countries, and referral vs. referring centers.
• To guide the optimization of delivery timing and mode to enhance perinatal outcomes.

Main Methods:

• A panel of experts was convened to address various aspects of FGR clinical practice management.
• Evidence was systematically prioritized using the GRADE classification system.
• Recommendations were developed through a practical approach, considering the availability of diagnostic, screening, and management options.

Main Results:

• A practical approach is presented for optimizing the timing and mode of delivery in FGR cases.
• The guidance aims to prevent unnecessary or excessive interventions.
• The goal is to improve overall perinatal outcomes for infants affected by FGR.

Conclusions:

• This document provides essential guidance for the clinical management of pregnancies with suspected FGR.
• It emphasizes a tailored approach, acknowledging resource limitations in different settings.
• The recommendations focus on improving perinatal outcomes through optimized management strategies.