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Related Concept Videos

Intrauterine Drug Delivery Systems01:21

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Controlled-release systems for intravaginal and intrauterine drug delivery have been developed primarily for the administration of contraceptive steroid hormones. These delivery routes circumvent first-pass hepatic metabolism, thereby enhancing bioavailability and allowing for reduced systemic dosages compared to oral administration. Such approaches contribute to improved therapeutic efficacy and patient compliance, particularly in long-term contraceptive regimens.Intravaginal Drug Delivery...
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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 Growth Restriction: Contemporary Evidence to Guide Delivery Timing and Intrapartum Management.

Ana Carolina Rabachini Caetano1, Ana Cristina Perez Zamarian1, Luciano Marcondes Machado Nardozza1

  • 1Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo 04023-062, SP, Brazil.

Diagnostics (Basel, Switzerland)
|March 14, 2026
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Summary

Fetal growth restriction (FGR) management requires careful timing of delivery based on fetal well-being and gestational age. Evidence guides clinicians on delivery approaches for FGR pregnancies, despite limited randomized trials.

Keywords:
Doppler velocimetrydeliveryfetal growth restrictionfetal surveillancemanagementperinatal morbidity and mortality

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Fetal Medicine

Background:

  • Fetal growth restriction (FGR) affects 5-10% of pregnancies, increasing perinatal morbidity and mortality.
  • Current evidence for optimal FGR diagnosis and management is limited.
  • A 2016 consensus aimed to standardize FGR terminology and diagnosis.

Purpose of the Study:

  • To update evidence on the optimal timing and methods for delivering pregnancies complicated by FGR.
  • To emphasize how fetal surveillance abnormalities guide delivery decisions at different gestational ages.

Main Methods:

  • Literature search of PubMed/Medline and LILACS databases (last 10 years).
  • Keywords: fetal growth restriction, management, delivery.
  • Results categorized by gestational age at delivery, mode of delivery, and labor induction methods.

Main Results:

  • Specific fetal surveillance abnormalities necessitate delivery at distinct gestational ages.
  • Management flowcharts were developed based on evidence.
  • Despite limited randomized trials, available evidence was summarized for clinical guidance.

Conclusions:

  • Optimal management of FGR pregnancies hinges on balancing prematurity risks with risks of fetal sequelae or death.
  • Fetal surveillance findings are critical for determining delivery timing in FGR.
  • Further high-quality research, including randomized clinical trials, is needed to refine FGR management strategies.