Talk:Abnormal Development - Fetal Growth Restriction
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Cite this page: Hill, M.A. (2024, April 18) Embryology Abnormal Development - Fetal Growth Restriction. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Abnormal_Development_-_Fetal_Growth_Restriction |
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Note - This sub-heading shows an automated computer PubMed search using the listed sub-heading term. References appear in this list based upon the date of the actual page viewing. Therefore the list of references do not reflect any editorial selection of material based on content or relevance. In comparison, references listed on the content page and discussion page (under the publication year sub-headings) do include editorial selection based upon relevance and availability. (More? Pubmed Most Recent)
Fetal Growth Restriction
<pubmed limit=5>Fetal Growth Restriction</pubmed>
Intrauterine Growth Restriction
<pubmed limit=5>Intrauterine Growth Restriction</pubmed>
2013
2012
Antenatal surveillance of fetal growth restriction
Obstet Gynecol Surv. 2012 Sep;67(9):554-65. doi: 10.1097/OGX.0b013e31826a5c6f.
Thompson JL, Kuller JA, Rhee EH. Source Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Duke University Medical Center, Durham, NC 27710, USA. Jennifer.l.thompson@dm.duke.edu
Abstract
Fetal growth restriction is a complex problem in modern obstetrics. It is a condition of suboptimal fetal growth based on a genetically predetermined potential and affects approximately 5% to 10% of pregnancies. It is traditionally defined as an estimated fetal weight less than the 10th percentile. Those pregnancies that are affected by growth restriction are associated with increased risk of perinatal morbidity and mortality. Because of this increased risk, these pregnancies are monitored more closely to try to identify those fetuses at the greatest risk of fetal demise and initiate delivery before this critical event. Although the ideal management strategy is still being determined, there are several modalities available to assist in assessment of the growth-restricted fetus. These include the nonstress test test, biophysical profile, and Doppler velocimetry, most commonly of the fetal umbilical artery, in addition to sonographic growth assessment. The use of multiple fetal assessment tools may help improve the prediction of adverse outcomes and initiate delivery before cardiovascular collapse.
PMID 22990459
Regimens of fetal surveillance for impaired fetal growth
Cochrane Database Syst Rev. 2012 Jun 13;6:CD007113. doi: 10.1002/14651858.CD007113.pub3.
Grivell RM, Wong L, Bhatia V. Source Discipline of Obstetrics and Gynaecology, The University of Adelaide, Women’s and Children’s Hospital, Adelaide, Australia. rosalie.grivell@adelaide.edu.au
Abstract
BACKGROUND: Policies and protocols for fetal surveillance in the pregnancy where impaired fetal growth is suspected vary widely, with numerous combinations of different surveillance methods. OBJECTIVES: To assess the effects of antenatal fetal surveillance regimens on important perinatal and maternal outcomes. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (29 February 2012). SELECTION CRITERIA: Randomised and quasi-randomised trials comparing the effects of described antenatal fetal surveillance regimens. DATA COLLECTION AND ANALYSIS: Review authors R Grivell and L Wong independently assessed trial eligibility and quality and extracted data. MAIN RESULTS: We included one trial of 167 women and their babies. This trial was a pilot study recruiting alongside another study, therefore, a separate sample size was not calculated. The trial compared a twice-weekly surveillance regimen (biophysical profile, nonstress tests, umbilical artery and middle cerebral artery Doppler and uterine artery Doppler) with the same regimen applied fortnightly (both groups had growth assessed fortnightly). There were insufficient data to assess this review's primary infant outcome of composite perinatal mortality and serious morbidity (although there were no perinatal deaths) and no difference was seen in the primary maternal outcome of emergency caesarean section for fetal distress (risk ratio (RR) 0.96; 95% confidence interval (CI) 0.35 to 2.63). In keeping with the more frequent monitoring, mean gestational age at birth was four days less for the twice-weekly surveillance group compared with the fortnightly surveillance group (mean difference (MD) -4.00; 95% CI -7.79 to -0.21). Women in the twice-weekly surveillance group were 25% more likely to have induction of labour than those in the fortnightly surveillance group (RR 1.25; 95% CI 1.04 to 1.50). AUTHORS' CONCLUSIONS: There is limited evidence from randomised controlled trials to inform best practice for fetal surveillance regimens when caring for women with pregnancies affected by impaired fetal growth. More studies are needed to evaluate the effects of currently used fetal surveillance regimens in impaired fetal growth. Update of Cochrane Database Syst Rev. 2009;(1):CD007113.
PMID 22696366
