Fetal growth restriction (FGR) is described as the failure of the fetus to fulfil its growth potential because of a pathological factor-like placental dysfunction.
It is the greatest cause of stillbirth, neonatal mortality, and short‐ and long‐term morbidity, globally. The agreements depending on current research in the diagnosis and management of FGR are described in a recent article, which delivers a comprehensive summary of available evidence and the practical recommendations regarding the care of pregnancies at risk of or complicated by FGR, to reduce the risk of stillbirth and neonatal mortality and morbidity associated with this condition.
The main recommendations for monitoring, timing and mode of delivery in cases with suspected fetal growth restriction are as follows-
a. UA PI(pulsatility index) >95th percentile, or
b. MCA PI <5th percentile, or
c. CPR(cerebroplacental ratio) <5th percentile, or
d. UtA( uterine artery) PI >95th percentile
4. In FGR with umbilical artery AEDV/REDV (absent or reversed diastolic velocity),
a. AEDV: 6.8%, OR(odds ratio) 3.6 [2.3–5.6]
b. REDV: 19%, OR 7.3 [4.6–11.4]
a. AEDV: 0%–1%
b. REDV: 1%–2%
a. AEDV: 5 days
b. REDV: 2 days
Inpatient monitoring is suggested along with Steroids for fetal lung maturation, BPP/NST 1–2 times per day, Doppler (UA, MCA, DV) every 1–2 days, and Growth monitoring every 2 weeks. The timing of delivery should be AEDV: 32–34 weeks, REDV: 30–32 weeks; which should be done by a cesarean section.
5. In FGR with abnormal ductus venosus Doppler,
a. Elevated DV PIV(pulsatility index for veins): 2%
b. Absent‐reverse a‐wave in DV: 4%
SOURCE-. Int J Gynaecol Obstet. 2021;152Suppl 1(Suppl 1):3-57. doi:10.1002/ijgo.13522