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REVIEW  UPDATE IN LATE FETAL GROWTH RESTRICTION 

Minerva Obstetrics and Gynecology 2021 August;73(4):462-70

DOI: 10.23736/S2724-606X.21.04845-4

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Clinical monitoring of late fetal growth restriction

Bronacha MYLREA-FOLEY 1, Christoph LEES 1, 2

1 Imperial College London, London, UK; 2 Centre for Fetal Care, Queen Charlotte’s and Chelsea Hospital, Imperial College NHS Trust, London, UK



Late fetal growth restriction (FGR) poses its own challenges in respect of diagnosis, surveillance and delivery timing. Perinatal morbidity is relatively rare, and mortality extremely unusual, but given that late FGR is much more frequent than early FGR, the burden on neonatal services must not be underestimated. Doppler findings are more subtle than in early FGR, and growth rate rather than absolute fetal size may be important in defining the condition. Though umbilical artery Doppler changes form the basis for triggering delivery: reversed end diastolic flow at 32 weeks, absent at 34 weeks and raised PI at 36 weeks, other modalities of monitoring - for example cardiotocography and cerebral Doppler - are important in surveillance and timing follow up of the condition.


KEY WORDS: Fetal growth retardation; Premature birth; Doppler ultrasonography; Umbilical arteries; Middle cerebral artery; Cardiotocography

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