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Minerva Obstetrics and Gynecology 2021 Apr 27

DOI: 10.23736/S2724-606X.21.04775-4

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

How to define late Fetal growth Restriction

Judit MARTINEZ 1, 2, David BOADA 1, 2, Francesc FIGUERAS 1, 2, Eva MELER 1, 2

1 Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic), IDIBAPS, University of Barcelona, Barcelona, Spain; 2 Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain


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A fraction of third-trimester small fetuses does not achieve their endowed growth potential mainly due to placental insufficiency, usually not evident in terms of impaired umbilical artery Doppler, but severe enough to increase the risk of perinatal adverse outcomes and long-term complications. The identification of those fetuses at higher-risk helps to optimize their follow-up and to decrease the risk of intrauterine demise. Several parameters can help in the identification of those fetuses at higher risk, defined as Fetal Growth Restricted (FGR) fetuses. Severe smallness and the cerebroplacental ratio are the most consistent parameters; regarding uterine artery Doppler, although some evidence in favour has been published, there is currently no consensus about its use. 32 weeks of gestation is the accepted cut-off to define late FGR. The differentiation with early FGR is necessary as these two entities have different clinical maternal manifestations, and different associated short-term and long-term neonatal outcomes. The use of angiogenic factors is promising but more research is needed on this field.


KEY WORDS: Late onset; FGR; Doppler assessment; Angiogenic factors

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