REVIEW  UPDATE IN LATE FETAL GROWTH RESTRICTION 

Minerva Obstetrics and Gynecology 2021 August;73(4):442-52

DOI: 10.23736/S2724-606X.21.04829-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Soft tissue assessment for fetal growth restriction

Wesley LEE ✉

Division of Women’s and Fetal Imaging, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA

Contemporary clinical practice heavily relies on interpretation of population-based birth weight standards to evaluate neonatal nutrition status. Obstetricians have adopted the use of estimated fetal weight in a similar manner to estimate fetal nutritional status. However, most fetal weight prediction models overemphasize skeletal parameters such as biparietal diameter, head circumference, and femur diaphysis length. Although most EFW calculations also include abdominal circumference, this 2D growth parameter is largely defined by liver size and a small rim of subcutaneous fat. Advances in 3D ultrasound imaging and the development of more robust image analysis tools have now made it possible to reliably add a soft tissue component for fetal nutritional assessment. This chapter explains why fetal soft tissue evaluation is clinically relevant, describes different techniques for evaluating these sonographic parameters, and outlines future directions for their practical utility in the care of malnourished fetuses.

KEY WORDS: Body composition; Fetal development; Fetal growth retardation; Fetal weight