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Archives of Gynecology and Obstetrics

, Volume 295, Issue 5, pp 1061–1077 | Cite as

Fetal growth restriction: current knowledge

  • Luciano Marcondes Machado Nardozza
  • Ana Carolina Rabachini Caetano
  • Ana Cristina Perez Zamarian
  • Jaqueline Brandão Mazzola
  • Carolina Pacheco Silva
  • Vivian Macedo Gomes Marçal
  • Thalita Frutuoso Lobo
  • Alberto Borges Peixoto
  • Edward Araujo JúniorEmail author
Review

Abstract

Background

Fetal growth restriction (FGR) is a condition that affects 5–10% of pregnancies and is the second most common cause of perinatal mortality. This review presents the most recent knowledge on FGR and focuses on the etiology, classification, prediction, diagnosis, and management of the condition, as well as on its neurological complications.

Methods

The Pubmed, SCOPUS, and Embase databases were searched using the term “fetal growth restriction”.

Results

Fetal growth restriction (FGR) may be classified as early or late depending on the time of diagnosis. Early FGR (<32 weeks) is associated with substantial alterations in placental implantation with elevated hypoxia, which requires cardiovascular adaptation. Perinatal morbidity and mortality rates are high. Late FGR (≥32 weeks) presents with slight deficiencies in placentation, which leads to mild hypoxia and requires little cardiovascular adaptation. Perinatal morbidity and mortality rates are lower. The diagnosis of FGR may be clinical; however, an arterial and venous Doppler ultrasound examination is essential for diagnosis and follow-up. There are currently no treatments to control FGR; the time at which pregnancy is interrupted is of vital importance for protecting both the mother and fetus.

Conclusion

Early diagnosis of FGR is very important, because it enables the identification of the etiology of the condition and adequate monitoring of the fetal status, thereby minimizing risks of premature birth and intrauterine hypoxia.

Keywords

Fetal growth restriction Placental insufficiency Prediction Doppler Management Neurological development 

Notes

Author contributions

LMN Project development, Supervision. ACRC—manuscript writing. ACPZ—manuscript writing. JBM—manuscript writing. CPS—manuscript writing. VMGM—search on the literatute. TFL—search on the literature. ABP—critical review. EAJ—Critical review.

Compliance with ethical standards

Funding

This study was not funding.

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Luciano Marcondes Machado Nardozza
    • 1
  • Ana Carolina Rabachini Caetano
    • 1
  • Ana Cristina Perez Zamarian
    • 1
  • Jaqueline Brandão Mazzola
    • 1
  • Carolina Pacheco Silva
    • 1
  • Vivian Macedo Gomes Marçal
    • 1
  • Thalita Frutuoso Lobo
    • 1
  • Alberto Borges Peixoto
    • 1
    • 2
  • Edward Araujo Júnior
    • 1
    Email author
  1. 1.Department of Obstetrics, Paulista School of MedicineFederal University of São Paulo (EPM-UNIFESP)São Paulo-SPBrazil
  2. 2.Mario Palmério University HospitalUniversity of Uberaba (UNIUBE)Uberaba-MGBrazil

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