Because there is no effective treatment to reverse or stop the progression of placental insufficiency, fetal surveillance and decision regarding when delivery should take place are the main strategies in the management of these fetuses. Although many studies have been conducted, there is a lack of consistent evidence to safely recommend a specific time of delivery in cases of fetal growth restriction (FGR). The objective of a clinical protocol for the management of FGR is to combine the existing evidence on various methods for assessing fetal vitality (cardiotocography, biophysical profile, and Doppler) to achieve better growth and lung maturity and minimize the risk of morbidity as well as fetal and neonatal mortality. A type of management described in the literature is to group patients into stages of development on the basis of the follow-up results, birth time, and similar fetal risks. In this chapter, we will describe a management protocol based on the evidence available in the literature and the characteristics of our practice and of our patient population. A uniform management, based on protocol, improves perinatal outcome, reducing stillbirths.
KeywordsFetal growth restriction Small for gestational age Management Surveillance
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