Abstract
Fetal growth restriction (FGR) is a failure of fetus to reach its expected biological growth, based on its genetically predetermined potential. Whenever effective fetal weight is less than, 10th percentile or 2 standard deviation of population-specific growth curve, it is considered small for gestational age (SGA). The FGR is associated with poor somatic growth with concomitant changes in placental and cerebral blood flow and/or biochemical markers along with EBW < 3rd percentile. It is an important cause of perinatal mortalities and morbidities. Ultrasound plays a definitive role in diagnosis and its management. This article is aimed to mini review the published guidelines on FGR and SGA and summarize the areas of consensus.
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Unterscheider J, Daly S, Geary MP, Kennelly MM, et al. Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO study editorial comment. Obstet Gynecol Surv. 2013;68:549–51. https://doi.org/10.1097/ogx.0b013e3182a0597.
Gordijn SJ, Beune IM, Thilaganathan B, Papageorghiou A, et al. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol. 2016;48:333–9. https://doi.org/10.1002/uog.15884.
Avagliano L, Garo C, Marconi AM. Placental amino acids transport in intrauterine growth restriction. J Pregnancy. 2012;2012:972562. https://doi.org/10.1155/2012/972562.
Chen YY, Gupta MB, Grattton R, Powell TL, et al. Down-regulation of placental folate transporters in intrauterine growth restriction. J Nutr Biochem. 2018;59:136–41. https://doi.org/10.1016/jjnutbio.2018.06.003.
Peleg D, Kennedy CM, Hunter SK. Intrauterine growth restriction: identification and management. AAFP. 1998;58(2):453–60.
Lee AC, Kozuki N, Cousens S, Stevens GA, et al. Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21 (st) standard: analysis of CHERG datasets. BMJ. 2017;358:j3677. https://doi.org/10.1136/bmjj3677.
D’Ercole AJ, Dai Z, Xing Y, Boney C, et al. Clemmons DR brain growth retardation due to the expression of human insulin like growth factor binding protein-1 in transgenic mice: an in vivo model for the analysis of igf function in the brain. Brain Res Dev Brain Res. 1994;82(1–2):213–22.
Ye P, Carson J, D’Ercole AJ. In vivo actions of insulin-like growth factor-I (IGF-I) on brain myelination: studies of IGF-I and IGF binding protein-1 (IGFBP-1) transgenic mice. J Neurosci. 1995;15(11):7344–56.
Hill JM, Agoston DV, Gressens P, McCune SK. Distribution of VIP mRNA and two distinct VIP binding sites in the developing rat brain: relation to ontogenic events. J Comp Neurol. 1994;342:186–205.
Murphy VE, Smith R, Giles WB, Clifton VL. Endocrine regulation of human fetal growth: the role of the mother, placenta, and fetus. Endocr Rev. 2006;27(2):141–69.
Sharma D, Farahbakhsh N, Shastri S, Sharma P. Intrauterine growth restriction—part 2. J Matern Fetal Neonatal Med. 2016;29(24):4037–48. https://doi.org/10.3109/14767058.2016.1154525.
Singh M. Disorders of weight and gestation. In: Singh M, editor. In care of the newborn. 5th ed. New Delhi: Sagar Publications; 1999. p. 224–45.
Eduard Gratacos. Integrated management of fetal growth restriction BCNatal—Barcelona Center of Maternal-Fetal and Neonatal Medicine. 2013.
Fleiss B, Wong F, Brownfoot F, Shearer IK. Knowledge gaps and emerging research areas in intrauterine growth restriction-associated brain injury. Front Endocrinol. 2019;10:188. https://doi.org/10.3389/fendo.2019.00188.
Sharma D, Shastri S, Sharma P. Intrauterine growth restriction: antenatal and postnatal aspects. Clin Med Insights Pediatr. 2016;10:67–83.
Unterscheider J, O’donoghue K, Daly S, Geary MP, et al. Fetal growth restriction and the risk of perinatal mortality-case studies from the multicentre PORTO study. BMC Pregnancy Childbirth. 2014;14:63. https://doi.org/10.1186/1471-2393-14-63.
Winder NR, Krishnaveni GV, Veena SR, Hill JC, et al. Mother’s lifetime nutrition and the size, shape and efficiency of the placenta. Placenta. 2011;32:806–10. https://doi.org/10.1016/j.placenta.2011.09.001.
Martyn CN, Barker DJ, Osmond C. Mothers’ pelvic size, fetal growth, and death from stroke and coronary heart disease in men in the UK. Lancet. 1996;348:1264–8. https://doi.org/10.1016/S0140-6736(96)04257-2.
Barker DJ, Osmond C, Golding J, Kuh D, et al. Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ. 1989;298:564–7. https://doi.org/10.1136/bmj.298.6673.564.
Leitner Y, Fattal-Valevski A, Geva R, Eshel R, et al. Neurodevelopmental outcome of children with intrauterine growth retardation: a longitudinal, 10-year prospective study. J Child Neurol. 2007;22:580–7. https://doi.org/10.1177/0883073807302605.
Chang TC, Robson SC, Boys RJ, Spencer JA. Prediction of the small for gestational age infant: which ultrasonic measurement is best? Obstet Gynecol. 1992;80(6):1030–8.
Hughes DS, Magann EF. Antenatal fetal surveillance “Assessment of the AFV”. Best Pract Res Clin Obstet Gynaecol. 2017;38:12–23.
Khalil A, Thilaganathan B. Role of uteroplacental and fetal Doppler in identifying fetal growth restriction at term. Best Pract Res Clin Obstet Gynaecol. 2017;38:38–47.
Barker DJP. The origins of the developmental origins theory. J Intern Med. 2007;261(5):412–7.
Barker DJ, Osmond C, Thornburg KL, Kajantie E, et al. The lifespan of men and the shape of their placental surface at birth. Placenta. 2011;32:783–7. https://doi.org/10.1016/j.placenta.2011.07.031.
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Dr. Deepti shrivastava is a Professor and Head of the Department of OBGY, JNMC Sawangi, Wardha, Maharashtra, India and Dr. Ayesha Master is the MBBS, Resident of the Department of OBGY, JNMC Sawangi, Wardha, Maharashtra, India.
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Shrivastava, D., Master, A. Fetal Growth Restriction. J Obstet Gynecol India 70, 103–110 (2020). https://doi.org/10.1007/s13224-019-01278-4
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DOI: https://doi.org/10.1007/s13224-019-01278-4