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Introduction to fetal growth restriction

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Comparison between a normal two-day-old baby (right) with two low birthweight babies.
The baby on the left, aged four weeks, was born nine weeks before term;
the baby in the middle, aged two weeks, was born at full term but weighed
only 1200 g. Science Photo Library. Enlarge

Fetuses with fetal growth restriction (FGR) greatly contribute to perinatal mortality and short- and long-term morbidity, with a 3–10 fold increase in perinatal mortality in pregnancies complicated by this condition. One of the challenges in obstetric practice is to identify potentially growth restricted fetuses and then, from this group, those that are 'small and healthy' and those that are 'small and unhealthy'. Intervention in the former group, which may involve early delivery, is associated with an increased risk of prematurity with no fetal advantage, whereas failure to intervene in the latter group may result in stillbirth or hypoxic damage.

Learning objectives

By the end of this tutorial you should, in respect of FGR, be able to:

  • define what is meant by the terms FGR and small for gestational age, and the differences between symmetrical FGR and asymmetrical FGR
  • understand its aetiology
  • understand the adverse outcomes associated with the condition
  • understand how to screen for and diagnose the condition
  • understand the principles of management of pregnancies recognised to be complicated by the condition

 

Last updated: 16/02/10 (new section added on the Evidence for the effectiveness of umbilical Doppler ultrasound in high-risk pregnancies)

15/01/10 (new animation on Umbilical artery data and placental resistance added)

15/12/09 (tutorial reviewed and updated by Professor Gary Mires)

19/11/09 (Full text PDF of Romo et al 2009 added to the Preliminary reading page)

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