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Fetal growth restriction: current knowledge

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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.

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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.

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  1. Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo-SP, CEP 05089-030, Brazil

    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 Júnior

  2. Mario Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba-MG, Brazil

    Alberto Borges Peixoto

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  1. Luciano Marcondes Machado Nardozza
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Nardozza, L.M.M., Caetano, A.C.R., Zamarian, A.C.P. et al. Fetal growth restriction: current knowledge. Arch Gynecol Obstet 295, 1061–1077 (2017). https://doi.org/10.1007/s00404-017-4341-9

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