Fetal Growth Restriction as a Perinatal and Long-Term Health Problem: Clinical Challenges and Opportunities for Future (4P) Fetal Medicine

2014 ◽  
Vol 36 (2) ◽  
pp. 85-85 ◽  
Author(s):  
Eduard Gratacós ◽  
Francesc Figueras
Keyword(s):  
Fetal Growth ◽  
Health Problem ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Fetal Medicine ◽  
Challenges And Opportunities

INTRAUTERINE GROWTH RETARDATION - A REVIEW ARTICLE

2018 ◽  
pp. 184-195
Author(s):  
Minh Son Pham ◽  
Vu Quoc Huy Nguyen ◽  
Dinh Vinh Tran
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Growth Potential ◽  
National Guidelines ◽  
Intrauterine Growth ◽  
No Gold Standard

Small for gestational age (SGA) and fetal growth restriction (FGR) is difficult to define exactly. In this pregnancy condition, the fetus does not reach its biological growth potential as a consequence of impaired placental function, which may be because of a variety of factors. Fetuses with FGR are at risk for perinatal morbidity and mortality, and poor long-term health outcomes, such as impaired neurological and cognitive development, and cardiovascular and endocrine diseases in adulthood. At present no gold standard for the diagnosis of SGA/FGR exists. The first aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines. Another aim to summary a number of interventions which are being developed or coming through to clinical trial in an attempt to improve fetal growth in placental insufficiency. Key words: fetal growth restriction (FGR), Small for gestational age (SGA)

scholarly journals Genetic Background of Fetal Growth Restriction

2021 ◽  
Vol 23 (1) ◽  
pp. 36
Author(s):  
Beata Anna Nowakowska ◽  
Katarzyna Pankiewicz ◽  
Urszula Nowacka ◽  
Magdalena Niemiec ◽  
Szymon Kozłowski ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Metabolic Diseases ◽  
Prenatal Testing ◽  
Growth Restriction ◽  
Chromosomal Microarray ◽  
Third Trimester ◽  
Noninvasive Prenatal Testing ◽  
Current State

Fetal growth restriction (FGR) is one of the most formidable challenges in present-day antenatal care. Pathological fetal growth is a well-known factor of not only in utero demise in the third trimester, but also postnatal morbidity and unfavorable developmental outcomes, including long-term sequalae such as metabolic diseases, diabetic mellitus or hypertension. In this review, the authors present the current state of knowledge about the genetic disturbances responsible for FGR diagnosis, divided into fetal, placental and maternal causes (including preeclampsia), as well as their impact on prenatal diagnostics, with particular attention on chromosomal microarray (CMA) and noninvasive prenatal testing technique (NIPT).

scholarly journals Twin-Twin Transfusion Syndrome with and without Selective Fetal Growth Restriction Prior to Fetoscopic Laser Surgery: Short and Long-Term Outcome

2019 ◽  
Vol 8 (7) ◽  
pp. 969 ◽  
Author(s):  
Groene ◽  
Tollenaar ◽  
van Klink ◽  
Haak ◽  
Klumper ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Laser Surgery ◽  
Growth Restriction ◽  
Separate Analysis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short And Long Term ◽  
Perinatal Survival

As twin-twin transfusion syndrome (TTTS) and selective fetal growth restriction (sFGR) are both prevalent complications of monochorionic (MC) twin pregnancies, its coexistence is not uncommon. The aim of this study is to evaluate the short and long-term outcome in TTTS with and without sFGR prior to fetoscopic laser coagulation. All TTTS cases treated with laser surgery at our center between 2001–2019 were retrospectively reviewed for the presence of sFGR, defined as an estimated fetal weight (EFW) <10th centile. We compared two groups: TTTS-only and TTTS + sFGR. Primary outcomes were perinatal survival and long-term severe neurodevelopmental impairment (NDI). Of the 527 pregnancies eligible for analysis, 40.8% (n = 215) were categorized as TTTS-only and 59.2% (n = 312) as TTTS + sFGR. Quintero stage at presentation was higher in the TTTS + sFGR group compared to the TTTS-only group (57% compared to 44% stage III). Separate analysis of donors showed significantly lower perinatal survival for donors in the TTTS + sFGR group (72% (224/311) compared to 81% (173/215), p = 0.027). Severe NDI at follow-up in long-term survivors in the TTTS-only and TTTS + sFGR group was present in 7% (13/198) and 9% (27/299), respectively (p = 0.385). Both sFGR (OR 1.5;95% CI 1.1–2.0, p = 0.013) and lower gestational age at laser (OR 1.1;95% CI 1.0–1.1, p = 0.001) were independently associated with decreased perinatal survival. Thus, sFGR prior to laser surgery is associated with a more severe initial presentation and decreased donor perinatal survival. The long-term outcome was not affected.

INTRAUTERINE GROWTH RETARDATION - A REVIEW ARTICLE

2018 ◽  
Vol 8 (6) ◽  
pp. 184-195
Author(s):  
Son Pham Minh ◽  
Huy Nguyen Vu Quoc ◽  
Vinh Tran Dinh
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Growth Potential ◽  
National Guidelines ◽  
Intrauterine Growth ◽  
No Gold Standard

Small for gestational age (SGA) and fetal growth restriction (FGR) is difficult to define exactly. In this pregnancy condition, the fetus does not reach its biological growth potential as a consequence of impaired placental function, which may be because of a variety of factors. Fetuses with FGR are at risk for perinatal morbidity and mortality, and poor long-term health outcomes, such as impaired neurological and cognitive development, and cardiovascular and endocrine diseases in adulthood. At present no gold standard for the diagnosis of SGA/FGR exists. The first aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines. Another aim to summary a number of interventions which are being developed or coming through to clinical trial in an attempt to improve fetal growth in placental insufficiency. Key words: fetal growth restriction (FGR), Small for gestational age (SGA)

scholarly journals The Role of Proteoglycans in Contributing to Placental Thrombosis and Fetal Growth Restriction

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Joanne M. Said
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Potential Role ◽  
Pregnancy Complication ◽  
Growth Restriction ◽  
Increased Risk ◽  
Fetus And Neonate

Fetal growth restriction is an important pregnancy complication that has major consequences for the fetus and neonate as well as an increased risk of long-term morbidity extending into adulthood. The precise aetiology of most cases of fetal growth restriction is unknown although placental thrombosis is a common feature in many of these cases. This paper will outline the potential role of proteoglycans in contributing to placental thrombosis and fetal growth restriction.

Human fetal growth restriction: a cardiovascular journey through to adolescence

2016 ◽  
Vol 7 (6) ◽  
pp. 626-635 ◽  
Author(s):  
A. Sehgal ◽  
M. R. Skilton ◽  
F. Crispi
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Monitoring And Evaluation ◽  
Well Being ◽  
Growth Restriction ◽  
Childhood And Adolescence ◽  
Fetal Life ◽  
Wide Range ◽  
Novel Concept

Intrauterine growth restriction has been noted to adversely impact morbidity and mortality in the neonatal period as well as cardiovascular well-being in adolescence and adulthood. Recent data based on a wide range of ultrasound parameters during fetal and neonatal life has noted early and persistent involvement of the cardiovascular system. Some of these measures are predictive of long-term morbidities. Assessment of vascular mechanics is a new and novel concept in this population, and opens up avenues for diagnosis, monitoring and evaluation of the likely effectiveness of interventions. Prevention of these adverse vascular and cardiac outcomes secondary to fetal growth restriction may be feasible and of clinical relevance. This review focuses on growth restriction in humans with respect to cardiovascular remodeling and dysfunction during fetal life, persistence of functional cardiac impairment during early childhood and adolescence, and possible preventive strategies.

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