June 2004 · Vol. 16, No. 6Fetal growth restriction
3 keys to successful management
DEV
MAULIK,
MD, PHD;
GENEVIEVE
SICURANZA,
MD;
ANDREZJ
LYSIKIEWICZ,
MD, PHD;
REINALDO
FIGUEROA,
MDDr. Maulik is chairman, department of obstetrics and gynecology, Winthrop-University Hospital, Mineola, NY, and professor of obstetrics and gynecology, State University of New York, Stony Brook, NY. Dr. Sicuranza is chief of obstetrics and director of maternal-fetal medicine, department of obstetrics and gynecology, Winthrop-University Hospital, Mineola, NY, and associate professor of obstetrics and gynecology, State University of New York, Stony Brook, NY. Dr. Lysikiewicz is director of obstetrical and gynecological ultrasound services, department of obstetrics and gynecology, Winthrop-University Hospital, Mineola, NY, and professor of obstetrics and gynecology, State University of New York, Stony Brook, NY. Dr. Figueroa is director of graduate education, department of obstetrics and gynecology, Winthrop-University Hospital, Mineola, NY, and associate professor of obstetrics and gynecology, State University of New York, Stony Brook, NY.
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KEYS TO SUCCESS
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Antepartum recognition of fetal growth restriction is essential for proper surveillance and management.
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Because growth-restricted fetuses are at risk for adverse outcomes in utero, fetal surveillance is vital for timely recognition and intervention.
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Once growth restriction is identified, management should be individualized to ensure optimal gestational development and safe delivery.
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A rational strategy for antepartum identification, close fetal surveillance, and individualized intervention is based on meta-analyses, Cochrane reviews, and current standards of care.
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Not only is fetal growth restriction (FGR) associated with perinatal mortality and morbidity, but it may be linked to adverse consequences in adulthood.1 Its many causes involve diverse pathological processes; thus, it should not be considered a single disease. Many aspects remain unclear, a substantial number of affected infants are not identified before birth, and effective antepartum prevention and treatment remain elusive.
Fortunately, managing FGR has hopeful aspects. Meaningful recent advances elucidate its etiologic and pathophysiologic mechanisms and help clarify diagnosis and management.
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