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Chapter-45 Fetal Growth Restriction: Monitoring and Management

BOOK TITLE: Manual of High-Risk Pregnancy

Author
1. Balsarkar Geetha
2. Murkey Jagruti
ISBN
9789352703920
DOI
10.5005/jp/books/14143_46
Edition
1/e
Publishing Year
2018
Pages
7
Author Affiliations
1. Nowrosjee Wadia Maternity Hospital and Seth GS Medical College, Parel, Mumbai, Maharashtra, India, Nowrosjee Wadia Maternity Hospital, Mumbai, Nowrosjee Wadia Maternity Hospital, Seth GS Medical College, Parel, Mumbai, Nowrosjee Wadia, Maternity Hospital, Seth GS Medical College, Parel, Mumbai, Nowrosjee Wadia Maternity Hospital, Seth GS Medical College, Mumbai, Maharashtra, India, Seth GS Medical College, Nowrosjee Wadia Maternity Hospital, Mumbai, Maharashtra, India, Nowrosjee Wadia Maternity Hospital; Seth GS Medical College, Mumbai, Maharashtra, India, Nowrosjee Wadia Maternity Hospital, Seth GS Medical College, Mumbai; JOGI; Young Talent Promotion Committee FOGSI, Seth GS Medical College; Nowrosjee Wadia Maternity Hospital, Mumbai, Maharashtra, India, Maniben Jamnadas Memorial Clinic, Mumbai, Maharashtra, India
2. Nowrosjee Wadia Maternity Hospital, Seth GS Medical College, Mumbai, Maharashtra, India
Chapter keywords
Fetal growth restriction, FGR, pre-eclampsia, PE, chronic fetal hypoxia, placental disease, early-onset FGR, late-onset FGR, middle cerebral artery, MCA

Abstract

Fetal growth restriction (FGR) is defined by the American College of Obstetricians and Gynecologists (ACOG) as ‘the failure of a fetus to achieve its individual potential. It is associated with high-risk for perinatal morbidity and mortality where the risk increases with severity of condition’. This chapter covers the rules of fetal growth, history, examination, monitoring the growth restricted fetus, early-onset fetal growth restriction, late-onset fetal growth restriction, stage-based classification and management of FGR. Early-onset FGR represents 20–30% of all FGRs. Early FGR presents in association with early pre-eclampsia (PE) in up to 50%. Early-onset FGR is highly associated with severe placental insufficiency and with chronic fetal hypoxia. Late-onset FGR represents 70–80% of FGR. Its association with late pre-eclampsia (PE) is low, roughly 10%. In late onset FGR the degree of placental disease is mild, thus UA Doppler is normal in virtually all cases.

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