VP40.16: Relationship between the estimated fetal weight and adverse perinatal outcome in late onset fetal growth restriction

Selective fetal growth restriction (sFGR) has been reported to occur in about 10–15% of monochorionic (MC) twins. The diagnosis of sFGR has been based on variable criteria including estimated fetal weight (EFW), abdominal circumference and/or the degree of fetal weight discordance. Recent studies tend to use a simple definition which includes the presence of an EFW less than the 10th percentile in the smaller twin. Some would argue that the intertwin fetal weight discordance should be included in the definition. Indeed this factor plays a major role in the complications presented by these cases. While the majority of cases with one fetus below the 10th percentile usually will also present with a large intertwin EFW discordance, the contrary is not always true. Thus, it is possible to find MC twins with remarkable intertwin EFW discordance but the EFW of both fetuses are still within normal ranges. Although it appears to be common sense that a large intertwin discrepancy might represent a higher risk for some of the complications described later in this review, there is no consistent evidence to support this notion. Therefore, due to its simplicity, a definition based on an EFW below 10th percentile in one twin is probably the most useful for clinical and research purposes.

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EP20.15: Does Delphi's definition for late onset fetal growth restriction truly identify fetuses with the worse perinatal outcome? A prospective study

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.21543 ◽

2019 ◽

Vol 54 (S1) ◽

pp. 364-364

Author(s):

K. Melchiorre ◽

M. Rosati ◽

E. Clementini ◽

I. D'Emilio ◽

C. Petini ◽

...

Keyword(s):

Prospective Study ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Perinatal Outcome ◽

Late Onset ◽

Growth Restriction ◽

A Prospective Study

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Perinatal outcome of stage-based management of fetal growth restriction in a government tertiary care hospital in Kerala, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212175 ◽

2021 ◽

Vol 10 (6) ◽

pp. 2354

Author(s):

Bhargavi Rangarajan ◽

Lalithambica Karunakaran

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Perinatal Outcome ◽

Late Onset ◽

Medical Condition ◽

Tertiary Care ◽

Perinatal Outcomes ◽

Growth Restriction ◽

Care Hospital ◽

Medical College

BACKGROUND: Fetal Growth Restriction (FGR) is the largest contributing factor to perinatal morbidity, mortality and impaired neurodevelopment. This research strives to elucidate the perinatal outcomes of stage based management of fetal growth restriction using Obstetric Doppler and its association with maternal sociodemographic profile.METHODS: The research was conducted among 320 antenatal women whose Estimated Fetal weight was <10th centile. Periodic follow up with Doppler was done and managed as per the stage of FGR. Perinatal outcomes were compiled.RESULTS: The incidence of FGR in T.D Medical College, Alappuzha was 15.23%. SGA accounted for 47 %. The proportion of early and late onset FGR was 10.3% & 89.7% respectively. 57.18% of the newborns were admitted to NICU. The common complications were: Low birth weight – 47.8% ARDS – 21% , Sepsis – 9.6%, Necrotizing enterocolitis – 4%, Hyperbilirubinemia – 4.9%. The incidence of Neonatal death and stillbirth were 1.56% and 0.3% respectively. Mothers who were underweight, inadequate weight gain during pregnancy and short inter pregnancy interval had increased risks. Hypertensive disorders of pregnancy was the commonly associated medical condition. CONCLUSION: Prolongation of pregnancy even by one day results in 2% increased chances of survival of the newborn. Hence, it becomes imperative to identify the benign forms of FGR to prevent iatrogenic prematurity. Antenatal women should be screened for risk factors and undergo vigilant antepartum surveillance to bring about favourable perinatal outcome.

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The effect of maternal obesity on sonographic fetal weight estimation and perinatal outcome in pregnancies complicated by fetal growth restriction

Journal of Clinical Ultrasound ◽

10.1002/jcu.22273 ◽

2015 ◽

Vol 44 (1) ◽

pp. 34-39 ◽

Cited By ~ 11

Author(s):

Fiona Cody ◽

Julia Unterscheider ◽

Sean Daly ◽

Michael P. Geary ◽

Mairead M. Kennelly ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Perinatal Outcome ◽

Maternal Obesity ◽

Growth Restriction ◽

Fetal Weight ◽

Weight Estimation ◽

Fetal Weight Estimation

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OC04.10: Incidence and perinatal outcome of late onset fetal growth restriction (FGR) identified within a population of fetuses with suspected FGR diagnosed beyond 32 weeks

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.23801 ◽

2021 ◽

Vol 58 (S1) ◽

pp. 13-13

Author(s):

A. Dall'Asta ◽

T. Stampalija ◽

F. Mecacci ◽

G. Schera ◽

I. Fantasia ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Perinatal Outcome ◽

Late Onset ◽

Growth Restriction

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Cerebroplacental Ratio as a Predictor of Fetal Growth Restriction and Perinatal Outcome in Women with Hypertensive Disorder in Pregnancy: A Prospective Cohort Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47801.15307 ◽

2021 ◽

Author(s):

Upma Saxena ◽

. Alka

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Perinatal Outcome ◽

Fetal Distress ◽

Growth Restriction ◽

P Value ◽

Singleton Pregnancy ◽

Adverse Perinatal Outcome ◽

Cerebroplacental Ratio ◽

Nicu Admission

Introduction: Hypertensive Disorders in Pregnancy (HDP), is a common complication of pregnancy leading to majority of adverse perinatal outcome. The timely diagnosis of fetal compromise, before irreversible damage, is possible by doing Cerebroplacental Ratio (CPR), on doppler ultrasonography. CPR is calculated as ratio of Pulsatility Index (PI) of Middle cerebral Artery and Umblical Artery (UA). It reflects both the circulatory insufficiency in UA along with adaptive changes in Middle cerebral Artery (MCA). Aim: To evaluate role of Cerebroplacental Ratio as predictor of Fetal Growth Restriction and perinatal outcome in singleton pregnancy with HDP at 28-41 weeks of gestation. Materials and Methods: A prospective observational cohort study was carried out in the Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. The study included 150 women with singleton pregnancy, HDP and 28-41 weeks of gestation. Doppler ultrasound was performed and CPR calculated as ratio of MCA PI and UA PI, using ultrasound study performed within two weeks of delivery. All women were followed-up till delivery and perinatal outcome i.e., birth weight, preterm birth, cesarean for fetal distress, Meconium Stained Liquor (MSL) , APGAR at 5 minutes, still birth, Neonatal Intensive Care Unit (NICU) admission and early neonatal death, were recorded. The data entry was done in the Microsoft excel spreadsheet and the final analysis was done with the use of Statistical Package for Social Sciences (SPSS) software version 21.0. Results: Out of 150 women, 20% (30) had abnormal CPR. Abnormal CPR had significant association with Low Birth Weight (LBW) (p-value=0.0001), preterm delivery (p-value=0.0001), fetal distress (p-value=0.0001), caesarean for fetal distress (p-value=0.0001), 5-minute APGAR score <7 (p-value=0.0001), NICU admission (p-value=0.0001), Meconium Stained Liquor (MSL) (p-value=0.0001) and neonatal death (p-value=0.025). CPR had 100% sensitivity and 100% Negative Predictive Value (NPV) for predicting adverse perinatal outcome with diagnostic accuracy of 47.33%. Conclusion: The CPR is an independent predictor of Fetal Growth Restriction (FGR) in women with HDP. It can also independently predict perinatal outcome in women with HDP with or without FGR. Abnormal CPR had 100% sensitivity for identifying women with high risk of adverse perinatal outcomes, whereas normal CPR, with NPV of 100%, almost excludes it.

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