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

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. 

scholarly journals 721: Sonographic determinants of adverse perinatal outcomes at longitudinal surveillance in late-onset fetal growth restriction

2020 ◽  
Vol 222 (1) ◽  
pp. S457
Author(s):  
Andrea Dall'Asta ◽  
Tullio Ghi ◽  
Giuseppe Pedrazzi ◽  
Enrica Roletti ◽  
Monica Minopoli ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Late Onset ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Adverse Perinatal Outcomes

Adverse perinatal outcomes in fetuses with severe late-onset fetal growth restriction

2021 ◽  
pp. 1-7
Author(s):  
Maria Luiza Rozo Bahia ◽  
Guillermo Coca Velarde ◽  
Fernanda Campos da Silva ◽  
Edward Araujo Júnior ◽  
Renato Augusto Moreira de Sá
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Late Onset ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Adverse Perinatal Outcomes

Prognostic value of the aortic isthmus Doppler assessment on late onset fetal growth restriction

2019 ◽  
Vol 47 (2) ◽  
pp. 212-217
Author(s):  
Cecilia Villalaín ◽  
Ignacio Herraiz ◽  
Maria S. Quezada ◽  
Paula I. Gómez-Arriaga ◽  
Elisa Simón ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Late Onset ◽  
Perinatal Outcomes ◽  
Labor Induction ◽  
Growth Restriction ◽  
Reversed Flow ◽  
Aortic Isthmus

AbstractBackgroundAs conflicting results have been reported about the association of reversed flow on the aortic isthmus (AoI) and adverse perinatal results in fetal growth restriction (FGR), we aim to compare perinatal outcomes (including tolerance to labor induction) of late-onset FGR between those with anterograde and reversed AoI flow.MethodsThis was an observational retrospective cohort study on 148 singleton gestations diagnosed with late-onset FGR (diagnosis ≥32+0 weeks), with an estimated fetal weight (EFW) <10thcentile and mild fetal Doppler alteration: umbilical artery (UA) pulsatility index (PI) >95thcentile, middle cerebral artery (MCA)-PI <5thcentile or cerebral-placental ratio <5thcentile. Anterograde AoI flow was present in n=79 and reversed AoI flow in n=69. Delivery was recommended from 37 weeks in both groups. Perinatal results were compared between the groups.ResultsThe global percentage of vaginal delivery of fetuses with anterograde and reversed blood flow was 55.7% vs. 66.7% (P=0.18) and the percentage of cesarean section (C-section) for non-reassuring fetal status was 12.7% vs. 15.9% (P=0.29), respectively. When evaluating those that underwent labor induction, the vaginal delivery rate was 67.9% vs. 77.2% (P=0.17), respectively. There were no significant differences regarding any other perinatal variables and there were no cases of severe morbidity or mortality.ConclusionWe observed that the presence of reversed AoI flow does not worsen perinatal outcomes on fetuses with late-onset growth restriction with mild Doppler alterations. Attempt of labor induction is feasible in these fetuses regardless of the direction of AoI flow.

Obstetric and pediatric growth charts for the detection of late-onset fetal growth restriction and neonatal adverse outcomes

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Beatriz Fernandez-Rodriguez ◽  
Concepción de Alba ◽  
Alberto Galindo ◽  
David Recio ◽  
Cecilia Villalain ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Late Onset ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Growth Restriction ◽  
Growth Standards ◽  
Postnatal Diagnosis ◽  
Increased Risk

AbstractObjectivesLate-onset fetal growth restriction (FGR) has heterogeneous prenatal and postnatal diagnostic criteria. We compared the prenatal and postnatal diagnosis of late-onset FGR and their ability to predict adverse perinatal outcomes.MethodsRetrospective cohort study of 5442 consecutive singleton pregnancies that delivered beyond 34 + 0 weeks. Prenatal diagnosis of FGR was based on customized fetal growth standards and fetal Doppler while postnatal diagnosis was based on a birthweight <3rd percentile according to newborn charts (Olsen’s charts and Intergrowth 21st century programme). Perinatal outcomes were analyzed depending on whether the diagnosis was prenatal, postnatal or both.ResultsA total of 94 out of 5442 (1.7%) were diagnosed as late-onset FGR prenatally. Olsen’s chart and Intergrowth 21st chart detected that 125/5442 (2.3%) and 106/5442 (2.0%) of infants had a birthweight <3rd percentile, respectively. These charts identified 35/94 (37.2%) and 40/94 (42.6%) of the newborns with a prenatal diagnosis of late-onset FGR. Prenatally diagnosed late-onset FGR infants were at a higher risk for hypoglycemia, jaundice and polycythemia. Both prenatally and postnatally diagnosed as late-onset FGR had a higher risk for respiratory distress syndrome when compared to non-FGR. The higher risks for intensive care admission and composite adverse outcomes were observed in those with a prenatal diagnosis of late-onset FGR that was confirmed after birth.ConclusionsCurrent definitions of pre- and postnatal late-onset FGR do not match in more than half of cases. Infants with a prenatal or postnatal diagnosis of this condition have an increased risk of neonatal morbidity even if these diagnoses are not coincident.

Fetal Biometry and Doppler Study for the Assessment of Perinatal Outcome in Stage I Late-Onset Fetal Growth Restriction

2018 ◽  
Vol 44 (4) ◽  
pp. 264-270 ◽  
Author(s):  
Cecilia Villalaín ◽  
Ignacio Herraiz ◽  
María Soledad Quezada ◽  
Paula Isabel Gómez-Arriaga ◽  
Enery Gómez-Montes ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Perinatal Outcome ◽  
Late Onset ◽  
Growth Restriction ◽  
Stage I ◽  
Fetal Biometry ◽  
Doppler Study
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